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Doctors, Therapists, & Moms

Posted By Katharine Sileo, Tuesday, September 30, 2014

9-16% of new mothers experience some form of post-partum depression. As my friends started to have children I noticed how they were changing after childbirth. My first thought was that being a parent is hard and they’re just going through a transition period. However, I started to notice some friends were becoming extremely depressed, displaying OCD like symptoms or expressing hopelessness. I began to wonder why my friends were reacting to this life change so powerfully and why it was going unnoticed.



I started asking questions. The most informative and moving answer I received was “being a new mother is hard, but feeling like you should be happy, and not feeling happy, is even harder.” This conversation sparked my interest in post-partum depression and other perinatal mood disorders.

For many women, childbirth brings about feelings of extreme anxiety, depression and OCD tendencies. When mothers are experiencing these symptoms, they often feel lost and alone. When mothers struggle, the whole family struggles. Under these circumstances children are less likely to form secure attachments, marriages experience more difficulties and men begin to experience similar symptoms of depression and hopelessness.

As a clinician I am interested in the relationship between these symptoms, the tendency to ask for help, and the availability of that help. I explored the relationship between perinatal mood disorders, new mothers and their doctors. I was interested in whether or not the doctors identified their symptoms before they became harder to manage and if doctors were able to assist them in finding help. Beyond this, I was interested in whether or not the doctor and therapist were able to work collaboratively with the mother to discover the most beneficial treatment plan.  

Because of her perinatal mood disorder she experienced postpartum psychosis

To research this I met with a few mothers who experienced postpartum depression and listened to their personal stories. These women differed in many ways, from how many children they had to what post-partum symptoms they experienced. One of the women I had the pleasure of speaking with has four children under eight years old and is a full time working mom. She experienced post-partum depression after all of her children except the first. Her OBGYN suggested that she may be “having a hard time” and began prescribing anti-depressants, with no referral to a therapist. While this was a good catch on the part of the doctor, I wonder what would have happened if she was also referred to therapy. Her last episode of post-partum depression landed her in the UNC inpatient hospital. One of the other mothers that I spoke to reported that, with the help of anti-depressants, but no therapist, she lost custody of her daughter. Her perinatal mood disorder became so severe that she experienced postpartum psychosis and attempted suicide. While we cannot be sure, we can presume that with the help of therapy these women may have experienced different outcomes. I believe that this is evidence for greater collaborative between doctors and therapists. 


My goal in writing this blog post is to not only normalize the concept of postpartum depression and perinatal mood disorders but to inform mothers, fathers, doctors and therapists that there is a need for collaborative care in mental health. Providers can take the first step in officering collaborative care by encouraging their clients to sign releases allowing providers to share information. Ideally, collaborative care teams would consist of therapists, OBGYN’s and primary care doctors or pediatricians. They would collaborate on treatment plans, medication management and any changes that the client is experiencing.  Some barriers to collaborative care are the time that it takes for busy professionals to collaborate, as well as, the fact that many clients may refuse to sign releases allowing doctors to share information.

While there are many positive outcomes to be achieved if collaborative care became standard practice, we are far away from this being the standard. As the arena of mental health continues to gain recognition in the media and reduces its stigma, both patients and clients alike will feel more comfortable with collaborative care techniques.  It is becoming increasingly important to understand mental illness and figure out ways in which we can enhance awareness and help people have access to more resources; collaborative care is a promising first step. 


Katharine Sileo, MA, LMFTA is the co-owner of Mathews & Sileo Therapy Services in Cary, NC. Katharine completed her undergraduate degree in Psychology from North Carolina State University. She graduated at the top of her class from Pfeiffer University and received her Masters Degree in Marriage and Family Therapy. Katharine fell in love with Medical Family Therapy after interning at Duke Cancer Patient Support Program. 


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