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Courtney Culham is shown with her two daughters and husband Owen Rabey

Five Things New Moms Should Know About Postpartum Depression

Having a baby is a joyous time, but for some it can also trigger unexpected disturbances in mood.

Courtney Culham, a nurse practitioner with Pure North with 20 years of health care experience, has both professional and personal knowledge of perinatal mood disorders (PMD).

Still, Culham was blindsided by PMD following the birth of her first daughter four years ago. “I went six months without the correct treatment largely to my symptoms being unrec­ognized, dismissed or minimized,” she says. “I had no known risk factors, all of the resources and supports in place, but I still struggled in a huge way.

“PMD is the most underdiagnosed obstetric complication following birth,” Culham says, adding that symptoms are often incorrectly attributed to exhaustion and first-time-mom anxiety.

Today she works to reduce stigma surrounding PMD by pro­viding support, increasing awareness, teaching at a medical school and fundraising.

Five things about Perinatal Mood Disorders:

  1. Poor screening: Every pregnant woman is tested for gestational diabetes and 14 per cent develop it. There’s no standard screening for PMD, however 20 per cent experience it.
  2. Risk factors: Pre-existing mental health conditions such as depression, general anxiety disorder, bipolar disorder, OCD, ADHD or a family history are risk factors. Lack of support, a poor marital situation, a traumatic birth experience, among others, contribute, too.
  3. The spectrum: The baby blues affect 50 to 85 per cent of new mothers. Symptoms include mood swings, anxiety, sadness, reduced sleep, appetite and decreased concentration, lasting up to two weeks postpartum. Postpartum depression affects 13 per cent and its symptoms — severe mood swings, depression, anxiety, difficulty bonding with baby, feelings of inadequacy or guilt, thoughts of harming self or baby — can last months. Postpartum psychosis, a medi­cal emergency, affects 0.2 per cent, with paranoia, disorienta­tion, hallucinations, delusions, sleep disturbances or attempts to harm self or baby.
  4. Maternal nutritional depletion: The partitioning of micronutrients between mom and baby during pregnancy, as well as other medical conditions or complications of labour, can deplete mom’s nutritional reserves. Suboptimal levels of vitamins and minerals such as iron, vitamin D and vitamin B12 can contribute to PMD risk.
  5. Help is available: Nurse practitioners at Pure North’s Primary Care Clinic are trained in the assessment, treatment and referral of PMD. They help develop tailored treatment plans for women and their families affected by this disorder. The Women’s Mental Health Clinic at Foothills Medi­cal Centre, Family Matters (https://www.familiesmatter.ca) and Postpartum Progress (https://postpartumprogress.com) are excellent resources for those in need.
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