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Treatment for Perinatal Mood and Anxiety Disorders.

Maternal Mental Health
Maternal Mental Health

You are not alone. 

Maternal Mental Health Disorders (also referred to as perinatal mood and anxiety disorders or PMADs) are the most common complication of childbirth. At least 1 in 5 new mothers are affected by perinatal mental illness; within this 15-20% very few reach out for the help that they so desperately need and deserve. My greatest hope is for parental mental health to be prioritized as a component of routine prenatal and postpartum health care.

 

Maternal Mental Health Disorders

Perinatal mood and anxiety disorders include: prenatal depression and anxiety, postpartum depression, postpartum anxiety and panic disorder, postpartum traumatic stress disorder, prenatal and postpartum obsessive-compulsive disorder, bipolar disorders, and postpartum psychosis. 

 

Occurrence & Onset 

These illnesses can occur during pregnancy (prenatal onset) and up to twelve months after birth (postpartum onset). It is important to be aware that these illnesses may also follow pregnancy loss and adoption. As well, if these illnesses are left untreated the symptoms may not resolve by the twelve month mark. Sharing this information with your health care provider can help to ensure that you receive appropriate and timely treatment.

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Preparing for Pregnancy and the Postpartum Period

By engaging in therapy as you prepare for pregnancy (or during pregnancy) we are provided with an opportunity to screen and assess for factors which may indicate an increased risk for developing a mental health issue during or after pregnancy. By implementing measures to support your wellness during the prenatal and postpartum periods, the chance of occurrence and/or the severity of an illness can be reduced. 

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Treatment: The Path to Wellness

Perinatal mood and anxiety disorders are temporary and treatable with informed professional care. If you believe that you (or someone you love) may be experiencing a maternal mental illness please know that this is not your/their fault; you/they have done nothing wrong to have caused this. By connecting to care, you have already taken the first step of your recovery!

Paternal Mental Health
Paternal Mental Health

Fathers are affected too

10 to 25% of father's experience mood and anxiety disorders during the perinatal period - from conception, up to twelve months after the birth of their baby. These illnesses include: depression, generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and psychosis (though very rare in men). 

 

Postpartum Depression

1 in 10 fathers experience postpartum depression. The most current research indicates that if a mother is experiencing postpartum depression - there is a 50% chance (1 in 2) that her partner is experiencing depression. 

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What are the potential contributors?

There are a significant number of changes occurring for a father as he transitions into his new parental role. He may be experiencing a lack of sleep, identity and role shifts, relationship changes, financial pressures, and expectations set to be more involved in his fathering (than what might have been modeled to him by previous generations). In addition, research studies are showing that fathers experience hormonal changes; these shifts are connected to the occurrence of post-partum depression.

 

Fathers may also ensue higher levels of stress during the perinatal period which increases the risk of developing a mood and/or anxiety disorder. It's helpful to know that a father may experience a new (first) episode of an illness or a relapse, if there is history of mental health issues. 

 

Whole-family Care

A father's mental health is integral to the well-being of the whole family. The most meaningful and loving contribution a father can make to his family is himself - being involved, engaged, and emotionally available to his partner and their children. Reaching out for support and taking care of your health - to care for your family to the best of your ability - is an incredible act of love.

Assessment & Treatment
Assessment & Treatment

A Safe Space to Share, Process and Recover 

Motherhood is often imagined as a beautiful and purely joyous season of life; this myth can leave both mothers and fathers vulnerable to the unexpected events, uncertainty, stress and worry that can occur along the path to and through parenthood. The truth? Parenthood is comprised of both magical moments and challenging hiccups; parental support is essential. Therapy offers a safe and confidential space to navigate all of these pieces.

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Intake Process

Once we have booked your first session, you will receive an appointment confirmation and an invitation to set up your client portal via e-mail. Prior to our first session, I will ask that you complete a brief intake form as well as informed consent and confidentiality agreement forms. These forms can be completed from your phone or computer.

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Your First Session

During your initial session, we will review the forms mentioned above and I invite any questions that you may have. Next, we move into the assessment phase of therapy which is completed over the course of two or three sessions. I carefully take the time to understand your presenting issues and concerns; we begin to discuss what you would like to accomplish in therapy and develop your treatment plan. From the beginning, effective tools and strategies will be offered for symptom relief and overall improvement of emotional/mental distress.

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Working Together

Appointments are provided virtually via video session. It is recommended that therapy sessions be scheduled on a regular basis (i.e., weekly or bi-weekly) to begin; we can talk more about this depending upon your specific needs. Sessions are usually 50-minutes; however, 70-minute and 90-minute sessions are available. Brief fifteen-minute telephone "check-ins" are available for current clients between regularly scheduled sessions. Upon completion of therapy, "booster" sessions are available as needed.

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We may also include and connect with other perinatal practitioners such as your family physician, obstetrician, psychiatrist, or midwife - to strengthen your support system.

Cognitive Behavioral Therapy
Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (often referred to as CBT) is a well researched, time sensitive, and collaborative psychotherapy model recommended for the treatment of perinatal mood and anxiety disorders. The genetic, neurochemical, psychological and environmental vulnerabilities that may act as both risk factors for and/or contributors to perinatal distress/illness are explored and integrated into an individualized treatment plan.

 

This holistic approach highlights the connections between the mind (thoughts), mood (emotions), body (physical sensations), behavior (what we do, how we respond), and the surrounding environment. Whether we are aware of our thoughts or not, research has shown that there are specific patterns of thinking that tend to occur with certain moods. By learning to identify and change unhelpful thinking patterns (such as negative or worrisome thoughts) we can learn to think differently and in response feel differently (emotionally and physically) and behave in new ways to achieve wellness.

 

Over the course of therapy, clients learn that the scary thoughts (or images) and uncomfortable feelings they may be experiencing are symptoms of their illness. As therapeutic tools and skills are introduced, I (as your therapist) also explain how the intervention will bring symptom relief. CBT is flexible and prioritizes the client/therapist relationship as an integral component of therapy. Clients are provided with a safe, warm, and respectful space to work toward their therapy goals. 

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To obtain best results, the therapeutic skills and coping strategies are applied outside of the therapy sessions. This process supports the client in overcoming their illness and sustaining mental wellness on a day-to-day basis. Upon the completion of therapy, the continued practice of these individualized tools can reduce the occurrence of relapse. 

Mindfulness & Self-Compassion
Mindfulness & Self-Compassion

Mindfulness

Current research supports that the practice of mindfulness is effective in achieving emotional and physical wellness. Jon Kabat-Zinn defines mindfulness as "awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally."

 

Often our thoughts keep us stuck in the past (depression) or worrying about the future (anxiety). The practice of mindfulness enables present moment awareness where one can learn to observe their thoughts, feelings, actions, and surroundings without judgement.

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By creating space between our experiences and our reactions - we can begin to pause and respond with intention. Infused into sessions for clients interested in exploring mindfulness are a variety of activities, home-practice exercises, and meditations. 

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Self-Compassion

A favorite quote (by Chris Germer) summarizes the beauty of self-compassion so well: “A moment of self-compassion can change your entire day. A string of such moments can change the course of your life.”

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Integrating the practice of self-compassion into your wellness plan offers many health benefits. Research has shown that this practice lowers the bodies stress hormone cortisol while increasing oxytocin (the feel-good, love hormone). Through the many seasons of parenthood, self-compassion offers a sense of calm and emotional balance as stress levels are reduced. 

 

According to psychologist Kristin Neff, self-compassion is comprised of three components: 

  • Being kind to ourselves (just as we are to our loved ones, pets, neighbors)

  • Acknowledging our shared human experience (you are not alone)

  • Mindfulness (holding space for our feelings and experiences)

Support
Support & Emergency Care

Telephone Support

Health Link BC - Dial 811 (to speak with a registered nurse, dietitian or pharmacist).

BC Crisis Line - Dial 988 or 1-800-SUICIDE / 1-800-784-2433

BC Interior Crisis Line - 1-888-353-CARE / 1-888-353-2273

BC Mental Health Support Line 310-6789 *no area code

 

Emergency Care

Dial 911 or visit your nearest hospital emergency room.

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Websites 

Postpartum Support International (Resource line, therapist directory, free online support groups).

Postpartum Men (Information, education and support).

Cognitive Behavioral Therapy (Overview).

Self-Compassion (Take the quiz!)

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