In the past 7 days:
1. I have been able to laugh and see the funny side of things
As much as I always could (1)

2. I have looked forward with enjoyment to things
As much as I ever did (1)

*3 .I have blamed myself unnecessarily when things went wrong
No, never (1)

4. I have been anxious or worried for no good reason
No, not at all (1)

*5. I have felt scared or panicky for no very good
reason
No, not at all (1)

*6. Things have been getting on top of me
No, I have been coping as well as ever (1)

*7. I have been so unhappy that I have had difficulty sleeping
No, not at all (1)

*8. I have felt sad or miserable
No, not at all (1)

*9 I have been so unhappy that I have been crying
No, never (1)

*10. The thought of harming myself has occurred to me
Never (1)

Score of 10 is borderline; 11+?: .maternaldepression

in the mdm:

SWYC embedded questions, Edinburgh Perinatal Depression Score, and demeanour at today's visit altogether highly concerning for maternal perinatal depression. Per my clinical judgement, it seems unlikely at this specific point in time that mother requires emergent psychiatric intervention and may thus pursue outpatient management. Things to keep in mind as the years go on: studies consistently demonstrate higher risk for childhood ACEs when growing up in homes with guardians or caregivers with untreated mental health conditions, including depression; they also demonstrate a higher likelihood for developing mental health conditions like depression or anxiety themselves; finally, infants require frequent introduction of new stimuli (auditory, visual, physical) for optimal development, and it is well studied that maternal perinatal depression may affect the amount of time able to be devoted to stimuli. It is also my suspicion that parental exhaustion often leads to earlier introduction of smart devices and foods with suboptimal nutrition. In any case, it will be very important to mitigate these risk factors with early intervention programs (not to be confused with the EI we use upon identification of developmental delay).

Newborn affected by maternal perinatal depression
- SWYC +, EPDS >10
- Discussed the the well studied difference in outcomes between patients treated with CBT + SSRIs conjunction vs either solo
Plan:
- Close family member or friend identified to help Mom as she starts the process of connecting with a therapist and psychiatrist/adult provider
- I sent a paper copy of resouces Mom might find helpful as she seeks help

COPY AND PASTE IN THE INSTRUCTIONS!: .ins_ppdepression