Transcript
Announcer:
Welcome to Advances in Women’s Health on ReachMD. On this episode, we’ll hear from Dr. Alison Reminick, who will be discussing how clinicians can help patients recognize and prepare for postpartum depression, anxiety, and OCD. Dr. Reminick is an Associate Professor in the Department of Psychiatry at the UC San Diego School of Medicine, and the Former Founder and Director of the Women's Reproductive Mental Health Program at UC San Diego Health. Here she is now.
Dr. Reminick:
I think clinicians can feel more comfortable discussing symptoms of postpartum OCD, depression, and anxiety by teaching their patients—and teaching them early in pregnancy—about things that they can do to improve their mental wellness during the pregnancy that will hopefully continue postpartum, like taking care of their sleep, getting physical activity, and making sure they get outside at least once a day. It’s really important, if they can, to do it in the morning hours, because there's good benefit to that. We’re talking about meditation, talking about getting people to come in, help, and support them, and thinking about where they can tap in on in terms of getting support and help in the household with older children, pets, or whatever else might be taking up a lot of time in their lives.
I think it's really important to also discuss not only ways that they can keep their mental health in a very good place and what things they can do in order to support that—sleep, eating well, hydrating, getting outside, physical activity—but also discussing with the patient what to look for while they're pregnant. And they have a support person. So when postpartum depression comes up, it usually peaks at two or three months. I usually talk about looking at really big moments of transition, like when dad goes back to work, when mom goes back to work, when in-laws or parents leave and are no longer a help, when baby starts daycare or starts having sleep regressions, when mom has a menstrual cycle or is weaning. So there are a lot of different transitions that come up, and know that these are sometimes when we can see peaks of depression, anxiety, and OCD.
And then talk to the support person about the symptoms that they might see. You might see your partner being flat or not talking about the future. She really doesn't seem like she's laughing or enjoying herself, or she’s crying all the time. If she's anxious, she might be constantly ruminating, asking for reassurance, or not leaving the house, because she’s so anxious.
And then if they're having any OCD, really talk to them about the fact that it is very common to have intrusive thoughts as a parent. Sometimes, they can become pathological, in that they feel like it's a reality. And then talk about what types of OCD thoughts there are in the postpartum period, like baby getting sick or harm coming to the baby, and what behaviors might result as a product of that. So maybe they’re not bathing the baby, because they're afraid of the baby drowning. They’re getting rid of all the knives in the house, because they're afraid that they're going to hurt the baby with a knife. They’re afraid of dropping the baby down the stairs. They’re afraid of getting into a car accident, so they're avoiding driving. So there's a lot of avoidance behaviors that then come up in OCD, so we’re trying to really teach our patient and the patient support person about what to look for postpartum.
And I think then patients are going to feel more comfortable talking to each other if they know what to look for with their support people and with their clinician.
Announcer:
You just heard Dr. Alison Reminick talking about strategies for supporting mental health during and after pregnancy. To access this and other episodes in our series, visit Advances in Women’s Health on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
