Last week, I spent 3 days (October 27-30) at the annual Postpartum Support International conference. This year, it was held in conjunction with the biennial (every 2 year) Marce Society conference, which is traditionally held in the city of the current President of the Marce Society. With the current President of the Marce Society being Katherine Wisner of the Western Psychiatric Institute & Clinic, University of Pittsburgh Medical Center, this year’s conference took place in Pittsburgh.
Past PSI conferences I attended were in Jersey City, NJ and Kansas City, KS. With this year’s conference being held in conjunction with the Marce Society, there were over 400 people in attendance, including leading researchers and experts in postpartum depression (PPD). I was honored to be in the presence of so many individuals who have made such a huge difference on behalf of so many women who have suffered perinatal mood disorders.
Individuals like (note that there are too many to list here, but here are the ones that are most notable to me because I have read their research in the years I have been doing tons of reading on PPD):
- John Cox, DM, FRCPsych, FRCP, who, along with colleagues J.M. Holden and R. Sagovsky, developed the Edinburgh Postnatal Depression Scale (EPDS) in the 1980s. Dr. Cox was awarded the Louis Victor Marce Medal in 1986 for his pioneer research and clinical work in perinatal Psychiatry carried out in Uganda, Scotland and Staffordshire. In 2002 he was elected Secretary General of the World Psychiatric Association.
- Lee Cohen, MD, director of the Perinatal and Reproductive Psychiatry Clinical Research Program within the Clinical Psychopharmacology Unit of the Massachusetts General Hospital, as well as an associate professor of Psychiatry at Harvard Medical School. Dr. Cohen is a national and international leader in the field of women’s mental health, and is widely published with over 200 original research articles and book chapters in the area of perinatal and reproductive psychiatry.
- David Rubinow, MD, Chair of Psychiatry and Professor of Medicine at UNC Chapel Hill. Dr. Rubinow is currently President of the American Neuroendocrine Society and the Society of Biological Psychiatry, has won numerous awards for his research, his clinical supervision and training, and his scientific administration, and serves on the editorial boards of six journals and has authored more than 300 scientific publications.
- Cheryl Tatano Beck, DNSc, CNM, FAAN, is a Distinguished Professor at the University of Connecticut School of Nursing. Dr. Beck serves on the editorial boards of 4 journals and has published over 125 scientific articles as well as 4 books.
I was one of the minority there who was not a mental, medical or public health professional, or social worker. There were 3 other young ladies there who, like me, are simply moms who want to learn more about perinatal mood disorders and find ways to help spread awareness, as well as to advocate on behalf of and provide support to other mothers. These young ladies were Katherine Stone, Lauren Hale and Amber Koter-Puline. This was my 2nd time meeting Katherine and 1st time meeting both Lauren and Amber. This was the first time all 4 of us PPD bloggers were together in one place.
Here we are:
Amber Koter-Puline, Katherine Stone, Lauren Hale, and me
Another highlight of the conference was the appearance of Former First Lady Mr. Rosalynn Carter as the keynote speaker and book signing of the book “WITHIN OUR REACH: Ending the Mental Health Crisis,” which she co-authored along with Susan K. Golant and Kathryn E. Cade.
There was so much information provided at the conference, but I was able to take away these 2 really important points that I would like to share with you:
- It is critical that we integrate behavioral health with medical care that is provided by those charged with the reproductive health of women. I learned there is a multi-disciplinary approach to treating women with perinatal depression comprised of a psychiatrist, obstetrician, obstetrical nurse practitioner, and psychiatric social worker at Kaiser Permanente Medical Center in San Francisco. We REALLY need more of these throughout the country! In certain other countries, it’s the midwives and early childhood nurses–in addition to GPs–that are the front line of screeners.
- There was a presentation about the proposed changes being made regarding the treatment and screening of PPD for the DSM-5 due to be published in May 2013. During this presentation, the ballroom grew noticeably hotter as one by one members of the audience took to the microphone to state their questions and concerns. Most of them centered around the announcement that 4 weeks is the cut-off date for onset. I mean, have you heard of a more ridiculous thing than that?! That means that any screening that may occur (as not all OB/GYNs or other health professionals screen today) would only occur in the first 4 weeks postpartum, since a postpartum mood disorder (PPMD) would’ve had to rear its ugly head by then. Why, then, you ask would they propose such an outlandish thing? Well, it’s because all these years the DSM-IV and all its predecessors are based purely on statistics obtained directly from research. Not doctor’s offices or hospitals or clinics. Not from data obtained from the EPDS given to the thousands of moms that give birth each year. Sounds like typical political, ahem, B.S. if you ask me….
Okay, so what does this all mean? This means that moms will not only continue to have their OB/GYNs dismiss their PPMD symptoms, but now in addition, there will be a specific cutoff of 4 weeks. Anything after 4 weeks will risk being shrugged off, as doctors will be referring to the handy dandy DSM-5 as the Bible and complacently inform these moms that they couldn’t have a PPMD because they were more than 4 weeks postpartum.
There is still opportunity to improve on the DSM-5 as it is being proposed. You can help make a positive difference. How? Well, starting in May 2011 and ending midnight of June 30, 2011, the public will be able to submit comments on the draft of the DSM-5 on the American Psychiatric Association’s DSM Development website. I will be signing up to do so, and I hope you will too. The more women who do, the better chance we have of convincing the powers that be that they need to extend the onset period to 1 year (or even 3 months would be far better than 4 weeks)! Voice your concern. Tell them why. Share your story. I know numerous women whose symptoms of PPD didn’t begin until after the 6th week. Like me, for one. Other countries who have had ancient social support customs in place for centuries have had 6-8 weeks as the period in which the new mom must be cared for. There is a reason behind that….just as there is a reason behind the Swedish model of the primary care physician (or general practitioner) performing postnatal screening between 8 and 21 weeks postpartum, with 13 weeks as peak prevalence.
To think that women who are sick with PPD will continue to be shrugged off and go untreated and allowed to suffer unnecessarily angers me to no end. We are supposed to make progress, but instead, we are more concerned about statistics obtained during very limited studies. Folks on the DSM-5 committee, this is a blatant example of not being able to see the forest for the trees.