What Research Says About Perinatal Depression Screening and Treatment

Professional treatment helps and women should be supported in seeking it

by Christiane Manzella, PhD
February 1, 2016

A few days ago the US Preventive Services Task Force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, recommended that all adults, including pregnant and postpartum women, be screened for depression.

The Task Force concluded that “evidence suggested that programs to screen pregnant and postpartum women, with or without additional treatment-related supports, reduced the prevalence of depression and increased remission or treatment response.”

That same day, spiritual self-help author Marianne Williamson posted the following status on her Facebook page:

While hormonal shifts after pregnancy are normal and the distress and mood swings they often trigger can be normal, anxiety and acute distress can also be signs of a developing and potentially serious mental illness such as a perinatal mood and anxiety disorder or, more rarely, postpartum psychosis. While meditation, prayer, nutritional, and social support can be helpful to a pregnant or postpartum woman, these are not evidence-based treatments for perinatal mood and anxiety disorders. Women should always check with a healthcare provider if their distress or mood changes are severe or do not improve after two weeks postpartum.

Perinatal mood and anxiety disorders encompass real illnesses — as real as diabetes or cancer. These disorders must be treated as such, and people at risk need to be screened as they would for any other disease for which they are at risk. We know that pregnant or postpartum women—with or without a history of mental illness—are at risk for perinatal mood and anxiety disorders, which is why the Task Force is making this important recommendation. We also know that, with effective treatment, they will recover.

An effective treatment for depression is talk therapy, and when necessary, therapy in combination with antidepressants. This combination is often recommended because it has been found to be most effective.

Each person’s treatment is unique and is best a collaborative effort between an individual and his or her mental health provider. Medication has helped many women, has saved lives, and has been the right treatment for many women. As such, we must support each woman’s choice to make the best decision for herself and her child, in consultation with a qualified mental health professional.

This recommendation from the USPSTF is one that we at the Seleni Institute are thrilled to see; many women are not getting the treatment they need because they are not being asked how they are doing and are not being referred to appropriate professional help. Screening can help a woman get the treatment she needs and deserves.

There is already a stigma to asking for professional help for mental health concerns. Giving broad suggestions for treatment without recognizing what is specifically needed for each person can be dangerous; if a woman is struggling, encourage her to seek out qualified professional support.

To our fellow maternal mental health advocates, thank you for your dedication to getting the word out about effective treatments for perinatal mood and anxiety disorders. We truly appreciate the bravery you demonstrate in sharing your stories so other women do not feel alone. And, to each woman who suffers, we want you to know that there are treatments that work and that will help you feel like yourself again.

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Christiane Manzella, PhD

Christiane Manzella, PhD, has been a therapist and grief counselor in New York City for more than 20 years. Dr. Manzella earned both her master's degree in clinical psychology and doctorate in counseling psychology from New York University and carried out her doctoral dissertation research at Beth Israel Medical Center hospice, with postdoctoral supervision in grief and bereavement work. She was named a Fellow in Thanatology: Death, Dying and Bereavement, awarded from the Association of Death Educators and Counselors (ADEC), and is completing the third year of a three-year term on their Board. 

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