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By Jan Jarvis

Bringing home a baby is supposed to be one of the happiest times in a woman’s life.

When it’s not, women often feel as if something is wrong with them, said Shanna Combs, MD, Assistant Professor of Obstetrics and Gynecology at UNT Health Science Center.

“They’re depressed, but women are very good at masking that,” she said.

The U.S. Preventative Service Task Force, a government advisory group made up of national experts in evidence-based medicine, has updated its recommendations on who should be screened for depression to include pregnant and postpartum women, regardless of risk factors.

Screening all women who are pregnant or have given birth is a step toward decreasing the stigma around mental illness. The screenings also must be covered under the Affordable Care Act.

As many as 1-in-7 women shows signs of depression after birth, but they may downplay the symptoms. Dr. Combs said she talks to her patients about depression and gives them a 10-question test that screens for it.

“A lot of the time, they’ll have a smile on their face,” she said. “But when I give them the test, they fail it.”

Patients with depression are usually treated with counseling and medication. But left untreated, depression can harm the baby, as well as the mother.

“When you have a depressed mom, it really affects the development of the child,” Dr. Combs said. “Lack of bonding and attachment can have a lifelong impact.”

Symptoms – including anxiety, frequent crying and obsessional thoughts – often show up within six weeks of the baby’s birth, but not always. Postpartum depression can occur up to a year later.

“For some women, it may not happen until they go back to work or start to wean the baby off breastfeeding,” Dr. Combs said.

Although there is still a stigma associated with depression, the guidelines focus attention on postpartum depression as a medical issue that needs to be screened for, Dr. Combs said.

“It’s a treatable disease, just like high blood pressure,” she said.

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