Counseling urged to prevent depression in at-risk new moms

WASHINGTON—Doctors already are supposed to screen new mothers for depression, to find those who need prompt care. Now they’re also being urged to identify women at risk — because counseling could prevent depression from setting in.

Up to 1 in 7 women experience what’s called perinatal depression, depression during pregnancy or after childbirth, according to the U.S. Preventive Services Task Force. More serious than the “baby blues,” it can leave mothers feeling intense sadness, anxiety and worthlessness, drained of energy and unable to bond with their baby. In severe cases, they may think about harming themselves or their baby.

The task force Tuesday issued a new recommendation that doctors shouldn’t wait until women already are depressed to act.

It found evidence that two types of counseling could help women at risk of the serious mood disorder, whether they’re pregnant or have given birth within the past year. Cognitive behavioral therapy teaches people to manage negative thoughts, while interpersonal therapy focuses on improving relationship problems that contribute to depression. The counseling can be done one-on-one or in group settings.

How to tell who’s at risk? The task force found wide-ranging risk factors including previous depression or depression in the family; physical or sexual abuse; an unplanned or unwanted pregnancy; and demographic factors such as low income or teen pregnancy.

The recommendation was published in the Journal of the American Medical Association.

An accompanying editorial cautions that most women won’t have easy access to specialists and may need options such as counseling via smartphone. And health providers will need to act quickly if counseling doesn’t help and depression strikes.

Despite the challenges, the recommendations “have the potential to improve many lives,” wrote Dr. Marlene Freeman, a psychiatrist at Massachusetts General Hospital, who wasn’t involved with the task force.