- 5/19/2025
In this critical Stay Well Health Chat, Nicole Michalik and Marisa Magnatta chat with Emilie Sheridan, LCSW, PMH-C dedicated psychotherapist for pregnant and postpartum patients at Virtua Health. Together, they explore the complex and often misunderstood world of perinatal mood and anxiety disorders (PMADs), shedding light on symptoms that extend beyond the typical "baby blues."
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00:01Hi, I'm Nicole from 92.5 XTU and Marissa Magnotter from the Preston and Steve show on 93.3 WMMR.
00:08And we're so excited to welcome licensed clinical social worker and perinatal mental health certified counselor, Emily Sheridan.
00:17Welcome.
00:18Thank you so much for having me. I'm so excited to be here.
00:22I know what Emily and I met before on another virtual women's health chat and you're one of a kind.
00:29So I'm very excited to talk to you. You're going to do wonders for so many women listening and men.
00:34It's important for men to know this information, too.
00:36Absolutely.
00:37Yeah. Well, so you're passionate about helping women through the pregnancies, watching them transition into motherhood, meeting the babies.
00:45How did you get started in this?
00:47Yeah. So honestly, I mean, I've worked in essentially every demographic of mental health that you could think of, every clinical setting.
00:54I love perinatal mental health because it's so unique, essentially, compared to any other type of mental illness.
01:01There's such a fascinating kind of like meeting between psychological, the psychiatric, the chemical component of it, and just the very significant life change that people go through.
01:13That's exciting.
01:14And we should mention that you are a virtuous first ever psychotherapist for pregnant and postpartum patients and have been instrumental in launching virtuous perinatal mood and anxiety disorder program.
01:28And this is something that is so, so, so important. And we're really excited to dive into more of this.
01:34Absolutely.
01:35So, I mean, and your energy is just protruding through the screen already.
01:40Pregnancy and motherhood are, you know, supposed to be a joyful moment, but they isn't for everybody.
01:45You have a lot of horrific instances that happen out there.
01:49Let's start from the beginning.
01:50Most people are familiar with postpartum depression, but the term perinatal mood and anxiety disorders is new to me.
01:58I know you and Nicole spoke.
02:00Are they more than the same?
02:01Tell us everything we need to know.
02:02Sure.
02:03So, we would consider postpartum depression and postpartum anxiety and postpartum psychosis and postpartum OCD.
02:10Those are all perinatal mood and anxiety disorders.
02:13Perinatal meaning from the moment of conception up to one year postpartum.
02:18So, this includes even perinatal bipolar while you're pregnant.
02:23Like, really, any psychiatric condition that occurs from the moment of conception to one year postpartum is considered a perinatal mood and anxiety disorder.
02:32And I think it's really important when you said moment of conceptions.
02:35A lot of people think it's after birth.
02:37Yes.
02:37You know, and a lot of people don't realize that they could go through.
02:40Your body is literally creating another human being inside.
02:43So, it makes sense that things could, you know, act not that your normal feeling, you know.
02:51And a lot of, yeah, a lot of people always talk about postpartum depression, but postpartum anxiety and postpartum psychosis, which I had two friends.
02:59And coincidentally, both of them gave birth at Virtua, who had both of those.
03:04And one had anxiety and psychosis.
03:06And it's crazy where, like, she thought her son was at the edge of the bed crying.
03:10Yeah.
03:11Like, it's really serious.
03:12And the fact that it's not talked about enough is scary in and of itself.
03:17So, it's amazing that you have people like you who are, you know, leading the way with that.
03:21Right.
03:22No, absolutely.
03:23Now, is this the same kind of thing might be called the baby blues?
03:26I've heard that phrase before.
03:27So, baby blues and postpartum depression are actually different.
03:32Baby blues generally starts within the first two weeks postpartum.
03:36It peaks three to five days postpartum.
03:39Sixty to eighty percent of women experience the baby blues.
03:44But if the symptoms are continuing after two weeks postpartum or they're causing very significant impairments in general functioning,
03:51a very marked change from your baseline, then we would start looking at an actual postpartum depression diagnosis.
03:58Oh, that's so interesting.
03:59Okay.
04:00I didn't realize that.
04:01So, what are the most common symptoms of PMADs?
04:05Yeah.
04:06So, it depends, right?
04:07So, if we're talking about anxiety, you know, it shares all the key symptoms of anxiety or major depression, anything non-perinatal related.
04:15But for perinatal specific sort of things, it's a lot of anxiety about the pregnancy, let's say, for example.
04:22We're Googling everything.
04:24Any slight change in the way that we're feeling or the baby moved one move less than he normally does.
04:31Now we're spiraling, right?
04:33So, rumination, panic attacks are very, very common.
04:37Intrusive thoughts are very, very common with PMADs.
04:40And then depression-wise, it shares essentially all the same symptoms of regular major depression, but it's applied more so for the baby, right?
04:50So, feeling a lack of connection with your baby, a lack of interest in the baby, dealing with a lot of inappropriate or excessive guilt, feeling like you're a bad mother, wanting to isolate from people, not taking care of yourself.
05:04And obviously, to the most severe degree, we do encounter people who have suicidal ideations at times.
05:10I think it's important to talk about because a lot of people could have generalized anxiety disorder, right?
05:15Or maybe you don't.
05:16What is that like?
05:17People without anxiety?
05:19Right.
05:19What?
05:20Apparently.
05:21Yeah.
05:22Or a lady living.
05:24But then there's also just the general worry of being, especially if you're like a first-time mom or first-time parent.
05:31Right.
05:31So, how do you tell the difference, which is normal of like, oh, I'm nervous just about this, taking it to the next level of this is a disorder?
05:42Right.
05:42Exactly.
05:43I mean, that's something that's actually very important for me clinically is, like, we don't want to pathologize, if you will, within normal limits, like new mom things, especially first-time new mom things.
05:54But where it crosses the line is the functional impairments, and in my opinion, the change of baseline, right?
06:01Like, if you are somebody who generally is very bubbly and energetic, happy, social, now we're lurking in the house 24-7.
06:09We're scared to bring the baby anywhere.
06:12We're scared of things being contaminated.
06:14We're washing our hands a million times.
06:16And that's where it kind of crosses the line into being a little pathological, if that makes sense.
06:21So, baseline, yeah, baseline is the important word.
06:23Yeah.
06:23That is the key.
06:25But what are some of the risk factors?
06:28Like, who are the women that should be most concerned?
06:31Yeah.
06:31So, I mean, honestly, you know, everybody would assume, right, that having some sort of pre-existing, pre-pregnancy mental illness would predispose you to having, like, a perinatal mood and anxiety disorder or a postpartum mood disturbance, which is true.
06:46But actually, in a lot of cases, people who have no prior psychiatric history whatsoever have their first encounter with mental health concerns during pregnancy or postpartum.
06:55Yeah.
06:56That's so interesting.
06:57So, you know, there's still a stigma regarding mental health that prevents people from seeking help.
07:03So, how can people overcome these barriers?
07:05Like, and let's be honest, like, especially women who feel insecure, who don't feel good enough at baseline.
07:11Now, you're worried that you're not being a good mom or you shouldn't ask for help.
07:14And this is just, like, normal new parent stuff.
07:17So, it's like, how can we give women confidence to want to get help?
07:22Oddly enough, I find one of the biggest barriers is the word should, right?
07:27I do this with a lot of my moms, cognitive behavior therapy.
07:30So, the word should is considered, like, a cognitive distortion.
07:34It's a distorted thought that is not always rational or true.
07:37But when we accept it as true without question, that can cause distress, right?
07:41So, with mom guilt, the should is such a huge thing.
07:45And it usually goes something to the effect of, let's say, you know, I wanted this baby.
07:50I tried for this baby for years.
07:51Maybe I even got IVF.
07:53This is what I wanted.
07:54I should be happy.
07:55I should be able to handle this.
07:57I shouldn't be so sad, right?
08:00That precludes people from seeking help because they, therefore, are ashamed.
08:04And they feel guilty about the fact that they're even having these feelings in the first place,
08:08especially if it's a very desired pregnancy.
08:11So, to overcome that, I often encourage people to try to let go of the shoulds.
08:16Like, should doesn't exist.
08:18Could doesn't exist.
08:19Would doesn't exist.
08:20The only things that exist and matter in this instance is, I do feel this way.
08:25I am feeling this way.
08:26All of these feelings are valid.
08:28And it doesn't mean you're a bad mom or anything.
08:31It just means that you're, you know, going through something right now, as many people do.
08:35What is a session with you like?
08:37Is it virtual?
08:37Is it in person?
08:38How do you make a diagnosis?
08:40Sure.
08:41So, I mean, we can do really whatever.
08:42Like, as long as you're in the state of New Jersey, I can see people virtually.
08:47As you might expect, most of my new moms, especially with the newborns, do prefer the telehealth option,
08:52which makes total sense.
08:53You can also come in person.
08:55By all means, bring the baby with you.
08:57That's, like, my favorite part of my day, you know?
09:00Yeah.
09:00So, it's really up to the patient what they want to do.
09:03Generally, what it looks like is our first session is a one-hour-long individual intake session.
09:09This is where I kind of just collect, like, the whole history, right?
09:12So, your lifetime mental health history before babies were even a thing, any prior mental health treatment you've done,
09:19including therapy, medications, higher levels of care, obviously your obstetric history,
09:23kind of the antecedents to you becoming pregnant, were there fertility medications involved,
09:30how was your pregnancy in general, were you anxious during the pregnancy,
09:33which, surprisingly, a lot of people have no issues with depression or anxiety during the pregnancy,
09:39and then still develop postpartum, and vice versa, for that matter as well, right?
09:44So, we go over all these things, family history, and then we just sort of get a game plan together, right?
09:50Like, I usually tell people what I'm diagnosing them with and why.
09:54I kind of give them a general overview of what types of interventions I'm looking at initially.
10:00And then follow-up sessions, I do them weekly or biweekly.
10:03It really depends on the severity of the symptoms, I suppose.
10:07And those are where we start really doing the interventions.
10:10So, cognitive behavior therapy, dialectic behavior therapy, IFS, grounding techniques.
10:17And we just kind of work through all this stuff until you feel like you don't need it anymore, basically.
10:21Wow. What's dialectic?
10:25So, dialectics is all about, like, regulating emotions and things like that,
10:29whereas cognitive behavior therapy is primarily focused on, like, changing your thinking
10:34and thereby changing your behavior.
10:36DBT is just all about controlling reactivity, like, with the baby, for example,
10:42or with your spouse, who a lot of times people might want to strangle, you know,
10:46that's very common after the baby is born.
10:48So, that's what DBT is really about.
10:51I know a lot of people who don't have kids that could use that.
10:54Yes.
10:54Oh, yeah.
10:55It's one of my favorite interventions.
10:57Yeah.
10:58But that's for another virtual wellness chat.
11:03But so important to know.
11:05It is, which leads me to ask, you know,
11:08what role do support groups and peer support groups play in the recovery?
11:13Yeah.
11:13Oh, crucial, honestly.
11:14Because, you know, many moms will tell you, especially first-time moms, right?
11:18Like, it can be a very isolating experience, unfortunately, to have a baby.
11:22All these people were so invested in your pregnancy.
11:25Oh, my God, have you gone into labor yet?
11:27You know, everything.
11:28Many women feel once the baby's born and the initial novelty wears off,
11:32they're very alone, you know, and isolated.
11:34So, having that peer support, mom-to-mom, women who are dealing with the same thing
11:39is absolutely crucial.
11:41Therapy is fantastic and important and necessary,
11:44but having that, like, social peer support is honestly integral.
11:48Wow.
11:49I can tell how passionate you are about your patients and about just the community in general.
11:54Well, and what about partner support, spouse support?
11:58You know, I feel that, like, there are so many times where women have a hard time expressing
12:05and then men aren't going through it, so they are like, well, how bad is it?
12:09And, you know, you're fine.
12:11How can you lead to tell your partner, obviously, if you're in a heterosexual relationship,
12:17that, like, this is real, you know?
12:19Absolutely.
12:20No, and that's something that I deal with a lot,
12:22especially because, in many cases, the moms I have are people who typically are the one
12:27who shows up for everyone.
12:29They counsel people through their own stuff, you know?
12:31So, I think just being as straightforward as possible and just essentially saying,
12:36listen, I'm not thrilled about this either, but I am not feeling like myself.
12:40This is why I'm not feeling like myself.
12:43Maybe you've noticed some things as well.
12:45If so, what are they?
12:47Let's just kind of process through it together and then decide what kind of help I'm going to get.
12:52Mm-hmm.
12:53Wow.
12:53Yeah.
12:54I mean, this is the goal of these videos.
12:56We hope that everybody watching it now, whether you are suffering through this or you know somebody,
13:01or maybe you just know somebody who is currently expecting this might be something to pass along
13:06to them to prepare them for the next step.
13:08And if you are somebody, you know, is experiencing these symptoms, you can always reach out to
13:14virtua.org slash postpartum depression.
13:18That's virtua.org slash postpartum depression to get more information.
13:23Yeah.
13:23And obviously, if you're a friend or like a peer, even a coworker, a family member, like,
13:30you know, there's definitely times with my friends where I've said, like, are you okay?
13:34Like, it's important.
13:35Even I've had calls, like, people who call me on the phone, oh, my baby's four weeks old.
13:39I'm like, how are you doing?
13:41You know, it's sometimes it's very simple just to ask that.
13:43And it really does matter.
13:45And the fact that it's 2025 and we have all these incredible resources to help you feel
13:50better, like, don't suffer and don't suffer alone.
13:54You know what I mean?
13:54That's the beauty of Virtua's program and you and your expertise.
13:58And, you know, you deserve to be a good friend.
14:00Being a good friend.
14:01But, you know, I think so many women don't realize that, like, you're allowed to feel
14:05grace.
14:07Yes, absolutely.
14:08You know, and I tell people all the time, you know, like, number one, this is no time to
14:11be a hero, right?
14:12This is no time to be white knuckling our way through things.
14:16And number three, most importantly, like, OK, your job is baby.
14:19Sure.
14:20But like, my job is you.
14:22Right.
14:22Like, I think every mom deserves to have at least one setting, preferably more if possible,
14:27like a support group, but one setting where like, you are the focus.
14:30It's all about you.
14:31I'm here for you.
14:33And then, you know, you being well taken care of will help you take care of your baby
14:36better.
14:37Absolutely.
14:38Yeah.
14:38Yeah.
14:39All right.
14:40Well, for everybody out there, this is so important.
14:43And these Virtua Stay Well Health Chats are important.
14:45If not for you, somebody in your life can benefit from them.
14:48It's Virtua.org slash postpartum depression.
14:52Virtua.org slash postpartum depression.
14:54It's on the page.
14:55It's on our website.
14:56It's everywhere.
14:57There are people there to help.
14:58And we're here to spread the message.
14:59Yeah, absolutely.
15:00Thank you so much, Emily.
15:02It's so good to see you.
15:03My pleasure.
15:03So great to see you.
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