Perinatal Mental Health
Pregnancy and motherhood are tremendous period of growth and change in a women's life. The term "matrescence" has been used to define the physical, emotional, hormonal, and social transition to becoming a mother, a time that can leave women feeling vulnerable, overwhelmed, and susceptible to mental health issues. Dr. Guinan underwent specialized training in perinatal psychiatry during her fellowship at Duke University and is passionate about serving women during this time in their life. If you are still experiencing symptoms despite psychotherapy, Dr. Guinan can help by offering different medication options. Listed below are some of the conditions Dr. Guinan has experience in treating.
Depression can be a symptom at anytime during the perinatal period and is impacted by the changes in hormones and metabolism that accompany pregnancy. Following delivery, many women experience “baby blues”, feelings of sadness or concerns about your ability to care for your newborn. These feelings are expected and may begin and end within the first few weeks after the birth of your baby. However, if you are experiencing ongoing severe symptoms of low mood that are impairing your ability to care for yourself or your infant at any time during the perinatal period, it is important to seek further evaluation and treatment. Dr. Guinan takes special consideration of risks and benefits of the use of medications in perinatal women and works collaboratively to determine a plan of care that meets her patient's personal needs and preferences.
It is common for new mothers and mothers-to-be to experience worries about the well-being of their child. However, if these worries become excessive and lead to difficulties in concentration, sleep problems, panic attacks, or repeated thoughts or images of frightening things happening to your baby, additional assessment and support is needed. Untreated anxiety has been linked to an increased risk in development of preeclampsia, premature birth, and low birth weight of infants and proper treatment can improve both the health of the mother and baby.
Bipolar Disorder in the Perinatal Period
Women diagnosed with bipolar disorder prior to pregnancy are at increased risk of recurrence of depressive, manic, and sometimes psychotic symptoms during pregnancy as well as postpartum. Several important factors must be considered when treating bipolar disorder during the perinatal period given some medications used to treat bipolar disorder carry risk of harm to the developing fetus. Dr. Guinan will work closely with mothers and mothers to be to weigh the risks and benefits of medication use, allowing her patients to make individualized informed decisions for the well being of themselves and their babies.
While rare, postpartum psychosis is a serious and potentially dangerous mental health condition that can occur following delivery. It can be characterized by disorganized thinking and sometimes perceptual disturbances (hallucinations). Some women may be more prone to developing postpartum psychosis depending on their mental health history. Being vigilant for signs and symptoms of postpartum psychosis is crucial to ensuring urgent and appropriate medical care.
Infertility (defined as the inability to conceive despite one year of carefully timed, unprotected sexual intercourse) affects about 1 in 5 women in the United States, yet is an often associated with stigma and shame. Infertility can negatively impact mental health and has been linked to increased rates of depression and anxiety. Medication to target these symptoms may be appropriate in some cases, and Dr. Guinan will be able to make specific recommendations while providing comprehensive risks and benefits of these options.
Loss of a pregnancy can be one of the most devastating events of a woman's life, resulting in intense grief, sadness, anger, and feelings of isolation. If symptoms persist and result in significant functional impairment, despite psychotherapy, treatment with medications may be necessary. Dr. Guinan will work closely with your care team/therapist to tailor treatment for your individual needs.