Do You Really Need a Specialist To Treat Your Postpartum Depression?

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I was very happy to see that Parents magazine and CNN.com have covered the specialized inpatient unit for women with severe perinatal mood and anxiety disorders, including postpartum depression, at the University of North Carolina. Go Dr. Elizabeth Bullard, Dr. Samantha Meltzer-Brody and nurse Chris Raines!!!!

“Immediately, Meehan-Machos’s obstetrician referred her to the University of North Carolina at Chapel Hill (UNC). There, doctors had recently debuted a groundbreaking inpatient psychiatric unit, the first in the nation specifically tailored to women suffering perinatal (prenatal and postpartum) mood disorders. Unlike a general psychiatric unit, it offered:

  • A core group of doctors specializing in perinatal issues
  • Psychiatrists attuned to medications that wouldn’t harm a pregnancy or a nursing newborn
  • An unusual policy of allowing children, even babies, on the ward during extended visiting hours
  • Mom-only counseling focused on anxiety and bonding”

There aren’t near enough specialized programs for women with postpartum anxiety, postpartum depression and postpartum psychosis. These women have a distinct set of issues and deserve treatment from clinicians who have a lot of experience treating them. Whether its psychiatrists, psychologists, therapists and social workers who specialize in postpartum depression, special inpatient units like the one at UNC or special outpatient units like the one at Women and Infants Hospital in Rhode island, we need more hospital administrators and healthcare systems to recognize that perinatal mental illness is a public health problem and to create the kinds of services that help new moms and moms-to-be get better as quickly as possible.

I can tell you that when I had postpartum OCD I first went to a psychiatrist that I later came to realize had almost no experience with women with postpartum depression. After dealing with that for ONE YEAR (argh!) and making little headway, I switched to someone who had trained under specialists in perinatal mood and anxiety disorders. It was like night and day. Out came the sun!!

I realize that not everyone has access to specialists. It is my wish that one day every woman will, no matter in which corner of this country (or any other) she lives. It is my personal opinion, though, that seeing a specialist in the best case scenario for women trying to get well. If it’s a friend of mine, a relative, a neighbor or my own daughter, I’m going to fight like hell to find a specialist to help her.

I’m just saying.

Update:

I received the following comment to this post and I’d like to share it so that it isn’t missed.

“With reimbursement of mental healthcare as poor as it is, there are not (and may never be) even enough regular psychiatrists to go around, much less psychiatrists who treat only patients with perinatal issues. If we have special clout and extra connections we may be successful in getting our friend, relative or neighbor in to see a specialist (as long as she lives in a major metropolitan area and has good insurance, of course). But the vast majority of people aren’t so well connected. We need to make sure not to alienate non-specialists. OBs, family physicians, midwives etc. can and should be trained well enough to treat straightforward perinatal mood disorders. And if general psychiatrists are unable to successfully treat the more complicated cases, I don’t think the solution is just to hope and wait for more postpartum specialists. The solution is to insist that general Psychiatric training programs adequately address these common and important conditions.”

Thank you for your comment. I understand what you are saying. It is true that we are sorely lacking in this country when it comes to having enough psychiatrists to go around, especially in rural areas. I do not think, though, that you need any particular clout when it comes to seeing a specialist. Insurance, perhaps, but not clout. When I was sick I had zero clout. When I finally got tired of being treated by someone who didn’t know what they were doingthe only thing I did have was empowerment. The courage to demand more for myself and my health and to ask around and ask around and not give up until I found someone with more training than the average doc on these illnesses (which doesn’t take much actually, because as you rightly point out, the current med school training is inadequate). There are many healthcare providers from various disciplines who have taken the time to learn more, get CEUs, attend a conference or go to a PSI training.These are the people I think women should try and see.

Additionally, I know that many of the specialists in this field do consults and confer with women’s personal physicians to discuss care for perinatal mood and anxiety disorders like postpartum depression. They are aware that, because this specialty is so unique, their expertise is needed both inside and outside of their “neighborhoods”.

And finally, I would never suggest women who are suffering wait and hope until we have every specialist we need. I hope that’s not how it came across in my post. Thankfully, with organizations like Postpartum Support International, women don’t have to. They can connect with one of more than 100 trained volunteers spread out across our country in every state who can offer information on healthcare providers in the vicinity who can help.

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About Katherine Stone

is the founder & editor of Postpartum Progress. She was named one of the ten most influential mom bloggers of 2011, a WebMD Health Hero and one of the top 25 parent bloggers using social media for social good. She also writes the Fierce Blog, and a parenting column for Disney's Babble.com.

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Comments

  1. I so agree with you about specialists, Katherine. Although when I was inpatient there were no specialists (that's how I ended up on 7 different psych meds by the time I was released) I did have specialists for every other step of my journey. My OB caught my PPOCD in a screening, they had a therapist onsite who saw me before I went home and weekly after that (she I should add was covered by a grant so I didn't have to worry about money), and even my psych was a maternal mental health specialist. I could go on and on about the wonderful care and that program being the reason I am still alive. I only wish I would have had access to a hospital that specialized in perinatal issues. Maybe I wouldn't have spent close to 2 months over 3 stays if that had been the case.

  2. Janet Wilson says:

    answer: HELL YES, says one woman in Seattle, WA who went undiagnosed for 2 yrs !

  3. What an AMAZING program – I am so impressed that they recognize the need for truly specialized treatment. I didn't know a specific type of psychiatric facility like that even existed. Thanks so much for sharing, and I hope other places start to follow suit.

  4. With reimbursement of mental health care as poor as it is, there are not (and may never be) even enough regular psychiatrists to go around, much less psychiatrists who treat only patients with perinatal issues. If we have special clout and extra connections we may be successful in getting our friend, relative, or neighbor in to see a specialist (as long as she lives in a major metropolitan area and has good insurance, of course). But the vast majority of people aren't so well connected.
    We need to make sure not to alienate non-specialists. OBs, family physicians, midwives etc. can and should be trained well enough to treat straightforward perinatal mood disorders. And if general psychiatrists are unable to successfully treat the more complicated cases, I don't think the solution is just to hope and wait for more Post-Partum specialists. The solution is to insist that general Psychiatric training programs adequately address these common and important conditions.