Perinatal Mental Health

Perinatal: trying to get pregnant, being pregnant and the first year postpartum (after the birth). 

PMADs: Perinatal Mood and Anxiety Disorders 

Depression during pregnancy or within the first year after your baby is born. Symptoms might include:

● Feeling sad, depressed, or crying a lot  

● Decreased interest in your pregnancy/being a parent  

● Feeling guilty or worthless  

● Difficulty sleeping  

● Increased or decreased appetite  

● Low energy  

● Restlessness, irritability, or difficulty focusing  

● Physical symptoms such as headache, chest pains, heart palpitations, or numbness ● Thoughts of harming oneself  

Anxiety disorders such as generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), and/or panic disorder experienced during pregnancy or within the first year after your baby is born. Symptoms may include:  

● Excessive worry  

● Repetitive thoughts or images about bad things happening to the baby 

● Compulsive behaviors  

● Difficulty sleeping  

● Panic attacks  

A form of psychosis that occurs after your baby is born, most typically within the first two weeks but can be anytime within the first year. Postpartum psychosis is always a psychiatric emergency. Often, the person struggling is not aware that they have this condition and those close to them may be the only ones to notice the signs. Symptoms may include:  

● Delusions (thoughts not based in reality, odd new beliefs)  

● Hallucinations (hearing or seeing things that only you can hear or see) ● Paranoia or suspiciousness  

● Feeling agitated or having more energy that you usually do  

If you or your family notice signs of postpartum psychosis, go to the emergency room immediately or call 911. 

Whether you already have depression, anxiety, OCD, bipolar disorder, ADHD, PTSD or any other mental health issue, the perinatal period can be difficult. For many people, symptoms can develop for the first time during pregnancy or postpartum. You are not alone even if it really feels that way. Effective treatments are available. Please reach out. 

Medications can be a recommended treatment option for many conditions during pregnancy and postpartum. Psychiatric Mental Health Nurse Practitioners (PMHNPs) at Brooklyn Parent Support can work with you to determine what medication(s) may work best for you and provide accurate, up to date information about medication use while pregnant or breastfeeding.   

Therapy is considered one of the most effective treatment options for mental health conditions. Therapists at Brooklyn Parent Support are specially trained to help people manage their mental health during pregnancy and postpartum. If Brooklyn Parent Support does not currently have openings for new therapy patients, we will provide trusted referrals.  

Just like taking medication for physical illnesses like asthma or high blood pressure, taking medication for psychiatric reasons during the perinatal period is often a matter of weighing the risk of the medication against the risk of untreated illness. For example, untreated depression, anxiety, bipolar disorder have been found to increase the risks of certain complications in pregnancy. Although it is hard to do research during pregnancy we do have a large and growing amount of information about the perinatal use of psychiatric medications. One of the best parts of our work is having this discussion with you, sharing information and helping you make decisions that make sense for you. 

Just like taking medication for physical illnesses like asthma or high blood pressure, taking medication for psychiatric reasons during the perinatal period is often a matter of weighing the risk of the medication against the risk of untreated illness. For example, untreated depression, anxiety, bipolar disorder have been found to increase the risks of certain complications in pregnancy. Although it is hard to do research during pregnancy we do have a large and growing amount of information about the effects of psychiatric medications. One of the best parts of our work is having this discussion with you, sharing information and helping you make decisions that make sense for you. 

We offer individual therapy, support groups, and medication management.  

● Individual therapy involves talking with a therapist one on one. 

● Medication management involves meeting with a provider to determine if you could benefit from medication to treat your mental health condition and following up to adjust your prescription as necessary.  

● Combined visits: some people see our Nurse Practitioners for both therapy and medications. 

● Support groups help to treat your mental health condition and develop community.  Groups we offer include Mood Support for Pregnancy and Postpartum (free of charge) and LGBTQIA+ Parents Support Group. 

We will work with you to determine your options for payment.  

● We are in-network with United, Aetna, Oscar, Oxford, and Cigna. Brooklyn Parent Support providers are currently not in-network with any community plans (plans administered by Medicaid).   

● If we do not accept your insurance and you have out of network benefits, you will be billed out of pocket. Brooklyn Parent Support’s team can provide you with a superbill that can then be sent to your insurance company for reimbursement if you have met your deductible.  

● If you do not have any of the accepted insurance plans or out of network benefits, you can pay out of pocket or Brooklyn Parent Support can provide you with in-network referrals.  

We provide mostly virtual services via a secure telehealth platform. When needed, or when desired by our clients, we can see you in person in Williamsburg, Brooklyn. 

Several of us provide telehealth services only. 

Services are provided in English and Spanish. 

We are licensed in New York only, clients must be physically located in New York at the time of the session. 

A PMHNP is a registered nurse who has received a Masters or Doctorate degree in psychiatric care. We are specially trained to provide therapy and prescribe medications. Our nursing background helps us to emphasize education and shared decision making with patients. At Brooklyn Parent Support, our PMHNPs have specialized experience in helping patients with mental health conditions during pregnancy and postpartum.   

You don’t have to decide! If you contact our office, Janaris, our (super friendly) Practice Manager, she can let you know who a good match might be and who has availability. We have Nurse Practitioners who have been midwives, women’s health nurse practitioners, assistant professors, lactation consultants, and family nurse practitioners, who have worked on psychiatric inpatient units, fertility clinics, public hospital labor and delivery units, critical care/ICU, Nurse Family Partnership, and GYN clinics! 

There are treatments that work. Our goal is for you to be well. We believe in true patient centered care: we are an expert resource to help you make a plan that you feel comfortable with, one that takes into account your symptoms, your values and your life. For many people that includes a discussion of medication options and therapy options as well as an exploration of supportive behaviors and social supports. 

This is our specialty. We are happy to see you as you prepare for pregnancy and follow you through the postpartum. Or we can see you for a one visit consultation and help you make a plan so you can return to care with your own prescriber. If you would like us to communicate the plan directly with your prescriber or your OB team, we can do that too. 

We are happy to meet with you for a full evaluation. We can discuss your treatment options during pregnancy, lactation and postpartum, what you might expect given your personal situation and what supports you might consider. If you want to return to your current psychiatric provider we can speak with them about our recommendations. Some people choose to stay with us through pregnancy and postpartum and then return to their previous prescriber. 

Connection, expertise and personalized care

Collaboration with your care team: You may find it helpful for us to talk to your family, your OB team, your therapist, your doula, your pharmacist, your labor and delivery team or someone else. We want everyone to be on the same page and supportive of the treatment that is keeping you well. 

Letters to support you: Even if you don’t want us to talk to anyone directly, we will provide you with letters explaining and supporting your treatment plan which you can share with anyone during pregnancy, labor/birth or postpartum who might ask questions about your medications. 

Postpartum planning visits: We spend a lot of time during our visits working on a plan that will work for you postpartum but we also like to have a visit with you and your partner or main support person during the second half of pregnancy. At this visit we help identify possible challenges, build on strengths and develop an individualized plan which can support your mental health and wellness postpartum. 

Medication visits that are much more than you are used to:  

We build in 30 minutes for your follow-up visits because we do more than send in refills. We know how fertility, pregnancy and postpartum can be disruptive, complicated and full of contradictory emotions. Relationships, jobs, medical complications, physical changes, social media – every visit is focused on you and building your strength and resilience as you face the challenges of this time.