What does perinatal mean?
Perinatal means the period "all around" birth. We use it to mean the period of time throughout pregnancy as well as the baby's first year.

How is this different than the “baby blues?”
Most new mothers – experts estimate about 80% -- experience mood swings and weepiness during the first 2-3 weeks after giving birth. Sometimes called “the baby blues”, this is a normal adjustment period and resolves without any medical assistance.

I feel scared and anxious. Is this related to PPD?
Yes it is related. PPD is a term that most people use to describe postpartum emotional distress, but many pregnant and postpartum moms have mostly anxiety-related symptoms – feeling irritable, agitated, or overwhelmed -- without primary depression. Perinatal anxiety might include insomnia, poor appetite, fears and worries, restlessness, and physical symptoms such as dizziness, rapid heartbeat, or aches and pains. Anxiety is a real condition, and it is completely treatable.

What should a mom do if she thinks she has perinatal depression or anxiety?
She should reach out as soon as she can, and talk to supportive and informed people. She should start by talking to her Health Care Provider. Admitting there may be a problem is the most important step a mother can take for herself and her family. Some mothers find it helpful to write down symptoms and feelings prior to an appointment with their Health Care Provider. It may also be helpful to take a supportive person with her to the appointment.

What causes perinatal mood and anxiety disorders? Why did I get this?
This is not your fault. There is no one cause for perinatal mood and anxiety disorders. Women who develop depression or anxiety during childbearing years have symptoms that are caused by a combination of psychological, social, and biological stressors. Hormonal fluctuations cause reactions in sensitive women. Risk factors do include a personal or family history of mood or anxiety disorders such as depression, anxiety, bipolar disorder (manic-depressive), or schizophrenia, and sensitivity to hormonal changes. Developing a perinatal mood and anxiety disorder is not your fault. You did not do anything to "get" this.

What kind of treatment will help?
Treatment plans might include self-care, social support, therapy and medication when necessary.

Self-care: This includes rest, good nutrition, assistance with baby and other children and caring for personal needs such as exercise, relaxation or time with spouse.

Social Support: This includes talking with others who understand and can provide encouragement.

Therapy: A therapist who specializes and understands perinatal mood disorders can be extremely beneficial. A therapist has educated answers to any questions and can provide validation and a safe place to express feelings. Most importantly, a therapist that specializes in PPD can also provide techniques that can alleviate symptoms.

Medication: Medications are available to successfully treat both anxiety and depression. Some women treat depression and anxiety with medication, some with diet and exercise, some with counseling, support groups, or spiritual practice and support. Many use all of them. Find what works best for you, make a plan of self-care, and stick to it. Learn about how to cope with depression and anxiety, and reach out to informed providers until you find the help you need.

How long will it take for me to get better?
Unlike strep throat or the flu, perinatal mood and anxiety disorders have no defined time frame. It is different for every woman and it depends on many things, including access to support and informed health care professionals. Every perinatal mood disorder, no matter how strong the symptoms are, is temporary and treatable.

What about medication?
Deciding if you need medication is a decision best made between you and your medical professional. Several medications are available to treat the symptoms of perinatal depression and anxiety. Some women take medication during pregnancy and while breastfeeding.

If I decide to go on medication, what is the best one to treat these symptoms?
The best medication to treat your symptoms should be decided during a conversation with your informed medical provider. Medications work individually with each person, so what works well for one may not work as well for another. If you have any questions about your reaction to medication, you should contact your provider and ask about it. You might experience side-effects, especially when your body is adjusting to the medication in the first few weeks, but you should not feel worse on medication. Experts say that if you have previously had a successful experience with medication, you might consider starting with that one. The best medication is the one that works for you and your individual situation.

Can I take medications during pregnancy?
Work with an informed provider who prescribes medication to weigh the benefits and risks of the medications versus your symptoms of depression and anxiety.

If I take medication can I breastfeed?
Women do breastfeed and take medication. It is a decision best made between the mother and a provider who is informed on the latest research about using medication during pregnancy and breastfeeding.

What do I say to friends and family who think I'm fine because I don't look ill?
You might look like you're doing better than you feel, and you can explain that to friends and family. You can explain that some people call postpartum depression "the smiling depression" because moms often try to put on a happy face even when they feel depressed. You don't need to tell anyone about your illness unless you are comfortable doing so. If you feel comfortable opening up, you may start out with saying things are more difficult than expected; that even though you don't have any outward signs to point to like a broken leg, you aren't feeling like yourself and do appreciate their support. Some families find helpful information from websites, brochures or books.

What if I don't have insurance?
Many therapists and psychiatrists offer a sliding scale for self-pay patients without insurance. Some may also be willing to work out a payment plan. Don't be afraid to ask about adjusting the fee. Many medications are available in an affordable generic form. There may also be cost-participation clinics in your area through which you may qualify for free treatment.

The purpose of Yad Rachel is to increase awareness among public and professional communities about the emotional changes that woman experience during pregnancy and postpartum.

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