To help us understand the difference between stress of motherhood and clinical symptoms of depression, I spoke with Mara Acel-Green, a psychotherapist specializing in mood and anxiety disorders during pregnancy and postpartum (i.e., perinatal period). Mara is the owner of Strong Roots Counseling and is also an instructor, training other clinicians on how to recognize and treat these disorders.
How do you tell if a mother is depressed or just overwhelmed?
One way to tell if you are depressed is to observe how you are feeling after you get more sleep. Are you able to see the rays of sunshine or do you wake up and continue to feel hopeless and sad? Do you have good days and bad days, or are you feeling depressed and down more often than not, for at least two weeks? Is your mood interfering with daily life, enjoyment of others, ability to connect with your partner, in which case you might be depressed, or are you sleep-deprived and overwhelmed by new stressors, but still able to enjoy your life, in which case you are probably not depressed?
What it the difference between perinatal depression and depression during other stages of life?
Think of it more as perinatal emotional complications, which can include depression, anxiety, OCD and trauma. The depression itself is not different from other depression, but it can be more irritable and can include some intense intrusive thinking that can be very upsetting. But it is not just crying and can’t get out of bed sadness, it can also be angry and irritable, and totally overwhelmed sadness.
Parenting is so hard: anybody would be feeling down in these circumstances. Should all new mothers speak to a professional?
I believe that therapy can be beneficial to lots of moms. After I do an assessment and determine that a mother is not clinically depressed, we often focus on the stressors she is experiencing and I try to provide her with suggestions on what to do differently so that the stressors go away. Usually a woman in this scenario only needs 8 sessions to right the system and adjust whatever wasn’t working.
On the other hand, if the same woman did not speak to a therapist (or a new moms’ group, a home visitor, a primary care physician) and no adjustments were made, the stress may start to accumulate and lead to depression.
What do you wish people understood about your work?
That we need to work with both men and women, the whole family system. 10% of men become depressed during the perinatal period. Only 17% of women diagnosed with depression will get treatment; most people don’t reach out. Perinatal emotional complications are treatable.
Prior to pursuing Social Work, Mara studied anthropology and women’s studies, and through this she learned the concept of multiple truths (people have their own paths towards their own truth). Mara is a gardener and in her free time like to grow tomatoes and cook.