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Mental Health

During pregnancy, we want the _____ amount of mental health medications necessary to keep mother __ Minimal; stable
Why must we know a mother's Hx of mental illness? Some medications contraindicated during pg
True or false: almost 1/3 of all PP women report their births were traumatic True
Women who develop PTSD r/t birth experience the following: 1) re-experiencing the event, 2) intrusive thoughts, 3) intrusive thoughts, 4) avoidance of factors associated with event, 5) panic attacks, nightmares, isolation
What behaviors may suggest abuse Hx? 1) obsessively detailed birth plans, 2) trust issues with authority figures, 3) inability to tolerate pelvic/vaginal exams, 4) extreme modesty, 5) dissociation during exams, 6) denial with known Hx
In regards to modesty, we must also consider ___ Cultural/religious issues
If a client discloses sexual abuse, we should ____ and let her know she's in a ____ place Validate; safe
Essentially, ____ is at risk when women are depressed Safety
Baby blues is a ____ period that occurs during ____ of PP Transient; first few days
S/sx of baby blues Tearful, weepy, sleep issues, moody, overwhelmed
Baby blues usually resolve in _____ days 10-14
PP depression's onset is _____. Typically is evident by ____ weeks Sudden or gradual. Typically evident by 6 weeks.
Women with PP depression may need a combination of ______ and meds Psychotherapy
We want to avoid __ because of the cardiac anomalies that develop in the fetus Paxil
ECT therapy may be thought to be ___ for pg to treat major depression Safe
Category ___ may be okay for treating depression during pg B/C
Category L__ okay for mothers L2-L3
SSRIs are mostly category _____ C
Benzodiazepines are considered category ___, lactation ____- and should be avoided if possible D; L3-L4 (may give if absolutely need benzo)
Lithium and ______ are ______ in pg Depakote; Contraindicated
Single medication at ___ dose is preferable to ____ meds Higher; multiple
______ is considered an emergency psychiatric condition PP psychosis
Women with bipolar disorder also have increased risk of ____ PP psychosis
____ are frequent in women with bipolar disorder Relapses
Most common psychiatric disorder is ______ Anxiety
If ___ is untreated, may increase suicide/self-harm and also have increased incidence of infanticide Schizophrenia
PP psychosis involves... A break from reality, hallucinations with paranoid sx
Neonatal effects of SSRI/SNRI drug use during pg include ______ (a syndrome) Psychotropic withdrawal syndromes
S/sx of psychotropic withdrawal syndromes: Atonia, jitteriness, transient tachypnea, respiratory distress, some sx persisting up to 3 months
Partner depression may have a __ onset than maternal Later
______ is discouraged with breastfeeding Lithium
Trigger "themes" r/t abuse 1) Control/loss of control, 2) pain/injury/bodily damage/invasion, 3) dependency on partner/caregiver, 4) mistrust of authority figures, 5) shame/being judged over body image/behavior/secretions, 6) exposure
Goal of care re: women w/ Hx of abuse Identify women with this concern, accept/anticipate trigger areas, explain thoroughly, structure so she has control, help her "stay present", praise, support, translate to partner if appropriate
Created by: lapio-obgyn