Screening can save moms and their kids from the risks of depression


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SALT LAKE CITY — For many women, pregnancy is one of the few times when they seek health care. Now, doctors are being asked to take advantage of the opportunity to screen them for depression. Screening and treatment have already changed the direction of one Utah mom's life.

"I have hope and I am happy and I enjoy the time that I spend with my daughters," said Diana Rivera. Her daughters, 3-year-old Luna and 1-year-old Lana, and a new job all keep Rivera very busy.

"I think I have more energy to spend with them," Rivera said.

This renewed energy has replaced the depression that threatened to take over Rivera's life during and after her pregnancies.

"Because when you are in the depression, you do not feel like you want to get out of your bed," she said.

After an emotionally draining first pregnancy, doctors screened Rivera for depression. They advised her to seek psychiatric treatment while carrying baby Lana.

Dr. Noel Gardner is a longtime psychiatrist and founder of the Polizzi Clinic, a free nonprofit mental health service for those without insurance or the ability to pay. Rivera was referred to the clinic in the spring of 2015 just after she became pregnant with Lana.

"She came to us and I treated her specifically because she was pregnant and severely depressed," Gardner said.

Psychiatrists like Gardner support a federal panel's recommendations to screen all pregnant and postpartum women for depression.

"In fact, rates of depression during pregnancy are nearly as high as they are in the postpartum period. Lots of changes and there are a number of risk factors," Gardner said.

Dr. Howard Sharp is vice chairman of clinical affairs for the University of Utah's Department of Obstetrics and Gynecology. He's impressed with the new recommendations to test women during pregnancy for depression.

"I have seen more awareness. I think that now that we talk about these things, it's easier for women to say, 'Yes, I do have this,'" Sharp said.

Sharp and his colleagues at the U. of U. will be using the Edinburgh Postnatal Depression Scale to screen their patients.

"So, this is a tool, it's a 10 question questionnaire that's fairly simple to give to a patient in the clinic and to score it right on the spot," said Sharp.

Answers to questions like, "I have felt sad or miserable in the past seven days?" can tip doctors off to the need for treatment.

"The good news is that treatment can often be very effective," Gardner said.

Throughout her second pregnancy, Rivera met regularly with Gardner at the Polizzi Clinic. Some medications were prescribed and Gardner talked with Rivera about her fears.

"There are specialized cognitive-behavioral therapies that are very helpful," Gardner said.

"The doctor was reminding me every month that don't worry, it's going to be OK. Everything is going to be OK," Rivera said.

And now, a year after Lana's birth, it is better than OK.

"I'm enjoying my two girls and I'm enjoying my life," Rivera said.

"It's just beautiful to watch her just beam with the happiness of her life and the beauty of her own children," Gardner said.

In fact, Gardner expects more men and women, not just those who are pregnant or postpartum, to be screened for depression. The Affordable Care Act offers incentives to primary care physicians who screen their patients for mental health issues like depression.

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UtahFamily
Sandra Olney

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