Perinatal mental health refers to a person's mental wellbeing during pregnancy, the postpartum period and first year after childbirth.
A perinatal mood, anxiety or related disorder is a treatable mental health condition or illness that occurs during the perinatal period. These include major depressive disorders, anxiety disorders, obsessive-compulsive disorders, post-traumatic stress disorders and psychosis. If left unaddressed, they can affect the health and well-being of parents, their children and their families. Seeking help early can help manage your symptoms and improve your well-being.
The Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders, as well as "Seeds of Hope: A Patient and Family Guide", were developed in consultation with an interdisciplinary team of expert researchers, frontline healthcare providers, persons with lived experience, and advisory panels from across Canada.
Guideline recommendations are organized based on the type and severity of symptoms, as well as their proven effectiveness. Healthcare providers are encouraged to allow ample time to discuss the risks, side effects and expected benefits of different treatment options with their patients. Options can include lifestyle changes, such as protecting sleep and taking part in physical activity, peer support, therapy and medication.
This guideline aims to provide a more comprehensive guidance on best practices in care and engage a target audience beyond psychiatrists to include all clinicians, such as family physicians, midwives, nurses, obstetricians, pediatricians, psychotherapists, social workers and others.
About the contributors
The Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders, as well as "Seeds of Hope: A Patient and Family Guide", were developed in consultation with an interdisciplinary team of expert researchers, frontline healthcare providers, persons with lived experience, and advisory panels from across Canada. The project was led by:
Dr. Simone Vigod, Professor in the Department of Psychiatry at the University of Toronto, and Head of the Department of Psychiatry at Women's College Hospital
Dr. Vigod is a leading expert in perinatal mood disorders and has conducted some of the largest studies worldwide on maternal mental illness around the time of pregnancy. Mental illness at this life stage poses unique risks to mothers and their children at a critical juncture in both of their lives. Her research is helping raise awareness about gaps in access to specialized perinatal mental healthcare, as well as identifying vulnerable populations where these gaps are most prominent. She also designs and evaluates novel health system interventions to improve access to and uptake of care for affected women. Her background includes an Honours BSc in Psychology from McGill University (1999), followed by an MD (2003), residency in psychiatry (2003-2009) and MSc in Clinical Epidemiology (2011) from the University of Toronto. She leads a clinical research program at Women's College Hospital as a Senior Scientist and the Shirley A. Brown Memorial Chair in Women's Mental Health Research in the Women's College Research Institute, and is a Senior Adjunct Scientist at ICES in Toronto, Ontario, where population-level health administrative data for her epidemiological studies are securely held.
Benicio Frey, Professor at the Department of Psychiatry and Behavioural Neurosciences at McMaster University, Academic Head of the Mood Disorders Program, and Medical Director of the Women's Health Concerns Clinic at St. Joseph's Healthcare
Dr. Frey is a clinician-scientist and neurobiologist by training. His PhD work pioneered the discovery of blood/peripheral changes in neurotrophic factors and oxidative stress in individuals with bipolar disorder, which is now well accepted in the scientific community through the concepts of allostatic load and neuroprogression in mood disorders. In his postdoctoral fellowships, he was trained in brain imaging using a variety of techniques such as MR spectroscopy, PET imaging and functional and structural MRI. His research lab discovered that bipolar disorder is associated with alterations in intracortical myelin, and these alterations are associated with impairments in cognitive and psychosocial functioning. Currently, he is the Director of the largest Canadian network of research in biomarkers of treatment response in depression (www.canbind.ca), where he and his team are investigating how the person's biology can inform the best antidepressant treatment option for that particular individual through biomarker-based clinical trials. For over a decade, Dr. Frey has been the medical director and academic lead of the Women's Health Concerns Clinic at St. Joseph's Healthcare Hamilton, a clinical program affiliated with McMaster University, focused on assessment and treatment of women suffering from severe premenstrual disorders, as well as mental health issues associated with pregnancy, postpartum and the menopause transition. Dr. Frey has more than 300 publications accepted in peer-reviewed journals and has received numerous career awards, including the title of University Scholar and the Douglas Utting Prize in Mood Disorders.
