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El Camino takes on postpartum depression

Mental health program raises awareness and offers counseling for mothers

Pregnancy and childbirth can an exciting time for expecting parents, but it can also be a time of depression and anxiety. Postpartum depression and other pregnancy-related mood disorders are prevalent and often untreated, and El Camino Hospital is reaching out to let people know the warning signs so new mothers can get the help they need.

The Maternal Outreach Mood Services program, or MOMS, is a behavioral health program at El Camino Hospital designed specifically for women who are experiencing pregnancy-related mood disorders. The program recently released a list of "warning signs" that women may be suffering from postpartum depression.

The warning signs include mood swings, lack of energy and body aches to feelings of hopelessness, guilt and thoughts about suicide. Anywhere from 10 to 20 percent of women are affected by postpartum depression.

The list of warning signs is, in part, a response to a recent New York Times article about a woman who struggled with postpartum depression, and ultimately jumped to her death with her 10-month-old child.

Nirmaljit Dhami, medical director of MOMS, said that despite the prevalence of postpartum depression, many people don't recognize the symptoms, or don't understand the link between childbirth and depression.

"There's this misconception that women are happy and glowing after having a child." Dhami said. "It's really a time for increased vulnerability."

Dhami said there's a lot of things going on in a woman's body during and after pregnancy -- like hormonal changes and sleep deprivation -- that can trigger these mental health problems. While depression can crop up for the first time following childbirth, women are at a much higher risk if they have a history of depression.

The symptoms of postpartum depression are somewhat similar to the "baby blues" that Dhami said affects 80 percent of women after childbirth. While the blues are very common, the symptoms are short-term, mild and generally don't require treatment. People may mistake it with postpartum depression, adding to misconceptions about the mental illness.

In some cases, new mothers can experience the rare but serious postpartum psychosis, which includes symptoms of hallucination, delusion, mania and "scary thoughts" of harming themselves or the baby, according to Dhami. Psychiatric hospitalization is required for postpartum psychosis, and rates of suicide and infanticide are at 5 percent and 4 percent, respectively.

Dhami said mothers in the program with unstable cases of postpartum psychosis are accepted as inpatients at El Camino Hospital.

Since MOMS began in 2008, hundreds of women have gone through the program every year for support. The treatment program includes group, individual and couples counseling, as well as medical evaluations to diagnose any mood disorders. The program allows patients to come in up to four days a week for counseling.

MOMS was the first therapy-based treatment program specifically designed for prenatal and postpartum depression in the Bay Area, and the second nationwide, according to the hospital website.

Dhami said prior to the start of the program, there was an unmet need in the community for maternal behavioral health services. A study conducted by the Santa Clara County Community Benefits Coalition in 2007, one year before the program launched, found that depression and mental health issues, especially maternal depression, was a problem that needed to be addressed.

Dhami said it's important to identify and treat postpartum depression and other pregnancy-related mental disorders because of its effect on infants and spouses. She it's important to develop a working attachment between the mother and the child that may have suffered because of postpartum depression.

Dhami said MOMS has a lot of room to grow, and they're trying new ways to measure feedback. For example, they can videotape interactions between the mother and child at the beginning and the end of treatment to see how well the treatment has improved the mother-child relationship, which Dhami said provides real-time feedback on how well the program works.

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