Medical Rounds with Art Guerra APRN, BC

Art Guerra APRN, BC, is Director of Residential and Adult Outpatient services at the Institute Of Living.

The U.S. Preventative Services Task Force recently announced guidelines for physicians to screen all adults, especially pregnant women and new mothers for depression. The Peri-Partum Mood Disorders Program at the Institute of Living at Hartford Hospital is a specialized program that is already performing these screenings to address the needs of moms that may suffer from anxiety, depression or other mental health issues.



Q. TELL US ABOUT THE PERIPARTUM MOOD DISORDERS PROGRAM AT THE IOL

A. Since the fall of 2015, the Adult Outpatient program started a program to address the needs of moms that may suffer from anxiety, depression or other mental health problems. It is an idea that came from our collaboration with OB-GYN’s at Hartford Hospital and has received financial support from the Hartford Foundation for Public Giving. This program is now open to the public.

The program fills a void in the Hartford area. Certain agencies like Ct. Postpartum Support International have been integral in getting support, warm line and therapy services set up for our State. Hartford Hospital and the Institute of Living felt that having a dedicated service was important; we can help with evaluation, medication management (if needed) and group therapy to assess for attachment difficulties between mother (and father) and child.

Q. WHO IS AT RISK AND WHAT ARE THE TREATMENTS?

A. The World Health Organization quotes in developed countries; 10% of pregnant women and 13% of women after childbirth experience a mental health problem. That number rises in underdeveloped countries to 15.6% and 19.8% respectively.
Moms (and Dads) who have had a previous history of depression (or other mental illness), family history of depression, significant family stress either with a spouse or financial problems are at increased risk. For some, there can be a hormonal connection. But, any mother can be affected.

We offer Talk Therapy including, Interpersonal Therapy and Cognitive Behavioral therapy, groups that help with support or skill building can be effective. For some, medication is needed.
This is the niche that we focused on at the IOL. Treatments are decided based on the severity, frequency and duration of symptoms. Obviously, more severe symptoms need to be addressed with medication.

Q. WHAT IS THE IMPACT OF UNTREATED DEPRESSION OR OTHER FORMS OF MENTAL ILLNESS ON MOTHERS AND BABIES?

A. The impact of untreated depressive or anxiety disorders during pregnancy can be quite problematic having a long-lasting impact on the fetus growth and development.
Maternal stress can cause increased level of stress hormones that could impact cognitive development, level of anxiety in the infant. Poor prenatal care or alcohol/drug use in the mom can develop.

It can also lead to an interruption of bonding and attachment that we are trying to address with interventions such as parenting groups at the IOL.

Q. DO MOMS (AND DADS) GET MANY MIXED MESSAGES AROUND PREGNANCY, POST-PREGNANCY AND THEIR MENTAL HEALTH NEEDS?

A. In talking with professionals and patients across the state, one consistent theme is the idealistic expectations we might have of both pregnancy and motherhood.

A theme of joy: those around a mom saying, “How lucky you are and how happy you must be.” This can be invalidating for a depressed mom and can silence her from asking for help.

Quoting a survivor of a serious depression post-partum; “It doesn’t become real until you have it. Then it becomes overwhelming.” Husbands can say, “This isn’t my wife.”

Untreated mental health issues during pregnancy and post-pregnancy can have a significant impact on the child, mom and entire family system. All components may need some level of support or treatment.


For more information

For more information contact the Peripartum Mood Disorders Program at the IOL at 860.545.7104.

Website: https://hartfordhospital.org/services/womens-health-services/departments-services/behavioral-health-services/postpartum-depression


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