Postpartum Depression with Behavioral Health Specialist Dr. Daniel Finch
From the Show: Valley Health System - NJ
Summary:
Air Date: 12/9/22
Duration: 10 Minutes
Being a new mom brings about many emotions, such as excitement, happiness, fear, or sadness. Your body experiences many physical and emotional changes during and after pregnancy. It is normal to experience worry, but if your feelings are extreme sadness or loneliness, mood swings, or crying spells, you may be experiencing postpartum depression. Talk to your doctor. There is treatment and getting the help you need will help you and your baby be as healthy as possible.
Transcription:
Maggie McKay (Host): Pregnancy is a process, a nine month journey. And after the baby's born, there's so much going on from breastfeeding to the mother, healing to the beauty of holding your baby for the first time. But there can also be postpartum depression, an unexpected event that new mothers may not have considered or prepared for. Our guest today is Dr. Daniel Finch, medical Director, department of Psychiatry and Behavioral Health for Valley Health System in collaboration with Christian Health. To fill us in on what to know about postpartum depression. , like who experiences it and is it dangerous or how is it treated and more.
Welcome to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm Maggie McKay. Welcome and thank you so much for being here, Dr. Finch. Let's dive right in. I feel like there is so much to know about postpartum depression that isn't necessarily shared until women are experiencing it. Would you say that's about accurate?
Dr Daniel Finch: Yeah, it's an extremely important topic, so thank you for having me and giving the listeners the opportunity to learn about it. Postpartum depression used to be very stigmatized, and only in recent years has it become slightly less so, but it still carries some stigma in certain social circles. So it's important that women and men become aware of the warning signs of postpartum depression and what to do about it.
Maggie McKay (Host): And to start, what is the difference between baby blues and postpartum depression?
Dr Daniel Finch: Baby Blues is a milder, short-lived, more common form of postpartum mood and anxiety symptoms that can include some sadness, anxiety, or irritability. Abnormalities in your sleeping pattern or eating pattern, but it doesn't reach the degree of being functionally impairing. Postpartum depression on the other hand, is longer lasting. It has to be at least two weeks, and you have more severe symptoms that do cause some sort of functional disability. And some of those symptoms are extreme sadness, a lot of crying, a loss of interest in things, difficulty bonding with the baby.
Not feeling joy about the baby, eating too much or too little, sleeping too much or too little outside of the normal disturbances that come with having a baby. Extreme fatigue, regardless of whether or not you get rest. Difficulty concentrating, pacing, restlessness, worthlessness, guilt, and the most severe case is thoughts of suicide or thoughts of harming the baby. Much more severe than baby blues.
Maggie McKay (Host): Is it a given that all moms get at least baby blues, or is that not the case?
Dr Daniel Finch: Not necessarily, but the prevalence is really high. Somewhere in the area of 70 to 80% of women experience baby blues and the actual number might even be higher because some women may still feel embarrassed about coming forward with symptoms or asking for help, even though it's talked about more openly these days.
Maggie McKay (Host): Is postpartum depression common?
Dr Daniel Finch: Postpartum depression is probably more common than most people think. Prior to Covid, the average prevalence of postpartum depression was one in every seven to eight women, which is already a very high number. But through the pandemic because of all the additional stressors and social isolation, the newer data is suggesting that the number of women with postpartum depression may be closer to one out of every four or five. That's like 20 to 25%. That's a huge number.
Maggie McKay (Host): Can men experience postpartum depression?
Dr Daniel Finch: That's a great question, and I really appreciate that you're asking. Men in the postpartum period because this really wasn't widely researched or spoken about publicly until the last 20 years or so, and this number will also surprise many listeners. It's estimated that one out of every 10 fathers experiences postpartum depression. And again, that number is likely higher because of resistance in coming forward. fear of embarrassment of being seen as weak, of trying to take the focus away from the mom. So it's a very important topic. Does not get talked about even as much as postpartum depression in women, but carries the same disability.
Maggie McKay (Host): Wow. So what causes postpartum depression?
Dr Daniel Finch: While there's no single cause, you can generally break down the contributing factors into three categories, the biological, the psychological, and the social. We call it the bio psychosocial model. So some biological factors are genetic predisposition. For example, if you have a family history of other women in the family with postpartum depression and hormonal changes that happen during and after pregnancy. Some of the psychological factors can include not having healthy coping skills, having a history of trauma such as childhood abuse or intimate partner violence. And the social factors can include food and housing insecurity, financial stress and little or no support from family and friends. And you're at an especially high risk if you have a history of depression in previous pregnancies or even depression prior to pregnancy.
Maggie McKay (Host): Dr. Finch, how long does postpartum depression last typically?
Dr Daniel Finch: So by definition, postpartum depression has to last at least two weeks and generally resolves within one year if proper interventions are taken. But it can last longer, and if not treated at all, it may not go away until the person seeks professional help.
Maggie McKay (Host): A year. Wow. Or longer. I never heard that?
Dr Daniel Finch: Yeah. In the last program I developed for, perinatal mood and anxiety disorders, which is sort of all encompassing of post pharma and pregnancy, depression, anxiety, and other disorders, we actually redefined that year and extended it out to two years because what we've seen is. The stresses don't magically go away even a year, right? Your baby becomes an infant, becomes a toddler, becomes new stresses So we actually redefined the normally accepted timeframes, which for primary care, maybe six months for psychiatry, maybe a year. And I've really expanded that out to two years.
Maggie McKay (Host): Wow. Yeah, it seems like the stresses actually just pile on. they don't get less. That's what I experienced. But how is it diagnosed?
Dr Daniel Finch: So your primary care doctor or your obstetrician may use a screening tool such as the Edinburg Postpartum Scale, or a PHQ nine. These are just standardized sets of questions that can identify somebody at being at risk for postpartum depression and need further evaluation by a professional. So I really appreciate when I get a new patient coming to me who's an advocate for themselves and says, Hey, how do you doctors decide who's depressed and who's just sad. Because this is something that I automatically teach my patients, every one of them.
But many of them don't know. The actual diagnosis is defined in a pretty much universal textbook called the DSM five, the Diagnostic and Statistical Manual around version five, and this is where the criteria that I spoke of earlier, the two weeks. five of those symptoms of sleep appetite, energy fatigue, concentration, is clearly written out. And so there's an objective measure of how we diagnose it.
Maggie McKay (Host): And then how do you treat it?
Dr Daniel Finch: Mild forms of postpartum depression can be treated with things like healthy lifestyle changes, diet and exercise, increase social support. Very often, even mild forms benefit from psychotherapy or talk therapy with a professional clinician. When you get to a moderate or severe postpartum depression, this at least requires the help of a therapist and really should be evaluated by a psychiatrist to at least have a discussion with the patient about what medications are available, what they do, what they don't do. What are the side effects and to dispel any misconceptions about these medications that, people may have coming into it, because they're actually very helpful and generally very well tolerated and safe.
Maggie McKay (Host): You touched on it a little bit, but what is the prognosis?
Dr Daniel Finch: So baby blues by definition, goes into remission generally without intervention or much intervention within two weeks, but there's a possibility that it can turn into postpartum depression and postpartum depression can be prolonged and more severe without proper intervention. Some studies have suggested that at least 20% of women with postpartum depression who go untreated will still be symptomatic at one year after birth.
Maggie McKay (Host): Dr. Finch, if you have postpartum with one child, will you have it with all your children automatically?
Dr Daniel Finch: Not automatically, but after one episode of postpartum depression, the risk is quite high. In the area of 50% or greater chance of having another postpartum depression episode with a second pregnancy if you've had it with the first. So it's really vital that you inform your doctors of your history and consider starting at least with a therapist even before you have symptoms in the second pregnancy, to establish that therapeutic relationship and build up those healthy coping skills just in case it does happen again.
Maggie McKay (Host): Is it unhealthy or dangerous for the baby?
Dr Daniel Finch: Yes, it can be during pregnancy. The risk of untreated postpartum depression, can include things like the baby being born smaller or earlier. Once the baby's born, it may not feed or sleep as well. There is an increased risk of admission to the neonatal ICU. With untreated postpartum depression, so very serious complications. and then after pregnancy, postpartum depression can affect a woman's ability to bond with the baby, which can affect its neurological development and her ability to breastfeed, which may impact the development of the baby's immune system.
Maggie McKay (Host): That's a lot. Dr. Finch, is there a way to prevent postpartum depression? The big question.
Dr Daniel Finch: I think prevent is a strong word. The words that I use are mitigate risk or lower risk. So in order to lower your risk of developing postpartum depression, you first have to be knowledgeable and that's really why we're sitting here today. This is what we're doing, informing people about what the signs and symptoms. Encouraging and reassuring, comforting people to be willing to ask for help. To help them learn where to get help and to avoid unhealthy coping behaviors like excessive alcohol, smoking, drug use, and to really proactively seek out a support system, whether it be friends or family or other moms and dads in support groups.
Maggie McKay (Host): Can it ever go away on its own? Let's say you don't get treated and you say, oh, it'll go away. Does that ever happen?
Dr Daniel Finch: Now untreated postpartum depression. As I said, some studies show approximately a 20% or more likelihood that the woman will still have residual symptoms, one year after giving birth.
Maggie McKay (Host): So most likely it does not go away on its own.
Dr Daniel Finch: I wouldn't take the chance. like I said, the risk factors to mom and baby are so high that, hopefully we've come to a society that's more understanding, less stigmatizing. You don't automatically need medications. You can go and talk to someone, a therapist, or a psychiatrist, and if you may need medications, nothing's ever forced on you. It's a discussion to be informed of what the benefits are, the risks and the alternatives.
Maggie McKay (Host): Are there some women who are more at risk than others?
Dr Daniel Finch: Yes. Women who give birth in their teenage years we know are at higher risk for developing postpartum depression. As are women who struggle with housing and food insecurity, those that have a history of depression or other mental health issues. Women who give birth to a preterm baby. Baby that's born early. Or one that needs to stay in the neonatal ICU after birth. And, also at risk are women with a history of trauma or drug and alcohol abuse among other risk factors.
Maggie McKay (Host): And when it comes to postpartum depression, is that the same as postpartum anxiety?
Dr Daniel Finch: They're not exactly the same, but they're kinda like two sides of the same coin with, a very high comorbidity. Someone with a primary depressive disorder is likely to have some symptoms of anxiety, and someone with a primary anxiety disorder is likely to have some symptoms of depression. And there's a lot of overlapping symptoms like poor sleep, poor appetite, fatigue, a loss joy and interest in things, etcetera. But anxiety is usually related more to that excessive worry, the ruminating or racing thoughts, panic attacks, which are a very physical manifestation of anxiety, short of breath, shaky, tremulous, and a lot of checking behaviors.
So checking on the baby excessively in the middle of the night to make sure they're still breathing or worrying more than average. Most women worry that something's gonna happen or that they're doing something wrong, but really excessively sort of constantly worrying to the point where your quality of life is impacted, your functionality is impact.
Maggie McKay (Host): We talked a little bit about how to treat postpartum depression. How do you treat postpartum anxiety? If you think you're suffering from either, what should you do?
Dr Daniel Finch: Yeah, very similar principles to postpartum depression. So, really focusing on improving self care, increasing your support system as much as you can. Good diet and exercise, healthy coping skills, maybe getting into talk therapy and medications can be very helpful for this in many cases. And if you even think that you might be having some postpartum depression or anxiety, but you're not sure, just ask your doctor for more information.
Maggie McKay (Host): And you talked about medication. Not everybody has to take it, but you can and it can be helpful in some situations. But what about, if you are breastfeeding, is the medication for postpartum depression and postpartum anxiety safe?
Dr Daniel Finch: This is something a lot of women rightfully are concerned about. Not all medications are the same. Some are found in very little or no amounts in the breast milk, and it's important to remember that untreated postpartum depression and anxiety by themselves, can carry risks for you and your baby. So they both may have some risks, but not treating It definitely has risks and it's a very important concept to remember. And so it's a conversation you really have to have with a doctor and try not to go hunting online for those answers or taking a poll from friends and family. Just, just talk to your doctor. They have the training and expertise.
Maggie McKay (Host): And what if someone gets pregnant again while they're on medication for postpartum? Same thing. Just ask your doctor.
Dr Daniel Finch: You find the answer to a lot of this is ask your doctor. and hopefully you have a doctor that you feel comfortable enough to ask, and I think that, sometimes. There's a perception that we're not comfortable, but most of us are. If you do get pregnant, while you're on a medication, it probably means you've needed the medication. And if you need the medication to control depression or anxiety symptoms. Coming off the medication can often be a higher risk than staying on the medication through pregnancy because again, the untreated anxiety depression are very risky for both mom and baby. And there are certainly medications that are considered relatively low risk in pregnancy compared to, being untreated and very symptom.
Maggie McKay (Host): Tell us about support groups for postpartum depression. What are they like?
Dr Daniel Finch: Support groups are amazing. I get a lot of women and dads remember who are apprehensive about going to a support group because they've never tried it before. It's people they don't know. They don't know what to expect. So this is a very important question and I make sure to go through this with everyone of my patients as a treatment option. They're often moderated by a professional who kind of helps guide the group. And it tends to be a group of, women or dads that are going through similar things. There's no contract.
You're not forced to stay in the group. If you go to a few sessions and you really feel like it's kind of triggering more symptoms than helping, you can leave with no obligation. Some are covered by insurance and many will offer a sliding. based on your ability to pay. So it's a treatment source that, like I said, I make all of my, moms and dads aware of. And most of the people that are apprehensive at first come back and they tell me, thank you for recommending that. I went and I realize that that's actually really helpful to have people that are going through the same things. It's a different type of help.
Maggie McKay (Host): And are there other resources that people can learn about postpartum depression as well as postpartum anxiety?
Dr Daniel Finch: There definitely are. My favorite, if I had to pick one, is Postpartum Support International. It's one of the most amazing organizations and resources, and you can find it online at www.Postpartum.net. Lots of great informational and, treatment resources, all in one place and you know, more locally, depending on where you are. There's organizations like one by me called the Partnership from Maternal and Child's Health of Northern New Jersey, and there's similar organizations probably near where you live. And again, the universal answer really is ask your doctor.
Maggie McKay (Host): Yes, definitely. I think that's worth, repeating because early on when we were talking, you said about, if you don't know if you have it, ask your doctor. I remember when I was in the hospital. I don't know if they still do this, because it was, yeah, a lot of years ago, but before they would release you, you had to fill out a whole questionnaire about postpartum and if you answered too many, I think they might have evaluated you or. I don't know, kept you in, but I just wanna get home. So I said, no, no, no, no, no to all of them. And my husband's like, be honest, that's what they're here for. Because once you leave here, and I was stubborn and I didn't, and I should have, but I really didn't think I had it. But I didn't know, so I should have asked somebody. Right?
Dr Daniel Finch: Yeah. And you're at a very vulnerable time right after birth, right? You're just overwhelmed, you're exhausted. The hospitals do, often, most hospitals administer a screening tool, as I talked about, and you probably took an Edinburg postpartum depression scale, and women will look at it and kind of obvious, what they're looking for. I think to most women, and many get scared, they immediately go to worst case scenario. They're gonna not let me take the baby home. They're gonna take the baby away because that's a kind of understandable, especially in that state of, stress and anxiety.
And I just wanna get home and take care of the baby. And especially if it's the first baby, I don't know what the heck I'm doing. And what's gonna happen if I answer truthfully, But the truth is that the whole point of that is to catch it early, to really get it early because early intervention improves prognosis significantly. But those screening tools also aren't perfect right after birth because sometimes the symptoms can have a delayed onset. They can start days, weeks, or even months after giving birth, depending on the situation at home. So it's important to keep that conversation going with your doctors.
Maggie McKay (Host): Good advice. Thank you so much Dr. Finch, for helping us understand postpartum depression and anxiety. I have never even heard of postpartum anxiety before this, so thanks for helping us understand it better and what to look out for, should we need to be treated for it. We appreciate you being here so much and sharing your knowledge with us.
Dr Daniel Finch: Thank you for helping me get that knowledge out to the people that need it.
Maggie McKay (Host): Absolutely. If at any point you have thoughts of harming yourself or your baby, call 911 to immediately seek. If you found this podcast helpful, please share it on your social channels. And for more topics of interest to you, check out our entire library of podcasts. Thanks for listening to Conversations Like No Other presented by Valley Health System in Ridgewood, New Jersey. For more information on today's topic, or to be connected with today's guest, please call 201-291-6090 or email This email address is being protected from spambots. You need JavaScript enabled to view it. . I'm Maggie McKay. Be well.
Maggie McKay (Host): Pregnancy is a process, a nine month journey. And after the baby's born, there's so much going on from breastfeeding to the mother, healing to the beauty of holding your baby for the first time. But there can also be postpartum depression, an unexpected event that new mothers may not have considered or prepared for. Our guest today is Dr. Daniel Finch, medical Director, department of Psychiatry and Behavioral Health for Valley Health System in collaboration with Christian Health. To fill us in on what to know about postpartum depression. , like who experiences it and is it dangerous or how is it treated and more.
Welcome to Conversations Like No Other, presented by Valley Health System in Ridgewood, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm Maggie McKay. Welcome and thank you so much for being here, Dr. Finch. Let's dive right in. I feel like there is so much to know about postpartum depression that isn't necessarily shared until women are experiencing it. Would you say that's about accurate?
Dr Daniel Finch: Yeah, it's an extremely important topic, so thank you for having me and giving the listeners the opportunity to learn about it. Postpartum depression used to be very stigmatized, and only in recent years has it become slightly less so, but it still carries some stigma in certain social circles. So it's important that women and men become aware of the warning signs of postpartum depression and what to do about it.
Maggie McKay (Host): And to start, what is the difference between baby blues and postpartum depression?
Dr Daniel Finch: Baby Blues is a milder, short-lived, more common form of postpartum mood and anxiety symptoms that can include some sadness, anxiety, or irritability. Abnormalities in your sleeping pattern or eating pattern, but it doesn't reach the degree of being functionally impairing. Postpartum depression on the other hand, is longer lasting. It has to be at least two weeks, and you have more severe symptoms that do cause some sort of functional disability. And some of those symptoms are extreme sadness, a lot of crying, a loss of interest in things, difficulty bonding with the baby.
Not feeling joy about the baby, eating too much or too little, sleeping too much or too little outside of the normal disturbances that come with having a baby. Extreme fatigue, regardless of whether or not you get rest. Difficulty concentrating, pacing, restlessness, worthlessness, guilt, and the most severe case is thoughts of suicide or thoughts of harming the baby. Much more severe than baby blues.
Maggie McKay (Host): Is it a given that all moms get at least baby blues, or is that not the case?
Dr Daniel Finch: Not necessarily, but the prevalence is really high. Somewhere in the area of 70 to 80% of women experience baby blues and the actual number might even be higher because some women may still feel embarrassed about coming forward with symptoms or asking for help, even though it's talked about more openly these days.
Maggie McKay (Host): Is postpartum depression common?
Dr Daniel Finch: Postpartum depression is probably more common than most people think. Prior to Covid, the average prevalence of postpartum depression was one in every seven to eight women, which is already a very high number. But through the pandemic because of all the additional stressors and social isolation, the newer data is suggesting that the number of women with postpartum depression may be closer to one out of every four or five. That's like 20 to 25%. That's a huge number.
Maggie McKay (Host): Can men experience postpartum depression?
Dr Daniel Finch: That's a great question, and I really appreciate that you're asking. Men in the postpartum period because this really wasn't widely researched or spoken about publicly until the last 20 years or so, and this number will also surprise many listeners. It's estimated that one out of every 10 fathers experiences postpartum depression. And again, that number is likely higher because of resistance in coming forward. fear of embarrassment of being seen as weak, of trying to take the focus away from the mom. So it's a very important topic. Does not get talked about even as much as postpartum depression in women, but carries the same disability.
Maggie McKay (Host): Wow. So what causes postpartum depression?
Dr Daniel Finch: While there's no single cause, you can generally break down the contributing factors into three categories, the biological, the psychological, and the social. We call it the bio psychosocial model. So some biological factors are genetic predisposition. For example, if you have a family history of other women in the family with postpartum depression and hormonal changes that happen during and after pregnancy. Some of the psychological factors can include not having healthy coping skills, having a history of trauma such as childhood abuse or intimate partner violence. And the social factors can include food and housing insecurity, financial stress and little or no support from family and friends. And you're at an especially high risk if you have a history of depression in previous pregnancies or even depression prior to pregnancy.
Maggie McKay (Host): Dr. Finch, how long does postpartum depression last typically?
Dr Daniel Finch: So by definition, postpartum depression has to last at least two weeks and generally resolves within one year if proper interventions are taken. But it can last longer, and if not treated at all, it may not go away until the person seeks professional help.
Maggie McKay (Host): A year. Wow. Or longer. I never heard that?
Dr Daniel Finch: Yeah. In the last program I developed for, perinatal mood and anxiety disorders, which is sort of all encompassing of post pharma and pregnancy, depression, anxiety, and other disorders, we actually redefined that year and extended it out to two years because what we've seen is. The stresses don't magically go away even a year, right? Your baby becomes an infant, becomes a toddler, becomes new stresses So we actually redefined the normally accepted timeframes, which for primary care, maybe six months for psychiatry, maybe a year. And I've really expanded that out to two years.
Maggie McKay (Host): Wow. Yeah, it seems like the stresses actually just pile on. they don't get less. That's what I experienced. But how is it diagnosed?
Dr Daniel Finch: So your primary care doctor or your obstetrician may use a screening tool such as the Edinburg Postpartum Scale, or a PHQ nine. These are just standardized sets of questions that can identify somebody at being at risk for postpartum depression and need further evaluation by a professional. So I really appreciate when I get a new patient coming to me who's an advocate for themselves and says, Hey, how do you doctors decide who's depressed and who's just sad. Because this is something that I automatically teach my patients, every one of them.
But many of them don't know. The actual diagnosis is defined in a pretty much universal textbook called the DSM five, the Diagnostic and Statistical Manual around version five, and this is where the criteria that I spoke of earlier, the two weeks. five of those symptoms of sleep appetite, energy fatigue, concentration, is clearly written out. And so there's an objective measure of how we diagnose it.
Maggie McKay (Host): And then how do you treat it?
Dr Daniel Finch: Mild forms of postpartum depression can be treated with things like healthy lifestyle changes, diet and exercise, increase social support. Very often, even mild forms benefit from psychotherapy or talk therapy with a professional clinician. When you get to a moderate or severe postpartum depression, this at least requires the help of a therapist and really should be evaluated by a psychiatrist to at least have a discussion with the patient about what medications are available, what they do, what they don't do. What are the side effects and to dispel any misconceptions about these medications that, people may have coming into it, because they're actually very helpful and generally very well tolerated and safe.
Maggie McKay (Host): You touched on it a little bit, but what is the prognosis?
Dr Daniel Finch: So baby blues by definition, goes into remission generally without intervention or much intervention within two weeks, but there's a possibility that it can turn into postpartum depression and postpartum depression can be prolonged and more severe without proper intervention. Some studies have suggested that at least 20% of women with postpartum depression who go untreated will still be symptomatic at one year after birth.
Maggie McKay (Host): Dr. Finch, if you have postpartum with one child, will you have it with all your children automatically?
Dr Daniel Finch: Not automatically, but after one episode of postpartum depression, the risk is quite high. In the area of 50% or greater chance of having another postpartum depression episode with a second pregnancy if you've had it with the first. So it's really vital that you inform your doctors of your history and consider starting at least with a therapist even before you have symptoms in the second pregnancy, to establish that therapeutic relationship and build up those healthy coping skills just in case it does happen again.
Maggie McKay (Host): Is it unhealthy or dangerous for the baby?
Dr Daniel Finch: Yes, it can be during pregnancy. The risk of untreated postpartum depression, can include things like the baby being born smaller or earlier. Once the baby's born, it may not feed or sleep as well. There is an increased risk of admission to the neonatal ICU. With untreated postpartum depression, so very serious complications. and then after pregnancy, postpartum depression can affect a woman's ability to bond with the baby, which can affect its neurological development and her ability to breastfeed, which may impact the development of the baby's immune system.
Maggie McKay (Host): That's a lot. Dr. Finch, is there a way to prevent postpartum depression? The big question.
Dr Daniel Finch: I think prevent is a strong word. The words that I use are mitigate risk or lower risk. So in order to lower your risk of developing postpartum depression, you first have to be knowledgeable and that's really why we're sitting here today. This is what we're doing, informing people about what the signs and symptoms. Encouraging and reassuring, comforting people to be willing to ask for help. To help them learn where to get help and to avoid unhealthy coping behaviors like excessive alcohol, smoking, drug use, and to really proactively seek out a support system, whether it be friends or family or other moms and dads in support groups.
Maggie McKay (Host): Can it ever go away on its own? Let's say you don't get treated and you say, oh, it'll go away. Does that ever happen?
Dr Daniel Finch: Now untreated postpartum depression. As I said, some studies show approximately a 20% or more likelihood that the woman will still have residual symptoms, one year after giving birth.
Maggie McKay (Host): So most likely it does not go away on its own.
Dr Daniel Finch: I wouldn't take the chance. like I said, the risk factors to mom and baby are so high that, hopefully we've come to a society that's more understanding, less stigmatizing. You don't automatically need medications. You can go and talk to someone, a therapist, or a psychiatrist, and if you may need medications, nothing's ever forced on you. It's a discussion to be informed of what the benefits are, the risks and the alternatives.
Maggie McKay (Host): Are there some women who are more at risk than others?
Dr Daniel Finch: Yes. Women who give birth in their teenage years we know are at higher risk for developing postpartum depression. As are women who struggle with housing and food insecurity, those that have a history of depression or other mental health issues. Women who give birth to a preterm baby. Baby that's born early. Or one that needs to stay in the neonatal ICU after birth. And, also at risk are women with a history of trauma or drug and alcohol abuse among other risk factors.
Maggie McKay (Host): And when it comes to postpartum depression, is that the same as postpartum anxiety?
Dr Daniel Finch: They're not exactly the same, but they're kinda like two sides of the same coin with, a very high comorbidity. Someone with a primary depressive disorder is likely to have some symptoms of anxiety, and someone with a primary anxiety disorder is likely to have some symptoms of depression. And there's a lot of overlapping symptoms like poor sleep, poor appetite, fatigue, a loss joy and interest in things, etcetera. But anxiety is usually related more to that excessive worry, the ruminating or racing thoughts, panic attacks, which are a very physical manifestation of anxiety, short of breath, shaky, tremulous, and a lot of checking behaviors.
So checking on the baby excessively in the middle of the night to make sure they're still breathing or worrying more than average. Most women worry that something's gonna happen or that they're doing something wrong, but really excessively sort of constantly worrying to the point where your quality of life is impacted, your functionality is impact.
Maggie McKay (Host): We talked a little bit about how to treat postpartum depression. How do you treat postpartum anxiety? If you think you're suffering from either, what should you do?
Dr Daniel Finch: Yeah, very similar principles to postpartum depression. So, really focusing on improving self care, increasing your support system as much as you can. Good diet and exercise, healthy coping skills, maybe getting into talk therapy and medications can be very helpful for this in many cases. And if you even think that you might be having some postpartum depression or anxiety, but you're not sure, just ask your doctor for more information.
Maggie McKay (Host): And you talked about medication. Not everybody has to take it, but you can and it can be helpful in some situations. But what about, if you are breastfeeding, is the medication for postpartum depression and postpartum anxiety safe?
Dr Daniel Finch: This is something a lot of women rightfully are concerned about. Not all medications are the same. Some are found in very little or no amounts in the breast milk, and it's important to remember that untreated postpartum depression and anxiety by themselves, can carry risks for you and your baby. So they both may have some risks, but not treating It definitely has risks and it's a very important concept to remember. And so it's a conversation you really have to have with a doctor and try not to go hunting online for those answers or taking a poll from friends and family. Just, just talk to your doctor. They have the training and expertise.
Maggie McKay (Host): And what if someone gets pregnant again while they're on medication for postpartum? Same thing. Just ask your doctor.
Dr Daniel Finch: You find the answer to a lot of this is ask your doctor. and hopefully you have a doctor that you feel comfortable enough to ask, and I think that, sometimes. There's a perception that we're not comfortable, but most of us are. If you do get pregnant, while you're on a medication, it probably means you've needed the medication. And if you need the medication to control depression or anxiety symptoms. Coming off the medication can often be a higher risk than staying on the medication through pregnancy because again, the untreated anxiety depression are very risky for both mom and baby. And there are certainly medications that are considered relatively low risk in pregnancy compared to, being untreated and very symptom.
Maggie McKay (Host): Tell us about support groups for postpartum depression. What are they like?
Dr Daniel Finch: Support groups are amazing. I get a lot of women and dads remember who are apprehensive about going to a support group because they've never tried it before. It's people they don't know. They don't know what to expect. So this is a very important question and I make sure to go through this with everyone of my patients as a treatment option. They're often moderated by a professional who kind of helps guide the group. And it tends to be a group of, women or dads that are going through similar things. There's no contract.
You're not forced to stay in the group. If you go to a few sessions and you really feel like it's kind of triggering more symptoms than helping, you can leave with no obligation. Some are covered by insurance and many will offer a sliding. based on your ability to pay. So it's a treatment source that, like I said, I make all of my, moms and dads aware of. And most of the people that are apprehensive at first come back and they tell me, thank you for recommending that. I went and I realize that that's actually really helpful to have people that are going through the same things. It's a different type of help.
Maggie McKay (Host): And are there other resources that people can learn about postpartum depression as well as postpartum anxiety?
Dr Daniel Finch: There definitely are. My favorite, if I had to pick one, is Postpartum Support International. It's one of the most amazing organizations and resources, and you can find it online at www.Postpartum.net. Lots of great informational and, treatment resources, all in one place and you know, more locally, depending on where you are. There's organizations like one by me called the Partnership from Maternal and Child's Health of Northern New Jersey, and there's similar organizations probably near where you live. And again, the universal answer really is ask your doctor.
Maggie McKay (Host): Yes, definitely. I think that's worth, repeating because early on when we were talking, you said about, if you don't know if you have it, ask your doctor. I remember when I was in the hospital. I don't know if they still do this, because it was, yeah, a lot of years ago, but before they would release you, you had to fill out a whole questionnaire about postpartum and if you answered too many, I think they might have evaluated you or. I don't know, kept you in, but I just wanna get home. So I said, no, no, no, no, no to all of them. And my husband's like, be honest, that's what they're here for. Because once you leave here, and I was stubborn and I didn't, and I should have, but I really didn't think I had it. But I didn't know, so I should have asked somebody. Right?
Dr Daniel Finch: Yeah. And you're at a very vulnerable time right after birth, right? You're just overwhelmed, you're exhausted. The hospitals do, often, most hospitals administer a screening tool, as I talked about, and you probably took an Edinburg postpartum depression scale, and women will look at it and kind of obvious, what they're looking for. I think to most women, and many get scared, they immediately go to worst case scenario. They're gonna not let me take the baby home. They're gonna take the baby away because that's a kind of understandable, especially in that state of, stress and anxiety.
And I just wanna get home and take care of the baby. And especially if it's the first baby, I don't know what the heck I'm doing. And what's gonna happen if I answer truthfully, But the truth is that the whole point of that is to catch it early, to really get it early because early intervention improves prognosis significantly. But those screening tools also aren't perfect right after birth because sometimes the symptoms can have a delayed onset. They can start days, weeks, or even months after giving birth, depending on the situation at home. So it's important to keep that conversation going with your doctors.
Maggie McKay (Host): Good advice. Thank you so much Dr. Finch, for helping us understand postpartum depression and anxiety. I have never even heard of postpartum anxiety before this, so thanks for helping us understand it better and what to look out for, should we need to be treated for it. We appreciate you being here so much and sharing your knowledge with us.
Dr Daniel Finch: Thank you for helping me get that knowledge out to the people that need it.
Maggie McKay (Host): Absolutely. If at any point you have thoughts of harming yourself or your baby, call 911 to immediately seek. If you found this podcast helpful, please share it on your social channels. And for more topics of interest to you, check out our entire library of podcasts. Thanks for listening to Conversations Like No Other presented by Valley Health System in Ridgewood, New Jersey. For more information on today's topic, or to be connected with today's guest, please call 201-291-6090 or email This email address is being protected from spambots. You need JavaScript enabled to view it. . I'm Maggie McKay. Be well.