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Is it the “baby blues” or postpartum depression? Only time can tell.
After giving birth, 80% of women respond to the sudden hormone change with mood swings and anxiety. If, however, this moodiness lasts more than two or three weeks, the cause could be postpartum depression or anxiety.


Gina Borelli Moore, MFT, is the facilitator of Pathways, a postpartum support group offered at Marin General Hospital. In this podcast, Gina discusses perinatal mood issues and how to tell when symptoms evolve into something worrisome for new moms and their families. Gina also discusses Pathways, the new mother support group she runs for Marin General Hospital. The six-session series takes on a different topic each week and mothers are encouraged to bring their babies along. Click here for more information.Bill Klaproth (Host): Statistically, 20% of mothers will suffer from depression or anxiety while pregnant, and approximately 15% of them will develop postpartum depression or anxiety. Here to talk about postpartum support is Gina Borelli Moore, a marriage and family therapist and the facilitator of Pathways, a postpartum support group with Marin General Hospital. So Gina, why do some women develop a perinatal mood disorder during pregnancy or postpartum?

Gina Borelli Moore, MA, MFT (Guest): Well of course there's a variety of reasons that can contribute to it. For some people, if they have a personal or a family history of a mood disorder, obviously they are more at risk. Some other contributing factors tend to be along the psychosocial realm. , they might have been experiencing high levels of stress including fertility treatments, things like that. Social isolation can contribute to, developing a perinatal mood disorder if they have a high need colicky baby postpartum things like that can contribute. Not getting enough sleep, which of course is a very common problem for moms postpartum.

But , the other thing is we're dealing with extreme hormone fluctuations, and we're dealing with the mother recovering from birth. So there's a lot of contributing factors along the biopsychosocial, realm.

Bill: So Gina, what are the symptoms, or what is it that a woman feels when she is having postpartum depression?

Gina: I think one thing I would like to say before I answer that question is that it's also very common to experience baby blues, about 80% of women experience that, which can include mood swings, anxiety, sadness, irritability, all of that. And I like to highlight that because I tend to see that women think if they're still experiencing those symptoms two, three months in, they're still thinking they have baby blues, but it's really crossed over into a postpartum depression or anxiety.

So I just want to highlight that piece because I do see a lot of women downplaying, "Oh, I don't really have any,   perinatal mood disorders, this is just the baby blues". Once it's gone past a few weeks, we're really looking at something different. So I just wanted to highlight that.

Bill: Yes, that's correct, so thank you for clarifying that, Gina. That's a really important point. So what is it that a woman is feeling when she has the baby blues or is entering into postpartum depression?

Gina: Well with postpartum depression, we're going to see agitation, irritability, a loss of interest, in the things that they used to enjoy.   They might experience a loss of appetite.   Sadness, crying in general what we see more with the depression once it's gone from baby blues to depression is if they're really reporting more sad days than good days. They might be feeling shame, helplessness, hopelessness,   and sometimes we even see difficulty bonding with the baby. It affects their attachments, and they start withdrawing from family and friends.   Unfortunately sometimes we also see thoughts of harming themselves or the baby. So we take these things very seriously, and it's really important to get intervention at that point.

Bill: And again, you mentioned earlier if someone is experiencing these feelings for two to three months, that's when it's definitely time to see a doctor.

Gina: Sure, I mean I think it's important that they see a doctor obviously before that, and, luckily we have pediatricians, and OBs who are kind of on the front lines of being able to identify these things. But really, baby blues is going to peak five days postpartum and those symptoms should resolve three weeks postpartum. So if the mom is feeling depressed or anxious beyond that point, it's really important to get the support that they need.

Bill: Thank you, Gina. That's,   really good. So you facilitate Pathways, a support group for postpartum moms with Marin General Hospital. So this is where you help women going through this. So tell us about the program.

Gina: Sure. So it's a wonderful program and it is a six week series. what that means is obviously needing six weeks for an hour and a half at a time, and, the thing is with postpartum depression or anxiety, feeling that shame and isolation, it is wonderful to have peer support, and to be around other moms who are identifying some of the struggles that they're going through, and being able to relate and support each other.

So within the six week series moms can get support from each other and from me, but we also try to cover certain topics. So I will hand out articles at the end of each group that they can read, so that the next group we can cover certain topics like,   a mother's changing identity, perinatal mood disorders the changes that might be happening in their relationship with their partner. Another topic that we,   think is really important is talking about unmet expectations, and then also covering self-care tools and how to work through any depression or anxiety they might be experiencing.

Another wonderful thing is that women can bring their babies with them. we really want to support, them being able to make it to a group, and sometimes it's difficult to get childcare, things like that. So of course they can bring babies to the group and do any feeding, and changing, and anything that they need to do during that time.

Bill: So does a woman need to attend all six sessions?

Gina: No, I mean it's ideal obviously because we are covering different topics, and it is brief, ? So we want them to get as much support as possible, but if they have to miss a group, of course that’s these things happen. So we support them in coming to as many as they can.

Bill: And Gina, does this replace therapy?

Gina: No, this is not a therapy group.   it is a support group, and I find it most beneficial to be doing individual work as well as the group because it's going to support you in different ways, and obviously individual therapy can provide a little more depth, But the group is again it kind of supports that you can't get from individual therapy because you're around other women who are right there with you, and they have their own maternal wisdom to be able to offer,   and support you on. So it's a different kind of support.

Bill: And how long is each session? Is it like an hour, or an hour and a half, or forty five minutes?

Gina: The group is an hour and a half, yeah. So that really allows time for check in, maybe a brief meditation and then it gives time to talk about the topic as well as free time to talk about whatever is up for each individual woman.

Bill: And Gina, what else should we know about your support group or postpartum depression?

Gina: Well   I think I covered the support group. I think the thing I would want you to know is that we're not just talking about postpartum depression. As you mentioned earlier in the podcast, it really can happen during pregnancy or postpartum. And the reason why we now use the word perinatal mood disorders is that we really want people to understand that we're looking at depression, we're looking at anxiety as well, and I seem to find in my practice a lot more perinatal anxiety, and so people don't necessarily know they're going through depression. They're really feeling hypervigilant, and having racing thoughts, and unable to sleep, and things like that.

So I think it's just important to know that there really is a range including disorders like perinatal psychosis, or perinatal bipolar disorder, which is much more rare, but it's out there. So really to have a wide radar so that we can catch, a lot of these different disorders that women are struggling with. and I think the other piece that I really want to get across is that a lot of this is triggered by hormonal fluctuations, and sleep deprivation, but a lot of this is treatable and also preventable with some, , thinking about certain tools ahead of time during pregnancy, and then really early postpartum women getting the support that they need.

Bill: Well that's really good information, and good to know that there is help. Gina, thank you so much for your time today. For more information, visit www.MarinGeneral.org. That's www.MarinGeneral.org. Or you can call 1(888) 99 MYMGH. That's 1(888) 99 MYMGH. This is The Healing Podcast, brought to you by Marin General Hospital. I'm Bill Klaproth, thanks for listening.