Leader in Screening for Post-Partum Depression, NJ Gains Dedicated Center

Lilo H. Stainton | May 8, 2017 | Health Care
Efforts in identifying and treating post-partum anxiety and depression pioneered by former NJ first lady Mary Jo Codey

Credit: NJTV
Mary Jo Codey
New Jersey has long been a leader in screening new moms for post-partum anxiety and depression. Now there is a clinical program devoted specifically to treating these mothers — and fathers — struggling with terrifying thoughts about how they might harm their baby.

Monmouth Medical Center opened on Thursday the state’s first Center for Perinatal Mood and Anxiety Disorders, which offers individual therapy, medication, peer groups, and more to new and expectant parents. The program, which grew from a support group founded at the Long Branch facility in 2011, is one of only a handful of clinics nationwide dedicated specifically to post-partum issues.

Experts said one in seven women may be affected by the condition, now known as perinatal mood and anxiety disorder, which can cause debilitating thoughts that range from a fear of dropping a baby to visions of violently injuring one’s child. The vast majority of these parents don’t act on these thoughts, but these concerns can result in sleeplessness, paralyzing anxiety, guilt, and depression. And, while the condition is highly treatable, only 15 percent of those suffering even ask for help.

NJ at forefront

The Garden State was the first nationwide to require new moms get screened for the condition, thanks to the work of Mary Jo Codey, the former first lady and wife of Sen. Richard Codey (D-Essex), who briefly served as governor. Codey — who spoke at the Monmouth Medical Center event last week — has been open about her personal battle with post-partum depression and launched a public-awareness campaign, “Speak Up When Your Down,” in 2005 that became a model for other states.

Since then, healthcare providers have screened hundreds of thousands of women, reaching more than 90 percent of all new births, in recent years. Between 11,000 and 16,000 women suffer PMAD each year in New Jersey, according to Monmouth Medical Center.

The state Department of Health maintains a webpage with information about the disease, a checklist of symptoms and a list of resources. But a chronic shortage of mental health providers has made it difficult for some women to actually get the treatment they need.

Mental health month

The program at Monmouth Medical Center, a RWJ/Barnabas hospital, has screened 800 patients for the condition and treated more than 500 since its inception as a weekly support group. The official opening, on Thursday, was also timed to coincide with Mental Health Month, which is recognized in May.

What began in a single room has grown to take up a suite at the Long Branch hospital with clinical space and large rooms for multidisciplinary treatment, including art therapy, infant massage, mentoring program, and more, explained RN Lisa Tremayne, the center’s program director. They also hold marriage workshops and a special meeting for fathers, she said.

“Every month we add more to our calendar,” Tremayne said. “It’s important for people to know this is temporary and treatable like any other pregnancy problem.”

Women can call the program directly at 732-923-5573 to learn more; some of the programs are free.

Postpartum progress

Tremayne served on a consortium that helped implement the screening protocols that grew out of Codey’s initiative and has worked with a national advocacy organization, Postpartum Progress, to share information on the condition and its symptoms. She also helped compile a list of treatment options nationwide — a process that helped her craft the Monmouth Medical program.

Through this process, Tremayne said she realized she herself had suffered PMAD when she gave birth several years earlier. She recalled sharing these scary thoughts about harming her children with her doctor, who told her she was “tired” and prescribed a shopping expedition to make her feel better.

“So I sat alone with it for five years, literally, when I could have been fixed in a matter of months,” Tremayne said. Connecting women with treatment doesn’t provide an immediate cure, she said, but helping them realize they are not alone is a critical first step.

“Intrusive thoughts are very, very scary,” Tremayne said. “I tell them, ‘I promise you you’re not a monster and I’m going to introduce you to 12 other women [experiencing the same stress] and you’re going to feel better in one hour,’” she added. “Prior to that, all they had were Facebook pictures from perfect people in a perfect world saying ‘I’ve never been happier!’”

Triggering mood swings

Dr. Robert Graebe, director of the Department of Obstetrics and Gynecology at Monmouth Medical, said a quick drop in a woman’s hormone levels after childbirth can trigger mood swings, depression, and anxiety. “Many new mothers are unable to get the rest they need to fully recover from giving birth. This constant sleep deprivation can lead to physical discomfort and exhaustion, which can contribute to the severity of PMAD,” he said.

“It’s important for women to know that this is very common and not their fault. It is equally important that they receive the proper care so they can get better,” Graebe added. His department is also participating in a multinational study on the treatment of perinatal mood and anxiety disorders to learn more about how best to care for these women.