 In this week's Your Health segment, Dr. Jill Rock-Bizel, Associate Professor of Psychiatry at the University of Maryland School of Medicine and Vice Chair of Clinical Affairs in the Department of Psychology at the University of Maryland Medical Center, Dr. thank you for being with us. Good to be here. So it is always Mental Health Awareness Month in your office, I'm sure, but it is the month of May is Maternal Mental Health Awareness Month, why is that important? That is important because depression and anxiety are two of the most common mental health issues in this nation and 40 million individuals suffer from anxiety disorders, 16 million from depression, and at the end of the day women are much more likely to suffer from these disorders than men. Are the disorders linked, depression and anxiety? They are, they can be much of the time they are, so often some of the symptoms of anxiety accompany depression and as depression gets worse, so do the symptoms of anxiety. That said they can both stand alone, at least half of the individuals with depression also have anxiety symptoms. What's the trend like, I mean is the incidence, the prevalence of this increasing would you say? I don't know that it is increasing, I think we are more aware of it, I think we're doing much more screening and we are trying to get the word out that there is treatment available to everyone. The stigma of mental illness is still very strong and it keeps people from getting the help they need. Is it declining at all? Do people talk more openly about stuff like that than they used to? I think they're starting to, yes, I think they are. And I think even as people go into their primary care offices or into schools and that there's more conversation about it, more physicians are asking their patients about symptoms of depression and anxiety, which makes it easier for people to talk about it or to bring it up themselves. Let's talk about the impact on the developing baby, but how much is known about that? Actually there's a fair amount known about the impact. First a woman has to recognize the symptoms that she has, but the reality is untreated depression and anxiety during pregnancy is very detrimental to the developing baby. It also has an impact in the postpartum period on the child and those impacts, those consequences we see sometimes out into adolescence. So during pregnancy, untreated depression and anxiety can lead to low birth weights, early labor. It's a real problem for the mother as far as bonding and attaching to her baby and to feel connected to that child so that once that child is born, that mother or baby bonding is very difficult for untreated symptoms. Why is that such a common thing? I mean, you think about the idea of the mother bonding with the baby is so central to the survival of the baby that it's baked into all of us, but this runs counter to that. It makes it difficult. Is there a physiological reason, hormone, something that triggers that reaction? I mean, certainly... The depression you mean? The postpartum depression is, I mean, it's a fascinating thing. It's a very stressful time. Your life has completely changed. What drives it? Well, depression in the postpartum period is not unlike any other depression in any other time of life. There's just many more consequences for the mother, for the baby, for the whole family for that matter. What causes depression? It's the nature versus nurture, so there's definitely genetic impact. There is a history of depression and or anxiety in the family. A mother, expecting mother, is increased, predisposed to having those symptoms. But there's also environmental factors that cause depression and anxiety, you know, a history of trauma, both an adult and a child, poverty, isolation, the use of drugs and alcohol also could precipitate these symptoms as well. So there's lots of risk factors that lead to these symptoms. The rate of depression during pregnancy is about one in every five women that are pregnant experience these symptoms. Unfortunately, only about 10% of those women get treatment. It's really detrimental. Is it not something that their providers are routinely asking about in prenatal visits? So we're getting better at that. I think for a long time that was not a focus. Now there are new screening tools and we are working very hard with our colleagues to make sure that there's routine screening in the OB office, OBGYN offices, to detect this and when there's hit a certain score on the Enberg postpartum depression scale, it's used both before and after pregnancy, you should absolutely be seen and evaluated and offer treatment. There's lots of different kinds of treatment, but it's the lack of knowing what's out there and recognizing the symptoms that can be problematic. Let me remind our viewers, if you have a question for us about depression, anxiety, give us a call. We'll have the number up on the screen. You can also tweet your questions. The Twitter address is at MPT news. So picking up on treatment, what's new? What are the trends? So the treatment for depression in general really focuses around the severity of the depressive and anxiety symptoms and the impact on an individual's functional ability, so whether it's social function, work function, interpersonal function. And treatment can consist of different types of therapies and there are a lot of new and evolving therapies, medication, or as most of our research shows, a combination of those actually gives the best benefit, the best results of that. So different kinds of therapy. There's personal therapy. There's cognitive behavioral therapies. There's simple behavioral activation type interventions that can be used in just about any office. Couple that with when appropriate medication, the responses can be dramatic. People's lives can be turned around. They can regain all their function. I think part of the problem is that people don't recognize when they're even depressed. They come to live with it. How can you tell? How can somebody sort of self-evaluate for depression? Well, you know, you look for depression first and foremost either a marked low mood or a real increase in irritability coupled with an inability to enjoy things you normally would enjoy. And then other things that accompany it would be things like depression, anxiety, they impact, well, they're a little bit different. So depression impacts your appetite. Some people overeat. A lot of people lose their appetite altogether, begin to lose weight. Insomnia can be a big problem, although some people also oversleep. So functional changes. Let's get a quick phone call. Anne Arundel County, this is George. George, thanks for calling. Go ahead. Thank you. I was wondering whether there's any indication that there's been an increase in postpartum depression currently back in the day when I was, I guess, it was 40 some years ago when I had my first child. I don't think I ever even heard the term. Obviously, we've had... George, we're short on time, so I'm going to get an answer to your question. Let's change. I think what's changed is there's better recognition of it. Many women would be depressed. It wasn't cool to talk about depression. It wasn't cool to talk about not wanting to take care of your baby. Now it's in the open. It's being talked about. Women aren't just pushing through it. They're actually recognizing it and getting help. Dr. Jill Rock-Bizel, University of Maryland. Thank you for being here. Thanks for having me. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.