Hi everyone my name is ILO I'm a registered Midwife and childbirth education instructor I have two lovely children at home and I practice Midwifery in a large urban center in Canada I really enjoy educating families throughout the perinatal period during their births and in the postpartum as well today we're going to focus on perinatal mental health and specifically perinatal depression so let's get started what is perinatal depression it's more than just a bad day or feeling a little bit blue perinatal depression can come about from a variety of different factors it could be your personal history your family history your biology your genetics it could be previous experience es it could be traumatic events depression manifests in many different ways for different people there are some symptoms of depression that are more common to keep an eye out for one of those can be difficulty concentrating so having a really hard time performing tasks feelings of hopelessness of agitation even anxiety weaving its way in there anxiety and depression can sometimes overlap or anxiety can precede depression other issues that can crop up are changes to our appetites difficulty sleeping sleep disturbances and again these can be common things that come up in the postpartum period that sleep deprivation learning a new skill these are all challenges so perinatal depression can be a little bit hard to diagnose in those cases other common signs of depression can include losing interest in things you found pleasure in previously withdrawing from loved ones avoiding loved ones and remember depression doesn't just affect new moms more and more research is coming out that tells us partners and expecting parents can also be affected by depressive symptoms some physical symptoms may also manifest you might find that you're having difficulty eating with a very very low appetite or the opposite and eating all the time for comfort you might find that you're quite stiff and having a lot of stiff muscles tense shoulders really bad headaches so these physical manifestations of depression can be signs as much as cognitive or emotional ones you may be feeling more pessimistic things are overwhelming everything just seems insurmountable there are of course variations to people's personalities so ask yourself what was I like before and is this a significant change to my personality you may also feel overwhelmed and hopeless like everything is just too much and the tasks keep piling one on top of the other you may also feel guil y around not being an adequate parent this is a big transition and it can feel like there's just too much to do and we are always comparing ourselves to other parents and sometimes in our own minds we don't live up to those expectations so that comparing and that pessimism and that hopelessness go hand inand now that we've covered some common symptoms of depression we want to take a look at the Imp imps on your day-to-day life to determine the severity so it could be impacting every once in a while every few days it could be happening most days most of the time or it could be impacting every single day all of the time if you're finding that your daytoday is significantly affected please reach out to your healthc care provider and if at any time I either you or a loved one are in any danger don't hesitate to call 911 or your local Crisis Line it could be the bravest thing that you ever do depression can manifest in different ways in different people so let's review a couple of scenarios to help illustrate that on the one hand we have Mel Mel has started to lose interest in day-to-day AC activities and things that gave her joy in her past life she's having trouble focusing concentrating she's quite anxious most of the time she's not eating particularly well and she's withdrawing from family and friends on the other hand we have Sarah Sarah is not sleeping well and quite cranky and she lashes out she's irritable she gets angry she also feels quite pessimistic and hopeless about the state of things one is losing interest in her life and is not eating well changing her eating and sleeping habits and is withdrawing is becoming more internalized the other is expressing herself in anger in frustration in pessimism and feeling guilt and sadness these are both different types of dep depression but they manifest in different ways for different people and it's important to recognize that depression is not going to look the same for everyone here are some tips for managing and coping with perinatal depression first thing consider exercise so getting that body moving getting that circulation flowing and just a little bit of physical activity can boost our feel-good hormones that serotonin and those endorphins and really just help us feel our best also mind your nutrition make sure you're getting a wide variety of nutritious foods and adequate hydration that leads me to sleep so sleep is so crucial and important lack of sleep can be a major trigger for depressive symptoms sometimes you're only able to get a few hours at a time but relying on your partner or your extended family to help take care of baby perhaps give baby a bottle so you can catch up on longer stretches of sleep can be so helpful make sure you're relying on that Social Circle so getting that extra social support that could be your family your partner loved ones it could be peer groups it could be friends other parents who are going through the same thing just checking in having a conversation talking to an adult can make you feel better we can incorporate mindfulness here as well mindfulness is really a way of being in the moment grounding yourself when you're starting to feel that anxiety or depression creep in mindfulness practice can be as simple as focusing on each one of your senses individually taking the time to notice what you can see touch hear taste and smell will bring you back into the moment there are so many good apps nowadays that can bring in that mindfulness practice even if you've never tried it before so don't be afraid to give it a go last we can consider journaling here and journaling again is something you may never have considered doing but it can be just as quick as picking up a pen and writing down a few bullet points people find it's helpful to take some of those racing thoughts and intrusive thoughts and externalize them actually put them physically down on a piece of paper then tuck it away and put it aside any of these strategies can be used at any time if you're feeling depressive symptoms start to creep in let's take a moment to delve into a less common perinatal mental health disorder postpartum Cy yosis affects about 1 in 500 postpartum women it is a disturbance in how you perceive reality the symptoms typically crop up in the first couple of weeks after baby's birth now this is quite different from baby blues and postpartum depression postpartum psychosis symptoms can be any of the following you may experience dep personal ization or feeling outside of yourself and withdrawn in your relationships with others and that includes your baby you may experience extreme restlessness and agitation you may have difficulty with your sleep even when you have opportunities to have sleep you may feel confused and have very disordered thinking you may have intense mood swings going all the way from Elation and Euphoria to the other end and feeling hopeless and extremely depressed you may have worries around harming yourself your baby or others you may even experience hallucinations hearing things that are not there seeing things that aren't there these hallucinations may tell you to do things you otherwise wouldn't you might notice delusional or distorted thinking and a distortion of the reality around you you may be more at risk for postpartum psychosis if you have a history of bipolar disorder a relative with postpartum psychosis or have had a postpartum psychosis in a previous pregnancy so how do you spot postpartum psychosis if you feel that you can survive on no sleep that should be a flag of course we need sleep we all need sleep to function at our best and feeling like you can go for days with without sleep is not common feeling an intense sense of euphoria that's outsize and doesn't fit the emotion of the situation that high feeling that intense adrenaline coursing through your body and racing thoughts can be a flag feeling like you might harm yourself so having thoughts about committing suicide that is definitely a flag and you need to address that immediately feeling like you're seeing things or hearing things that aren't there hallucinations are an extreme symptom and again need to be managed immediately that is an urgent call to 911 or your local Crisis Line you may feel intense confusion the kind of confusion where you forget what you're doing halfway through or walk around in a trance or even exist in this heightened sense of AG agitation anxiety maybe even aggression if you notice any of these features in yourself or in your partner it could be a sign of postpartum psychosis your healthc care team is an important part of your treatment plan and they may recommend any of these therapies cognitive behavioral therapy or dialectical behavioral therapy are treatment modalities that focus on changing the way that we respond to certain stressful triggers so they almost rework and rewire the brain and the way that we emotionally respond to certain things in our lives either of these treatments can work really well for postpartum anxiety or postpartum depression medications may also take a role in our treatments we may be starting medications for the first time or changing a dosage or or sometimes just trying something new so we can use other treatment therapies psychological support is also important to consider here that may be counseling it could be Psychotherapy or Psychiatry you may already be LinkedIn with a therapist these are all important modalities to consider and remember it's not just you who may be affected your partner can be affected by perinatal mental health disorders that brings us to the end of this video I really hope you found some useful information here and please be sure to check out the rest of the videos in this series take care and we'll see you again soon