PSI Chapter 2: Perinatal Mental Health Risks, PRotective Factors,
and Interactions (Blueprint - 10%)
Genetic and Family History:
- Genetic Factors:
- ✔️ Biological sensitivities to hormonal changes (runs in families).
- ✔️ Genetic predisposition.
- ✔️ Faulty belief systems (old vs. new view of self).
- ✔️ Previous history of PMADs.
- ✔️ Symptoms during pregnancy.
Sensitivity to Hormonal Changes:
- ✔️ Women with PMADs exhibit hormone levels similar to non-PMAD women but may be more
sensitive to changes in those hormone levels, especially during pregnancy.
Evidence-Based Risk Factors:
- ✔️ A history of significant mood reactions to hormonal changes (such as puberty, PMS, or hormonal
birth control) is a known risk factor.
- ✔️ A personal history of PMADs is considered a risk factor.
Non-Pregnancy Related Mental Health Disorders:
- ✔️ History of depression, anxiety, OCD, eating disorders, and bipolar disorders.
Epigenetics:
- ✔️ Refers to biological mechanisms through which relationships, environments, and early nutrition
affect "chemical signatures" on genes, influencing how they are turned on or off, affecting well-being
across a lifetime.
Exacerbating Factors for PMADs:
- ✔️ Pain can exacerbate PMADs.
, - ✔️ A history of thyroid imbalance increases the risk of PMADs; it’s crucial to assess patients for
thyroid dysfunction.
Increased Risk Groups for PMADs:
- ✔️ Women with endocrine disorders.
- ✔️ Women experiencing fertility challenges.
- ✔️ Those with thyroid imbalances.
- ✔️ Individuals experiencing pain.
Hormonal Interactions:
- ✔️ Thyroid dysfunction and anemia can reduce milk supply and potentially cause depression.
- ✔️ Galactagogues can help increase milk supply but may also cause depression.
- ✔️ Breastfeeding and depression have a bi-directional relationship.
- ✔️ Depression suppresses prolactin and oxytocin, both crucial hormones for lactation.
Impact of Delivery Method:
- ✔️ Suppression of oxytocin can occur with C-section deliveries, stressful or traumatic births, as well as
with interventions like epidurals, leading to potential lactation problems.
Pregnancy and Diabetes:
- ✔️ True: Postpartum depression (PPD) is more common among women with pre-pregnancy diabetes
(34.8% prevalence).
- ✔️ Gestational diabetes is not associated with increased rates of PPD.
Polycystic Ovarian Syndrome (PCOS):
- ✔️ A hormonal disorder that can lead to perinatal symptoms such as anxiety and depression.
Common Exacerbating Factors for PMADs:
- ✔️ Lack of sleep.
and Interactions (Blueprint - 10%)
Genetic and Family History:
- Genetic Factors:
- ✔️ Biological sensitivities to hormonal changes (runs in families).
- ✔️ Genetic predisposition.
- ✔️ Faulty belief systems (old vs. new view of self).
- ✔️ Previous history of PMADs.
- ✔️ Symptoms during pregnancy.
Sensitivity to Hormonal Changes:
- ✔️ Women with PMADs exhibit hormone levels similar to non-PMAD women but may be more
sensitive to changes in those hormone levels, especially during pregnancy.
Evidence-Based Risk Factors:
- ✔️ A history of significant mood reactions to hormonal changes (such as puberty, PMS, or hormonal
birth control) is a known risk factor.
- ✔️ A personal history of PMADs is considered a risk factor.
Non-Pregnancy Related Mental Health Disorders:
- ✔️ History of depression, anxiety, OCD, eating disorders, and bipolar disorders.
Epigenetics:
- ✔️ Refers to biological mechanisms through which relationships, environments, and early nutrition
affect "chemical signatures" on genes, influencing how they are turned on or off, affecting well-being
across a lifetime.
Exacerbating Factors for PMADs:
- ✔️ Pain can exacerbate PMADs.
, - ✔️ A history of thyroid imbalance increases the risk of PMADs; it’s crucial to assess patients for
thyroid dysfunction.
Increased Risk Groups for PMADs:
- ✔️ Women with endocrine disorders.
- ✔️ Women experiencing fertility challenges.
- ✔️ Those with thyroid imbalances.
- ✔️ Individuals experiencing pain.
Hormonal Interactions:
- ✔️ Thyroid dysfunction and anemia can reduce milk supply and potentially cause depression.
- ✔️ Galactagogues can help increase milk supply but may also cause depression.
- ✔️ Breastfeeding and depression have a bi-directional relationship.
- ✔️ Depression suppresses prolactin and oxytocin, both crucial hormones for lactation.
Impact of Delivery Method:
- ✔️ Suppression of oxytocin can occur with C-section deliveries, stressful or traumatic births, as well as
with interventions like epidurals, leading to potential lactation problems.
Pregnancy and Diabetes:
- ✔️ True: Postpartum depression (PPD) is more common among women with pre-pregnancy diabetes
(34.8% prevalence).
- ✔️ Gestational diabetes is not associated with increased rates of PPD.
Polycystic Ovarian Syndrome (PCOS):
- ✔️ A hormonal disorder that can lead to perinatal symptoms such as anxiety and depression.
Common Exacerbating Factors for PMADs:
- ✔️ Lack of sleep.
