New mothers should be screened for depression


The following editorial appeared in the Pittsburgh Post-Gazette on Thursday, Jan. 28:

“You must be so happy.”

It is a heartfelt expression of joy that is commonly uttered to a new mother. But imagine how that expression might sound to a woman who is silently suffering following the birth of a child, feeling frightened or anxious or puzzled or overwhelmed. You must be so happy … or there’s something wrong with you.

Experts estimate that as many as 1 in 7 women suffer from postpartum depression, even though it far too often is dismissed as “the blues,” a mere mood rather than the debilitating illness that it is.

The U.S. Preventive Services Task Force, an independent, volunteer panel of national experts in prevention and evidence-based medicine, takes the topic of depression very seriously. The panel on Tuesday renewed its call for widespread screening for depression among adults, and for the first time it specifically recommended evaluations for pregnant women and new mothers. This is a necessary and welcome component of women’s health care.

The recommendations are not onerous. The panel said any medical practice, whether a gynecologist or primary care doctor or someone else, can screen a patient. The group recommends using the Edinburgh Postnatal Depression Scale, a simple, 10-question survey that asks patients to check descriptions that best describe their feelings. For instance, it asks if the patient, in the past seven days, has “been able to laugh and see the funny side of things (1) as much as I always could; (2) not quite so much now; (3) definitely not so much now; or (4) not at all.

If treatment is necessary, it can be as varied as the patients themselves, although the report noted that cognitive behavioral therapy was helpful but some antidepressants can be harmful to the child during pregnancy or breast-feeding.

Depression is an illness as real and debilitating as a broken leg or an infection. It requires treatment, and simply waiting in the hope that symptoms will subside is dangerous. This knowledgeable panel of experts has provided a green light for doctors to broach the topic with their patients.

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