Hilary Waller – Postpartum Depression & Related Disorders: Clinical Strategies to Identify and Treat Mothers Who Are Suffering in Silence

Outline

The Clinical Profile of PMADs: (Perinatal Mood and Anxiety Disorders):

• What causes postpartum mental health disorders?
• The “perinatal masquerade” and illusion of perfection in motherhood
• Why “perinatal” is a multi-decade stage in life
• What makes mood disorders during this period unique
• Breaking through guilt, shame and silence
• Limitations of the research and potential risks

PMAD Screening and Assessment

• Are you asking the right questions?
• Red flags: What to look/listen for each time you see her
• Evidence-based assessment tools
• Differential diagnosis: The PMAD spectrum
  • Depression, Anxiety, OCD, PTSD, psychosis
• The Postpartum Stress Center PMAD Response Model
• How to respond if she discloses thoughts of harm to herself or the baby
• Where and how to refer to a specialist/higher level of care

Clinical Interventions for Mothers Who are Symptomatic, Exhausted, and Preoccupied

• How treatment differs for this population
• Create a safe “holding environment”
• Help her break through guilt, shame and silence
• Navigating scary intrusive thoughts
• Practical interventions for busy new moms
• The perinatal family: Identify and engage necessary supports in treatment
• Tools for healing the perinatal intimate partnership
• Psychotropic medications: Safe for pregnant or nursing mothers?
• Collaborative care with other providers
• Videos: Beyond the Fear & Voices of Recovery
• Exercises: Token assessment and case examples

The Nuanced Experience of the Perinatal Clinician

• Managing countertransference
• Ethical decision making: Breaking the rules and self-disclosure
• Collaboration and collegial support

Special Considerations

• Feeding issues: Breastfeeding and/or bottle
• Infertility/Assisted reproductive technologies
• Trauma
• NICU
• Perinatal grief and loss
• When PMADs are left untreated or present later in motherhood
• Multicultural factors