So, you have a positive screen for perinatal mood and anxiety disorders. Now what? The answer is based on your score, history, and treatment desires.
First, I like to rule out a medical reason for worsening anxiety and mood symptoms. If not done in the last 3-6 months, I recommend getting the following labs: TSH (Thyroid Stimulating Hormone), Vitamin D and Vitamin B12 levels, and Ferritin. Other labs that could be considered would be CBC (Complete Blood Count), CMP (Complete Metabolic Panel), and folate.
Self-care is essential to feeling better and is vital to taking care of yourself so you can help take care of your baby/family.
Are you getting enough sleep? Our brains need 5-6 hours straight to recharge. Sleep is always tricky during pregnancy when you have to get up frequently to go to the bathroom or after delivery when you have a crying baby to parent. Sleep hygiene is helpful. Build a regular sleep routine; unplug from technology/TV 30 minutes before bed; use a noise machine/sleep aid if needed.
Be active. Your body releases happy chemicals (dopamine and endorphins) during exercise such as walking, yoga, bike rides, and stretching exercises.
Adequate/healthy nutrition is essential. Your brain cannot feel "good" if all it is fed is junk or getting minimal nutrition. Eat three well-balanced meals/day, drink adequate water, and avoid caffeine.
Therapy is a vital component to lessening symptoms. I often hear, "but it did not help in the past." Perhaps you were not ready, or you and your therapist needed to be a better fit to work through the hard stuff. Cognitive behavioral therapy is learning to recognize your triggers and developing new patterns of thinking and new coping skills to alleviate anxiety/stress. I wish we had enough therapists for every school in the United States to teach us these methods at a younger age. I can give you recommendations for therapists. If you are a therapist, I encourage you to seek Perinatal Mental Health Certification through Postpartum Support International. Check out PSI-WV as we are working to fundraise to support and increase provider certification.
Virtual support groups are available through Postpartum Support International. If you go to this website, you can review all the available groups. https://www.postpartum.net/get-help/psi-online-support-meetings/. Also, check out your state chapter on social media for support, PSI-WV, in West Virginia.
Medication can help lessen symptoms of anxiety and depression. Most of these medications can take a while to work. Some initial side effects typically go away with continued use. Some medications have side effects with missed doses, so it is vital to take your medication as directed if you go this route. So, many medications are considered "safe" in pregnancy. "Safe" is establishing what are the risks of taking medication and the risks of not treating anxiety/depressive symptoms in pregnancy and postpartum. The only medication I would not recommend if you have a functioning uterus is Valproic Acid/Depakote, as this medication has severe neurological consequences for a fetus/baby if you were to have an unintentional pregnancy.
If you are in crisis with plans to hurt yourself or someone else, please go to the nearest Emergency Room or call 9-1-1. Additional resources are available through the National Suicide Prevention Lifeline (available 24/7) at 9-8-8 or 1-800-273-TALK (8255) or suicidepreventionlifeline.org/chat/.
