A Report From PSI’s Annual Conference

Experts emphasize need to treat PMADs as medical condition

I am just back from Postpartum Support International's 27th annual conference, cohosted by North Carolina's National Alliance on Mental Illness and the University of North Carolina's (UNC) Center for Women's Mood Disorders. Held on the campus of UNC at Chapel Hill, the attendees included researchers, clinicians, community advocates, and survivors of perinatal mood and anxiety disorders (PMADs).

The conference program and participants were diverse. With five keynote lectures and more than 20 breakout groups to choose from, the program explored PMAD epidemiology, reviewed the best practices in treatment, and highlighted successful community-organizing strategies. Each participant picked training sessions that focused on his or her interests. As a clinician, I chose groups on the etiology (causes) of PMAD and those exploring the effectiveness of different psychotherapeutic and psychopharmacological treatments.

The keynote speaker, David Rubinow, MD, chair of the department of psychiatry at UNC at Chapel Hill and former clinical director at the National Institute of Mental Health, has researched the relationship between reproductive hormones and mood disorders for decades. His lecture – along with talks by Kelly Brogan, MD, and Healy Smith, MD – emphasized the biological factors that underlie PMADs. These talks reinforced that PMADs are medical conditions, and that providers are, as Dr. Rubinow stated, "obligated" to treat them with as much seriousness and care as conditions like diabetes and asthma.   

One of my favorite breakout groups was led by Crystal Edler Schiller, PhDNoreen Esposito, EdD, and Anna Brandon, PhD. It included live demonstrations of three evidence-based psychotherapy styles for treating women with PMADs. 

Dr. Schiller demonstrated Acceptance and Commitment Therapy (ACT), a technique that merges mindfulness-based acceptance with behavioral goals tied to clients' individual values. Dr. Esposito demonstrated Dialectical Behavior Therapy (DBT), which focuses on building clients' capacity for emotional regulation and self care. Dr. Brandon demonstrated Interpersonal Psychotherapy (IPT), a protocol that focuses on helping clients build healthy, supportive relationships with others. It was a treat to watch master clinicians in action, but the biggest takeaway for me was that there isn't just oneright way to treat PMADs. 

Of course, therapists who treat PMADs must have specialized training, but there are a variety of effective psychotherapy techniques. What matters most is that a therapist's style is a good match for the client's personality and goals. This session reinforced for me how proud I am to work at Seleni, where our clinical team's diverse backgrounds and theoretical orientations allow us to provide client-centered care that is truly individualized. 

Overall, the conference bridged gaps between survivors' lived experiences, hard science, treatment options, and public policy. It highlighted that we all – researchers, clinicians, community advocates, and survivors – have work to do to improve care for women and families. But it reassured me that, together, we can do it.