April 2023

By Emily Taylor Yunker, DVM, CVMRT, CVH

In this VETgirl online veterinary continuing education blog, Emily Taylor Yunker, DVM, CVMRT, CVH discusses common perinatal mood disorders and some ways to combat these symptoms. As our veterinary profession is 90% women nowadays, this is important information to know!

Perinatal Mood Disorders in Veterinarians

May is Maternal Mental Health Awareness month, in addition to Mindful May. So this is the perfect time to bring attention to the mental health conditions that come up during the transition into motherhood.

Postpartum Depression (PPD) has been in the public consciousness for decades now. For a while, the word “postpartum” was basically synonymous with “depression.” More recently, it has become clear that there is a whole array of maternal mental health experiences, some of which reach the level of a defined pathology and others which are less severe but still surprising and disruptive.

About 80% of women experience the “Baby Blues” as hormone levels from birth fall precipitously over the next several days. This is usually a passing phase, and care providers can pretty much expect that on day 3-5 postpartum, moms will probably experience spontaneous crying, emotional hypersensitivity, and just general unexplainable sadness. Not a great day to invite the grandparents over to meet the baby.

There can be a number of other experiences that linger well beyond the first few weeks postpartum. These include hypervigilance, sensitivity to sound and visual clutter, difficulty following complex conversations, forgetting words or details, sensitivity to the perceived judgement of other people, intrusive thoughts, difficulty sleeping, fatigue, and more. All of these things are actually normal. They are not pathologic. They are the result of brain remodeling occurring rapidly during the postpartum. However, under the wrong conditions these experiences can become severe enough to be pathologic.

Some of the more common mental health disorders include:

  • Postpartum Depression (PPD)- 20-33%
  • Postpartum Anxiety (PPA)- 11%
  • Postpartum OCD (POCD)- 11%
  • PTSD- 9%
  • Perinatal Depression (includes pregnancy and even pre-conception)

I will say that while I do not have specific statistics to support it, I see higher rates among veterinarians than these statistics reflect. I suspect that at least 1/3 of veterinarian moms experience a Perinatal Mood and Anxiety Disorder (PMAD), and sometimes a combination of disorders.

Risk Factors for development of PMAD include:

  • Personal History of mood disorder
  • Family History of Perinatal Mood Disorder
  • Lack of Support, both emotional and physical – especially communication with partner
  • Inadequate postpartum planning, resulting in significant daily stress
  • Previous pregnancy loss
  • Fertility challenges
  • Unplanned pregnancy
  • Birth trauma
  • Birth injury
  • NICU stay
  • Feeding challenges
  • High-needs baby
  • Financial strain
  • Perfectionism
  • Perinatal medical diagnosis
  • Significant changes in social group
  • Body image challenges
  • Identity shift

When I review this list, it is clear why the incidence of PMAD is higher in veterinarians. Veterinarians come into pregnancy with a higher incidence of mental health history, perfectionistic tendencies, and fertility challenges (due to the delay in parenthood until 30s or later). Once in pregnancy, there are frequently medical diagnoses due to age and lifestyle factors. Additionally, in the US, there is very little professional postpartum support, no universal paid leave, and a lack of cultural awareness around the need to plan for postpartum.  Signs of PMAD are variable and it looks different between individuals and between pregnancies in the same individual. The most important factor is how it is impacting your life. If it is interfering with your ability to enjoy your baby and your life, it is worth seeking help.

Signs of PMAD to be aware of (and for your partner and circle of support to be watching for) include:

  • feelings of anger, fear and/or guilt
  • lack of interest in the baby
  • appetite and sleep disturbance
  • difficulty concentrating/ making decisions
  • thoughts of harming the baby or oneself
  • feeling very nervous
  • recurring panic attacks (shortness of breath, chest pain, heart palpitations)
  • many worries or fears
  • obsessions (persistent thoughts or intrusive mental images often related to the baby)
  • compulsions (doing things over and over to reduce the fears and obsessions)
  • avoidance
  • a sense of horror about the obsessions
  • reexperiencing of a trauma (dreams, thoughts, etc.)
  • avoidance of stimuli associated with the event (thoughts, feelings, people, places, details of event, etc.)
  • persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)

baby

Fortunately, there are actually things you can do IN ADVANCE to decrease the incidence and severity of PMAD.

  • Improve partner communication in advance. Work on your conflict navigation, expressing boundaries, asking for help, emotional awareness, and non-judgemental awareness
  • Practice mindfulness skills to improve mindset, reduce anxiety and perfectionism
  • Practice asking for and accepting help
  • Organize friends and family in advance to have daily emotional support contact during postpartum
  • Hire a supportive birth team. Be picky about your provider and place of birth. Hire a doula
  • Take a childbirth education class, beyond the hospital class
  • Create a birth plan that expresses your voice clearly
  • Create a postpartum plan that includes specific mental and emotional self-care, plus practical and physical support
  • Create a list of professionals to have on hand as needed, including maternal mental health professionals
  • Contact a lactation consultant prior to birth
  • Find a mom group near you to meet up with (often organized by hospitals/birth centers)

Most importantly, know you are not alone. This is common. So common that I guarantee someone you know personally and highly respect as a veterinary professional and parent has experienced PMAD. There are resources that can help. Talk to your medical provider, your therapist, your friends. You can live with PMAD and still enjoy your baby, your career, and your life. But you need support to do it. We are not meant to do this alone. You are an intelligent, talented, informed, powerful veterinarian mom.

Resources:
https://www.parents.com/baby/health/postpartum-depression/maternal-mental-health-disorders-and-how-to-ask-for-help/

https://www.postpartum.net/wp-content/uploads/2014/11/PSI-PMD-FACT-SHEET-2015.pdf

https://pmadslo.org/selfassessment-in-english

Biography
Dr. Emily Taylor Yunker holds a Doctorate of Veterinary Medicine from Auburn University. She practices small animal medicine in Cary, NC. Dr. Yunker is also a doula and childbirth educator, working one-on-one virtually and teaching classes for veterinarians specifically as they navigate the transition to motherhood. She also writes and speaks as an advocate for all parents within the veterinary workplace, bringing awareness to the needs of parents so we can improve workplace wellbeing and support employee retention. Dr. Yunker lives with her husband, three children, and three cats on a (non-functional) farm near Pittsboro, NC. In her non-existent spare time you can find her puttering about with herbs in the garden.

*Please note the opinions in this blog are the expressed opinion of the author and not directly endorsed by VETgirl.

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