The United States Preventative Services Task Force—an influential panel of experts in primary care and preventative medicine—recommended on Tuesday that women should be screened for depression during and after pregnancy, the New York Times reports.
Although studies suggest, as previously reported by the Times, that at least one in eight women develop symptoms of symptoms of depression, anxiety, bipolar disorder, and/or obsessive-compulsive disorder in the first year after giving birth (in a large 2013 study, a third who screened positively began to exhibit symptoms during pregnancy), this is the first time the panel has specifically recognized pregnant women and new moms in their depression screening guidelines.
The announcement follows similar recommendations in 2002 and 2009. What’s new this time is the special shout-out for pregnant women and new moms. They need special recognition, the task force says, because of evidence showing that they can be accurately diagnosed and successfully treated, and because untreated depression harms not only the mother but her child as well.
The New York Times reports that the panel gave its recommendation a “B” rating, meaning screenings must be covered under the Affordable Care Act; the panel underlined the Edinburgh Postnatal Depression Scale, a 10-question survey, as an effective screening method, and cognitive behavioral therapy as a useful treatment.
A story published last May in the New York Times Magazine highlighted the desperate situation faced by many pregnant women who previously relied on antidepressants. There is no steady consensus on the dangers of taking meds while pregnant weighed against the dangers of being extremely depressed while pregnant, but, as Andrew Solomon wrote, “The myth of the pregnant mother who is high on hormones has had considerable staying power.” It’s still hard, even today, to treat depression during pregnancy as something normal.
Beyond simply recommending screenings for women during pregnancy, the panel said that while the use of some antidepressants could cause “potential serious fetal harms,” “the likelihood of these serious harms is low.” According to the Times:
Dr. Pignone also emphasized that “untreated depression has a lot of adverse consequences itself.”
Among them, experts say, are that pregnant women with depression often take poorer care of their prenatal health. And maternal mental illness can affect children, leading to behavioral problems, emotional instability and difficulty in school.
The Times quoted Melissa Mead, 30, who was not screened for depression during or after pregnancy and experienced postpartum depression, anxiety, and O.C.D.; “I didn’t know what it was,” she said.
Ms. Mead cried constantly, barely slept, rarely left home and was “scared to death that my baby was going to suffocate,” she said. At her job as an optician, she said that people asked, “‘Isn’t everything so wonderful?’ and I was like ‘I kind of feel like dying on the inside,’ and you don’t want to say that because you’re afraid what people will think of you.”
After a year, she saw a psychiatrist for talk therapy. When her second son, Emmett, was born, and she had more symptoms, including fearing that she would stab herself with a kitchen knife, Ms. Mead tried several medications until one worked.
While New Jersey is currently the only state that requires screening—to mixed results, the Times reports, because of few treatment options and a lack of compensation for those conducting the screening—New York City mayor Bill de Blasio set a goal in November of providing universal screening for pregnant women and new mothers; in addition, legislation introduced in Congress in July would allow the government to fund treatment during and post-pregnancy.
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