The important role GPs have to play in helping women with perinatal depression
Perinatal depression (PND) is very common, affecting 1 in 7 new mums. Dr Stephen Carbone discusses the crucial role GPs have to play in identifying PND in mothers, in educating parents and in assisting those who experience PND.
Our baby girl arrived at a stressful time in our lives – my husband and I had just started new jobs and we had taken out a new mortgage. About six weeks after my daughter was born, I found myself in the shower one morning sobbing relentlessly after my husband had gone to work. I was thinking desperately of ways to take my life. I was having trouble sleeping, experiencing constant thoughts about how I was not a good mum, and seemed to think everyone else’s baby was happier, brighter, generally better off than mine. I felt that my new little family would be better off without me. My family didn’t really pick up on this as I put on a very good face of being the doting mum when they were around. But when they were not, I fell apart.
I knew something wasn’t right. I rang my GP at the time and to this day, I am so incredibly grateful for the compassion, care and medical attention I received from everyone in his practice, from the receptionist to his practice nurse who never let me out of her sight until my parents and husband arrived. I was hospitalised for several days, along with my daughter, whom I was encouraged to continue to care for, despite my state of mind, in order to maintain our bond. I had my first experience of medication and psychiatric care during this time. I feel lucky to have been surrounded by such support.
For GPs, helping women with PND is not only professionally fulfilling, it can be potentially life-saving.
For many parents, reaching out is the hardest thing. In this case, Natalie made the first move and asked for help. Many others in her position do not, often because they are experiencing feelings of embarrassment, shame or guilt. Proactive screening and assessment is sometimes the only way to uncover PND. GPs have a crucial role to play in identifying PND in mothers, in educating parents about this condition and in assisting those who experience PND.
In the pre-conception and antenatal phase, GPs can help by giving expectant parents all the information they need about the journey ahead, including a reminder to stay mindful of their mental wellbeing as they care for their new baby. In that first year after birth, the perinatal period, screening for PND should be routine. GPs should introduce the issue, ask the patient to complete a screening measure (such as the Edinburgh Postnatal Depression Scale), conduct a thorough psychosocial assessment that aligns with relevant guidelines, organise appropriate psychological and medical treatment and point women and their partners towards support services such as PANDA for further information and practical and social support.
GPs can refer patients to beyondblue’s Healthy Families website for information and advice. For GPs, helping women with PND is not only professionally fulfilling, it can be potentially life-saving. Just ask Natalie.
Dr Stephen Carbone
Dr Stephen Carbone is beyondblue’s Research and Evaluation Leader where he is working with others to find ways to promote mental wellbeing, prevent depression, anxiety and suicide and ensure people affected with these mental health conditions have the opportunity to get the supports and services that are right for them - at the right time.. He is a former GP with over three decades’ experience in mental health.