Maternal Depression Rates Rise During Pandemic, By Vanessa McMullan

Maternal Depression Rates Rise During Pandemic, By Vanessa McMullan

Originally run in Anton Community Newspapers

Pregnancy and childbirth are exciting times in a family’s life, filled with joy and awe. For some mothers, however, the situation is far more complex. While many women experience some mild mood changes during or after the birth of a child, 15 to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.

Fifteen to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.

At North Shore Child & Family Guidance Center, we work with moms and pregnant women whose symptoms may include feelings of sadness, irritability, guilt, lack of interest in the baby and changes in eating and sleeping habits. Some also experience trouble concentrating, thoughts of hopelessness and even thoughts of harming the baby or herself.
Research shows that the pandemic has increased the incidents of PMADs, and also heightened symptoms. One study found that the rate of symptoms of depression in new mothers amid the pandemic was nearly three times the rate of new mothers’ symptoms pre-pandemic.

The reality is that, as with so much about the virus, there are still many unknowns as to the impact of COVID-19 during pregnancy and for babies and young children, which creates enormous stress. Being a new mother can be isolating under normal circumstances, but during the quarantine and social distancing protocols, the sense of isolation has been greatly magnified. Expectant and new parents are concerned about a host of issues, from financial and job stability to the health of their babies and themselves.

The pregnancy and birth experience, especially during the height of the pandemic, was anything but normal. Many pregnant women and new moms had to go to their doctor’s appointments by themselves, and if they got bad news, they had no one with them to lean on. Most had no baby showers, no visits from grandparents, no birthday parties—even an absence of partners in the hospital before, during and after the birth. They often had very little support from friends and relatives who typically help the new parents in the days after the baby comes home, for fear of catching or transmitting the virus.

Families who have school-aged children have had to struggle with the decision of whether or not to send them back to the classroom, where they may be exposed to the virus and bring it home to the family. Even though New York has improved in terms of COVID-19 numbers since the height of the pandemic, being cautious is still important, and we have no way of knowing what the next several months will bring. And the fact that all of us will be inside more will likely present significant challenges.

The good news is that North Shore Child & Family Guidance Center has been able to serve these moms and families during the pandemic through remote therapy, either by video or phone. In addition to individual and family therapy, the Guidance Center has continued to offer remote group counseling, so parents don’t feel so alone. Our psychiatrists are also seeing clients remotely, in the cases where medication is needed.

Through our Diane Goldberg Maternal Depression Program, the Guidance Center provides:

• Screening and assessments
• Individual, couple and family therapy
• Crisis intervention consultation
• Psychiatric evaluations and medication management, where needed
• Support groups
• Back-to-work family support
• Help with self-care

As one new mother told us, “You’ve been my lifeline during this time when I needed connection and reassurance and support.”
If you or someone you love is experiencing symptoms of postpartum depression or other perinatal mood disorders, call the Guidance Center at 516-626-1971 and tell them you are seeking help for maternal depression. We are here for you.

Vanessa McMullan, LCSW, is supervisor at The Marks Family Right from the Start 0-3+ Center at North Shore Child & Family Guidance Center. She also heads up the organization’s Diane Goldberg Maternal Depression Program. Call 516-626-1971 or visit www.northshorechildguidance.org to learn more.

Maternal Depression Rates Rise During Pandemic, By Vanessa McMullan, December 7, 2020

Maternal Depression Rates Rise During Pandemic, By Vanessa McMullan, December 7, 2020

Pregnancy and childbirth are exciting times in a family’s life, filled with joy and awe. For some mothers, however, the situation is far more complex. While many women experience some mild mood changes during or after the birth of a child, 15 to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.

Fifteen to 20 percent of women have more significant symptoms of postpartum depression and other perinatal mood and anxiety disorders or PMADs.

At North Shore Child & Family Guidance Center, we work with moms and pregnant women whose symptoms may include feelings of sadness, irritability, guilt, lack of interest in the baby and changes in eating and sleeping habits. Some also experience trouble concentrating, thoughts of hopelessness and even thoughts of harming the baby or herself.
Research shows that the pandemic has increased the incidents of PMADs, and also heightened symptoms. One study found that the rate of symptoms of depression in new mothers amid the pandemic was nearly three times the rate of new mothers’ symptoms pre-pandemic.

The reality is that, as with so much about the virus, there are still many unknowns as to the impact of COVID-19 during pregnancy and for babies and young children, which creates enormous stress. Being a new mother can be isolating under normal circumstances, but during the quarantine and social distancing protocols, the sense of isolation has been greatly magnified. Expectant and new parents are concerned about a host of issues, from financial and job stability to the health of their babies and themselves.

The pregnancy and birth experience, especially during the height of the pandemic, was anything but normal. Many pregnant women and new moms had to go to their doctor’s appointments by themselves, and if they got bad news, they had no one with them to lean on. Most had no baby showers, no visits from grandparents, no birthday parties—even an absence of partners in the hospital before, during and after the birth. They often had very little support from friends and relatives who typically help the new parents in the days after the baby comes home, for fear of catching or transmitting the virus.

Families who have school-aged children have had to struggle with the decision of whether or not to send them back to the classroom, where they may be exposed to the virus and bring it home to the family. Even though New York has improved in terms of COVID-19 numbers since the height of the pandemic, being cautious is still important, and we have no way of knowing what the next several months will bring. And the fact that all of us will be inside more will likely present significant challenges.

The good news is that North Shore Child & Family Guidance Center has been able to serve these moms and families during the pandemic through remote therapy, either by video or phone. In addition to individual and family therapy, the Guidance Center has continued to offer remote group counseling, so parents don’t feel so alone. Our psychiatrists are also seeing clients remotely, in the cases where medication is needed.

Through our Diane Goldberg Maternal Depression Program, the Guidance Center provides:

• Screening and assessments
• Individual, couple and family therapy
• Crisis intervention consultation
• Psychiatric evaluations and medication management, where needed
• Support groups
• Back-to-work family support
• Help with self-care

As one new mother told us, “You’ve been my lifeline during this time when I needed connection and reassurance and support.”
If you or someone you love is experiencing symptoms of postpartum depression or other perinatal mood disorders, call the Guidance Center at 516-626-1971 and tell them you are seeking help for maternal depression. We are here for you.

Vanessa McMullan, LCSW, is supervisor at The Marks Family Right from the Start 0-3+ Center at North Shore Child & Family Guidance Center. She also heads up the organization’s Diane Goldberg Maternal Depression Program. Call 516-626-1971 or visit www.northshorechildguidance.org to learn more.

“Postpartum depression, poverty and bonding with your baby,” Blank Slate Media, February 8, 2019

Having a baby can be the happiest time in a woman’s life. But for many, new motherhood can also bring risk of an increase in existing depression or the occurrence of new depression.

In a recent report on maternal depression and economic mobility released by the Brookings Institution, author Richard V. Reeves states that “about 10 to 20 percent of mothers will be depressed at some time during their lives, and one in 11 infants will experience their mothers’ perinatal depression.”

Mental health experts agree that constancy of relationships from early childhood is the single most reliable predictor of positive outcomes in later life. Promoting safe and warm relationships with parents and other caregivers is an important factor in young children’s healthy development, later success in school and prevention of intergenerational transmission of poverty and lack of economic mobility.

One young mother who was recovering from postpartum depression at North Shore Child & Family Guidance Center brought her depression to life at a public event hosted by the Guidance Center. As she recalled, “I could barely lift my head off my pillow, let alone lift and hold and cuddle and care for my baby.”

Studies reveal that mothers who are poor are more likely to experience depression. When a primary caregiver (most often the mother) is depressed, it is difficult to make a positive connection with her baby or toddler, which is likely to negatively impact the child’s development. Of course, postpartum depression can strike any woman regardless of her socioeconomic status, but it can be especially difficult for people struggling to survive financial woes.

At the same time, developing the skills, confidence and aspirations needed to transcend living in poverty are byproducts of strong early bonding. 

So, if poverty, poor mental health, compromised child development and worse outcomes are likely factors contributing to perpetuation of poverty, what can be done to break the cycle? 

According to the Brookings report, the goals of policies necessary to intervene in breaking the cycle are: (1) Reduce poverty; (2) Reduce the impact of poverty on depression among caregivers; (3) Reduce the impact of caregiver depression on early child development; and (4) Reduce the impact of weaker early child development on later outcomes.

The Center of Disease Control in Atlanta administered a project aimed at identifying maternal depression early on. Two questions that they asked moms were: 1) Since your new baby was born, how often have you felt down, depressed, or hopeless?; and 2) Since your new baby was born, how often have you had little interest or little pleasure in doing things? 

The women who answered “often” or “always” to either question were classified as experiencing self-reported postpartum depressive symptoms. Detecting the problem is the first step in getting moms and their families the help they need.

One thing we can do to help to break the cycle is to encourage primary care physicians and other health professionals to incorporate screening tools into their encounters with pregnant women and mothers of infants.

The American Congress of Obstetricians and Gynecologists recommends that clinicians screen patients at least once during the perinatal period for depression and anxiety symptoms using a standardized, validated tool. Screening should be coupled with appropriate follow-up and treatment when indicated.

The American Academy of Pediatrics recommends that a woman experiencing negative feelings about her pregnancy should receive additional support from the health care team. She should be monitored for symptoms of severe postpartum depression and offered culturally appropriate treatment or referral to community resources.

They also recommend ongoing assessment soon after hospital discharge. Monitoring for continuing or worsening symptoms should occur from four to six weeks after delivery, including a review of symptoms for clinically significant depression to determine if intervention is needed.

Healthy attachments are not about  children getting what they want, but getting what they need — the assurance that an adult caregiver is by their side, looking out for them, teaching them how to manage their own feelings, and learning about the give and take of relationships. All children deserve this, regardless of their family’s socioeconomic status.

If you or your loved one is a caregiver of an infant or toddler and are experiencing symptoms of depression or anxiety, ask for the Diane Goldberg Maternal Depression Program at North Shore Child & Family Guidance Center at 516-484-3174. If there is a teenage girl in your family who is pregnant or parenting an infant child, ask for the Good Beginnings for Babies Program, also at the Guidance Center, at 516-997-2926. We turn no one away for inability to pay.

Andrew Malekoff is the executive director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. 

Katherine’s Story: Healing from Postpartum Depression

Katherine’s Story: Healing from Postpartum Depression

Katherine’s Story: Healing from Postpartum Depression

There is a picture that my husband took on my first Mother’s Day last year. I’m holding my 10 week old daughter. She is a wearing a bib that says “my first mother’s day.” I am wearing a diamond necklace that my husband gave me and my pre-pregnancy jeans. I might even have managed to wash and dry my hair that day. When my husband posted the picture on social media, people said, “You look amazing!!”

What struck me most about the comments was not so much their kindness as their irony. If anyone really knew about the day that picture was taken, they would know it was the lowest day of my life.

Katherine’s Story: Healing from Postpartum Depression

I hadn’t slept more than one hour a day in weeks. I had lost over forty pounds in 10 weeks because I was too anxious and too depressed to eat or drink. The truth was I was dying inside from perpetual, debilitating postpartum anxiety, depression and posttraumatic stress disorder.

The day of my daughter’s one month pediatrician’s visit, everything went perfectly. But when we got home, my daughter slept for a record hour and a half. I tried to give her a bottle at her feeding time, and she wouldn’t take it. She was lethargic and hard to wake. I called my mother frantically. “She’s not okay, something is wrong.” My mother, thinking she was coming over to talk me off the ledge, arrived and agreed, something was not right.

In a matter of the three hours since the wellness visit that my daughter had passed with flying colors, I found myself back at the pediatrician’s office where his exact words to me were: I do not have a good feeling about this. He sent us straight to the emergency room.

The next six days were a blur. They tried multiple times to start a fluid IV and to draw blood, both of which were incredibly challenging as her little body had miniature and dehydrated veins. I was so overwhelmed by the intensity, speed and clinicality of everything that was happening that I shut down. I paced and wept outside the room while my mother stayed by her side.

After several unsuccessful spinal taps to determine if she had meningitis, she was admitted to the hospital. It took three more days for her tests to come back positive for rotavirus.

My girl’s hospitalization was the beginning of the end for me. I could not move past the fact that she had almost died under my care. What if the next time I didn’t catch the signs and symptoms soon enough?

Every day at home following the baby’s hospitalization was worse than the one before. My sleep became more erratic, my appetite less, my mood more unpredictable. All I wanted to do was run away from my life. However, I couldn’t run a simple errand alone without rushing home in a panic that she might be getting sick again.

It became impossible for me to focus. I had panic attacks all day and night. I felt tremendous pressure to make sure that nothing like her illness ever happened to her again. However, this unbearable pressure took such an emotional toll that it drained my will to live.

I was so distraught that I wished I was dead. I didn’t want to kill myself, but my emotional and physical pain was so profound that I desperately wanted someone to end the suffering for me. Some days I imagined lying to my husband. Saying that I was going to run out and do an errand and then I would crash the car. I would injure myself enough that I wouldn’t die, but I would need to be hospitalized for several weeks. Once I was there, I thought, they’ll give me medicine to sleep and someone else can take care of the baby. If I could just get some rest, I wouldn’t feel like this anymore. On really bad days, I imagined wandering out into the middle of the street and letting someone hit me. Wouldn’t it be better for everyone if I was gone?

I finally realized that I needed professional help. I did some research online to see if I met the risk factors for postpartum depression. Much to my dismay, I not only met them, I appeared to be their poster child: depression, sadness, anxiety, panic, difficulty eating and sleeping, a feeling that I was “going crazy” and the most painful of all, a feeling that I should never have become a mother.

I was also demonstrating signs of post-traumatic stress disorder. The flashbacks of my daughter’s hospitalization and the events surrounding it: avoidance of stimuli associated with the event (i.e. my home), hypervigilance, panic attacks, and feeling a sense of detachment from my child haunted each day.

I needed someone to tell me that I could get through this. When I was finally connected with North Shore Child and Family Guidance Center, my life and my daughter’s life was changed forever. I left a message for Vanessa McMullan, supervisor of postpartum and maternal mental health services. She called me back at the exact moment I was trying to place my daughter into her carrier. The baby and I were both crying. Vanessa asked where we were going and if we were okay. I asked if she would call me back in 20 minutes once I got the baby into the car and she did. She insisted that I come in the next day.

When I arrived at the Marks Family Right from the Start Center, I was ashamed to be there. I needed professional help to be happy to be a mother. What a disgrace.

That first meeting, Vanessa asked a lot of questions. I went into details about the baby’s hospitalization. I needed someone to take away some of this pain. Vanessa mentioned the myriad of postpartum support services offered by the Guidance Center and I recall that I actually scoffed when she mentioned the time frame that the typical woman requires to recover from this illness. I did not have that kind of time nor was interested in being there for that long, not to mention, I wasn’t even really that sick.

Meanwhile, Vanessa and I just celebrated our 1 year anniversary.  Over the last 13 months, Vanessa has felt like a friend, a sister and a war buddy. She has never ceased to be the consummate professional. She was there to work through the Mother’s Day meltdown with me, she was there to talk me through the trauma, and the unexpected flashbacks that terrified my husband. She was there to help me transition back to work, this time as a mom. She has fielded my panicked phone calls when I’ve had a down day and feared that I was regressing, reminding me that it’s not a straight path to recovery and that not every day will feel like this.

Additionally, thanks to the Guidance Center’s network of services, Vanessa connected me with their psychiatrist. She too was professional, warm and understanding and alleviated many of my concerns. My work with Vanessa became more effective once the medication was competently managed and was able to help relieve my blinding anxiety and depression.

Last summer, Vanessa put together a support group for moms. She encouraged us to bring our children and gave us a place to normalize all that we’d been experiencing. There are no words to describe what it means to have the feelings that you thought were indicative of your deficiencies mirrored by another individual. It is liberating and healing to see and hear that motherhood is a bumpy road for us all. To have a safe space like the group that Vanessa created was extraordinary and essential to the recovery process.

The problem is that there are not enough programs like the one at the Guidance Center. Plus, the stigma associated with admitting that motherhood is hard and at times depressing is daunting to many women, and so they suffer in silence, sometimes with fatal consequences.

Being here tonight, I am admitting for the first time in public that I am a mother recovering from postpartum depression, anxiety and PTSD. It is singularly the most common complication following childbirth. What is more, it is not a disease that affects individuals. It is a disease that affects families. Had it not been for the compassionate work of Vanessa and her team, I might not have been here at all. The Guidance Center has helped to save my life and has given my daughter back her mother.

I am happy to report that my little girl is 15 months old. She is walking, talking, running, climbing the stairs and terrorizing the dog. She is gorgeous, healthy and the absolute light of my life. I am so grateful to have my life back and I am so grateful that I am able to share it with her confidently as my best, most imperfect self. While my recovery is still a work in progress, the Guidance Center continues to be a safe space for me and my family. A year ago, Vanessa promised that I would feel better one day, and that day is today.