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Perinatal mental health

Symptom Reduction and Deeper Transformation

If becoming pregnant, having a baby, or adopting has left you feeling constantly anxious, sleepless, irritable, angry, and tearful even when you think you “should” feel happy, you may be suffering from symptoms of pregnancy or postpartum depression without necessarily feeling “depressed”. In fact, these symptoms fall into a category called “Perinatal mood and anxiety disorders” meaning conception through the first year after birth, and can be far from what we think of as “Postpartum depression”. They apply to adoptive parents, same sex couples, and are seen in much higher rates in transgender parents and people of color. (See my signs and symptoms tab for more info on different conditions) Rage, insomnia, constant worries, and even scary thoughts are common for around a quarter of all birthing people in the first year after adding a new baby to the family. Because most parents with perinatal mood and anxiety disorders are able to take great care of their children and will feel more anxious and irritable than sad, these serious conditions are easy to dismiss. However, the cost of not getting support is high for the entire family.

Postpartum Depression and Anxiety Resources​

Structured and Solution Focused

Symptoms of PTSD are present for an equal number of birthing people following childbirth and affect partners who witness the birth as well. Parents who don’t seek help early on may feel not like themselves for months or years. I am certified in Perinatal Mental Health (PMH-C) by Postpartum Support International. My approach is structured, solution-focused and individualized to help you feel better as quickly as possible. I have worked with hundreds of “postpartum couples” and have witnessed partnerships strengthened, energy restored, and the experience of parenting enjoyed once again, or perhaps for the first time over and over again. There is hope. You will feel like yourself again! My expertise in perinatal mental health also includes working with those facing traumatic birth, a NICU babybi-polar disorder, adoption, miscarriageinfant loss, and abortion. For an expert in infertility or third-party reproduction, please see the Utah Infertility Resource Center’s website.

My approach is structured, solution-focused and individualized to help you feel better as quickly as possible.

i look forward to working with you

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My practice has moved to telemedicine for the foreseeable future. When you become a client, I send a link to my hippa-compliant virtual office. All sessions are currently available via Telehealth only through Doxyme, Facetime, or phone call.

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Fees & Policies

Fees

50-Minute Session – Individuals: $150

50-Minute Session – Couples: $175

I am no longer paneled with insurance companies but can offer you a superbill to submit for out of network reimbursement. HSA cards accepted.

Policies

CANCELLATION POLICY.   Please give 24 hours (1 working day) notice of cancellation. For Monday appointments, cancellations must occur on the prior Friday. For less than 24 hours notice, the full cost of the visit will be charged to you credit card on file.

URGENT NEEDS.  If you feel you are in crisis, you can leave a message on my voicemail and expect a return call, in most cases, within 24-48 business hours.  If your emergency is so acute that waiting for a response is not appropriate, please call 911 or go to the nearest Emergency Department.  UNI Crisis Service can also be reached 24/7 at (801) 583-2500.

EMAIL & PRIVACY.  Client information will not be shared, sold or otherwise disclosed to any other party except as requested by the client in writing. The law protects the relationship between a client and therapist with the exception of the following situations:

  • Suspected child abuse or dependent adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
  • If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
  • If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in insuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.
  • Therapists are required by law to report incidences of sexual misconduct on the part of other therapists.
  • Additionally, I may consult with my clinical supervisor and/or consultation group without disclosing any identifiable information.
  • I abide by HIPAA practice standards.

There are limits to protecting your confidentiality over the internet.  Please consider the information you submit over the internet prior to sending.  Please do not use email or “contact us” form to send messages of a personal or confidential nature. Even though I do my best to keep my email confidential, email is copied, archived, and retransmitted continuously as part of normal processing. Because of this, please use email only to request information about my services, or other non-confidential matters.

There are several ways you can communicate with me without having to send information over the Internet: in person, by phone, fax or mail.

Email and texting is intended in my practice for administrative purposes i.e. changing appointment times, contacting me to request an appointment, or confirm appointment times. Please recognize that email or texting is not completely secure or confidential. If you choose to communicate via email, be aware that emails are retained in the logs of internet service providers. While it is unlikely that someone will be looking at these logs, they are in theory available to be read by the system administrator(s) of the internet service provider. Please be aware that any emails received or sent can become part of the legal record.

Perinatal Depression/Anxiety

Treatment Options

Thyroid Tests 

About 10% of women will have thyroiditis during the postpartum period. Thyroid disorders can cause anxiety and depression. In order to rule out thyroiditis, a thyroid test (free T4, TSH, anti-TPO, anti-thyroglobulin) is recommended after six months postpartum if the woman is experiencing symptoms of depression or anxiety.

Lowering Inflammation: Key approaches 

Recent research has linked PPD/anxiety and other perinatal illnesses with increased levels of inflammation in the body. Inflammation levels generally rise at the end of pregnancy and chronic stress before, during, or after pregnancy can significantly increase inflammation leading to symptoms of depression and anxiety. The below treatments, including psychotropic medication, help to lower inflammation levels. 

Nutrition 

Deficiencies in major vitamins and minerals can cause symptoms of depression and anxiety. Continuing to take a high-quality food-based prenatal vitamin can help rule out this potential underlying cause. Ask your healthcare provider to test your vitamin D levels as low levels of this hormone can greatly influence mood. Omega-3 fatty acids have been shown to prevent and treat mild to moderate depression and anxiety in perinatal women at a dosage of 1000-3000mg combined DHA and EPA, and are considered safe for nursing. Some practitioners may recommend up to 9000mg depending on severity. They can be used along with psychotropic medications safely. 

Support Groups 

Social support in various forms has been shown to both prevent and mitigate the symptoms of PPD/anxiety. PPD support groups usually offer education and resources on her symptoms or mood disorders and often friendships formed in these support groups last for a long time. Usually babies are welcome in these groups. For a list of nationwide support groups contact Postpartum Support International at www.postpartum.net or 805-967-7636. 

Psychotherapy 

It is very important that a mother with symptoms of perinatal mood or anxiety disorders seek treatment from a therapist who specializes in treating pregnant and postpartum women or who is willing to get educated about these issues. A therapist who is well connected to the perinatal professional community should be a member of one of the major organizations that serve perinatal women, such as Postpartum Support International (www.postpartum.net or 805-967-7636). Postpartum depression is different from other types of depression. In fact, the term “Postpartum Depression” is used very loosely to also include postpartum anxiety, panic disorder (panic attacks), posttraumatic stress disorder (PTSD), and postpartum OCD (obsessive-compulsive disorder). The postpartum mother should ask the therapist what type of therapy the person would use. Research has shown that cognitive-behavioral and interpersonal psychotherapies are the most effective modalities to treat postpartum depression. 

Recent research also supports the use of acupuncture, bright light therapy, and yoga as effective treatments of mild to moderate depression in pregnant and postpartum women. St. John’s Wort, has been shown to be effective in treating mild to moderate symptoms in postpartum women but warrants further research on safety during pregnancy. Other approaches include amino acid therapy. Both 5-HTP and SAM-E are evidenced based treatments for depression and anxiety and do not require a prescription. Like many anti-depressants, they have not been well studied in nursing women. Ask your healthcare provider for more information. Postpartum doula care, exercise, massage, homeopathic remedies, chiropractic, hypnotherapy, and nutritional support are all being studied for effectiveness in prevention and treatment and are often helpful options for women to consider as they tailor a treatment plan unique to them. Women should always check with their healthcare provider for safety, as some herbs and illegal drugs can cause serious damage to both mother and infant. Often alternative therapies can complement counseling and/or medication when provided by a licensed healthcare professional.   

Postpartum Depression / Anxiety

Signs and Symptoms

This pages shares common emotional health reactions during pregnancy, the first year postpartum, and for those with a pregnancy loss, who have adopted, and women dealing with fertility challenges. The following can also be signs of Post-abortion Stress Syndrome or “PASS” as well.

Your emotional health during this time is extremely important. Below is a list of distressing emotional reactions that 1 in 5 women will experience during pregnancy and the first year after childbirth/adoption, infertility, miscarriage or loss. If any of these apply to you, please know that with proper support and early detection, most women can begin to feel better rapidly and more fully enjoy their lives, relationships, and the experience of parenting.

  • Baby Blues– Signs include weepiness, irritability, feeling overwhelmed and exhausted. Resolves or dramatically improves the first three weeks after childbirth. Up to 80% of women will experience the baby blues.
  • Depression/ Anxiety – Symptoms include feeling anxious, agitated, sleeping too much or difficulty “sleeping when the baby sleeps”, excessive worrying, tearfulness, irritability, anger, guilt & shame, feeling disconnected from your family and/or baby, appetite changes, difficulty concentrating, and possible thoughts of harming the baby or yourself. (10-25%)
  • Panic – Signs include feeling worried, anxious or very nervous most of the time. Recurring panic attacks, which include heart palpitations, shortness of breath and/or chest pain, nausea/vomiting or fear of dying. (15%)
  • Posttraumatic Stress Disorder – Can occur during pregnancy or following a childbirth which is perceived as traumatic. Usually involves distressing memories, irritability, difficulty sleeping, nightmares, hyper-vigilance, and efforts to avoid reminders of the trauma. Symptoms may be related to a prior traumatic experience or the birth itself. (3-5%)
  • Obsessive Compulsive Disorder – Symptoms include intrusive and disturbing thoughts and/or images of harm coming to the baby, as well as a sense of horror about having these thoughts. Usually includes a preoccupation with keeping the baby safe through repetitive actions to reduce the fear and obsessions. Women disturbed by these thoughts are very unlikely to ever act on them. (3-5%)
  • Postpartum Psychosis – Usually occurs within the first few days or weeks after birth. Includes having strange beliefs, hallucinations, irritability and agitation, inability to sleep, rapid mood changes, and poor decision-making. Women with psychosis are not disturbed by the nature of their thoughts or find them unusual. Women with psychosis are at significant risk for harming themselves and/or their infants, and need immediate crisis intervention. Occurs in 1-3 per 1000 births (.1-.3%)
  • For women with bi-polar disorder. Women with bi-polar disorder are at a significantly higher risk of experiencing psychosis, particularly if they are not taking medication and are extremely sleep-deprived. It is important to develop a wellness plan with a practitioner familiar with postpartum illnesses. Having adequate support is a must.

If you are experiencing any of the above symptoms, please call to make an appointment, contact your healthcare provider and/or call Postpartum Support International at (800) 944-4PPD (944-4773)  www.postpartum.net. PSI is the largest perinatal support agency in U.S. PSI’s toll-free WarmLine (English & Spanish) serves over 1,000 callers a month and is staffed by a volunteer team of PSI trained responders who rapidly refer callers to appropriate local resources, including emergency services.