Perinatal Mental Health Care
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What is Self-Care?

1/22/2018

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This weekend I went away with girlfriends to celebrate a close friend’s milestone birthday. I am so privileged and grateful to be able to afford to go on a trip like this every few years. We decided to go to Miraval, a beautiful resort outside of Tucson, Arizona. This place is the epitome of self-care and I enjoyed my weekend which included many activities like a rose renewal massage (pictured above), mindfulness meditation, yoga and hiking. This may be what many imagine is self care = too expensive and time-consuming. But that isn’t really an accurate definition.

What is self-care?
 
Self-care is about identifying your own needs and taking steps to meet them. It is taking the time to do some of the activities that nurture you as a living breathing human being who cannot (and should not) always be on autopilot. And it is particularly important for new and expecting moms. Why?

The only way I can answer that question is to tell a story. I used to fly a lot during my college and grad school years. The flight attendants always described the safety features of the plane and I got very used to ignoring this spiel. Then I had a baby. This time when the flight attendant said, “in case of a change in cabin pressure an oxygen mask will drop in front of you and you should put on your own oxygen mask before you assist anyone else,” I thought - Wait, what? I take care of myself first?!?! I decided on that very flight that I was learning something very important: Only when we first help ourselves can we effectively help others. Caring for yourself is one of the most important things you can do for yourself. It is also one of the easiest things to forget. But you benefit greatly from self care and so do others in your life.

Why is Self Care Important specifically for Women?

Women spend most of their lives nurturing others. This can be fulfilling and still have significant ramifications:
"When we find ourselves focusing more on others than ourselves, we become worn out, stressed out and run down. For those of us who spend time helping and caring for others, it is too easy to neglect our own needs. It’s like “running on empty” when we don’t take the time to re-fuel. We spend so much time and effort caring for our partners, children, pets, friends, family members, employers and employees. Add to that the numerous volunteer activities, errands, housework, family functions, meetings, etc.—and there isn’t much time left for caring for ourselves. Women need to balance the stress and activity of daily life with activities that bring a sense of peace and well being to their minds and bodies. Women who neglect their own needs and forget to nurture themselves often become unhappy, have low self-esteem and feel resentment. Self care can help you avoid this outcome by treating yourself as a worthwhile person who is valuable, competent and deserving."
*Fort Garry Women's Resource Centre

What are Some Examples of Self Care Activities?

Practicing self care does not have to cost a lot of money. In fact there are many things that you can do that are free or inexpensive:
  • Talk openly with a trusted friend
  • Sit outside and listen to the birds
  • Practice breathing exercises
  • Make sure you are eating a well balanced diet
  • Get enough sleep at night
  • Take a nap. Rest a while and “recharge”
  • Make exercise a regular part of your routine
  • Take a warm bath/shower. Warm water is very soothing and relaxing for tight and tense muscles and for the mind
  • Go to your church, mosque or synagogue or pray at home
  • Listen to music you enjoy. Dance if you feel like it
  • Try a yoga class or a yoga DVD
  • Journal/write your thoughts down
  • Read a good book recommended by a friend
  • Plant a garden
  • Buy yourself a little something—a flower, a candle to enjoy during your bath.
  • Attend a class to learn something new (meditation, pottery, a language, scrapbooking etc.)

My personal goal is to do one of these things for myself every single day. Sometimes I only get 10 minutes for myself. Other times I can spend an hour. But I make the time, because I am worth it and because it allows me to be the best mother, wife, psychologist, scientist, daughter, sister, friend etc. that I can be.
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Clinical Research Informs Practice

1/11/2018

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For registration information please click HERE
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My program of research at Cedars-Sinai focuses on mood and anxiety disorders during the female reproductive life course and in response to chronic illness. I study the physiological processes that are associated with higher risk for depression and anxiety in pregnancy, postpartum, perimenopause, and following diagnosis and treatment of breast cancer and heart disease. I am also interested in the association between maternal mental health and adverse pregnancy and birth outcomes. My results are published in peer-reviewed journals and I strive to produce work that informs my own and others' clinical practice.

I am the primary or co-investigator on three ongoing institutional review board (IRB)-approved research studies: (1) The Postpartum Heart Health Registry and Biorepository which is designed to understand how early cardiovascular screening and evaluation can help child bearing women reduce their risk of developing heart disease later in life. This database of women with complications during pregnancy will allow us to longitudinally study possible links between complications during pregnancy, mental health, and heart health; (2) The PROVIDE study: Preeclampsia Research on Vitamin D, Inflammation, & Depression which explores whether systemic inflammation and vitamin D deficiency place women at higher risk for developing preeclampsia and postpartum depression; and (3) The Postpartum Depression Quality Improvement Study which will determine accurate prevalence rates of postpartum depression at Cedars-Sinai, test the acceptability and effectiveness of the new Depression Screening, Education and Referral program and will provide valuable patient centered qualitative and quantitative data that can be used in future services planning.


In addition to the three ongoing IRB-approved research studies, I work on analyzing and writing up data collected on Vitamin D levels (not nutritional intake, blood levels) and perinatal depression and other important birth outcomes like preeclampsia and preterm birth. Some of this data will be discussed in an upcoming FREE webinar on Thursday February 1st, 2018. 


Session Goals:
African American women have the highest rates of prenatal and postpartum depression as well as adverse perinatal outcomes (e.g. preterm delivery & low birth weight babies) compared to other racial groups in the U.S. They are at increased risk for vitamin D deficiency because darker skin limits synthesis of vitamin D and due to lower intake of supplemental vitamin D. An exciting and novel area of research focuses on vitamin D’s anti-inflammatory properties and possible anti-depressant effects.
Learning Objectives:
1. Identify symptoms, prevalence and consequences of depression and anxiety in pregnancy and postpartum, with a focus on racial disparities.
2. Learn about the links between perinatal depression and vitamin D and inflammation.
3. Become familiar with research on adverse perinatal outcomes, including depression, and postpartum multi-systemic dysregulation, as measured by high allostatic load.

For registration information please click HERE.

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    Dr. Accortt in the News

    October 2020: The Candidly, PMDD Affects Millions Of Women. So Why Aren’t We Talking About It?

    October 2020: Cedars-Sinai Discoveries Magazine, A Real-Life Stress Test

    July 2020: Cedars Sinai Newsroom, 
    Reproductive Psychology Program Focuses on Mother and Family Wellness

    May 2020: ​Hawaii News Now, Sunrise, How to Prevent Anxiety & Depression Before and After Giving Birth

    April 2020: The Bump, How to Spot Postpartum Depression in Your Partner or Friend

    12/3/19: Quartz, Ten questions about mothers’ mental health could promote resilient pregnancies

    5/10/19: CGTN America, US comedian uses her act to turn the spotlight on postpartum depression

    5/1/19: KTLA News, How One Comedian’s Battle With Postpartum Depression Turned Laughs Into Legislation

    3/20/19: KFI News Radio, FDA Approves First Drug for PPD, Brexanolone (Zulresso)

    Winter 2019: Cedars-Sinai Discoveries Magazine, Stop The Stigma

    9/11/18: USC Center for Health Journalism, Cedars-Sinai PPD Screening Program May be Model for State

    ​
    Summer 2018: Cedars-Sinai Catalyst Magazine, The Helping Hand of Los Angeles Funds Postpartum Depression Screening Program, scroll down to page 40 of magazine

    5/18/18: TODAY.com, Alyssa Milano on Postpartum Anxiety

    5/3/18: Cedars-Sinai Maternal Mental Health Research

    10/19/17: Cedars-Sinai Postpartum Depression Screening Program

    3/24/17: MomCo. App for Social Support

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    Author

    Dr. Accortt is a California licensed clinical psychologist. When she isn't seeing patients in private practice she conducts research in the OBGYN department at Cedars-Sinai. She will update this page with important maternal mental health news and research.

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