Ask if the patient has been treated for any mental health issue in the past; depression, anxiety, bipolar disorder.
Ask if the patient has any family members suffering with mental health complications.
Ask if patient has severe PMS or PMDD
Ask if patient is currently on anti-depressants , anxiolytics, or mood stabilizers. If yes, who prescribes this medication?_____________________
Consider a phone consultation with prescribing MD.
If patient answers yes to any of these questions she is at a higher risk for maternal depression.
Treatment
If a patient has been successfully treated with a certain medication in the past, it is wise to restart them on the same medication, at a starting dose.
You can follow ACOG recommendations for medication and dosage.
Recommend Omega 3s (from fish oil) 1000mg and Vitamin D-3 1000mg. Both have a positive effect on depression.
Encourage hospitals to protect mom’s sleep. Write an order to delay vital signs , lab draws closer to breakfast and MD visits. Sleep deprivation starts many women down the road to maternal depression.
Provide patient with written info about maternal depression at her first visit. Discuss it again each trimester when she is screened. Include her partner, or family in the discussion.
