Essential reads & resources

Brandy Chalmers, M.A., LPC, NCC and Susan Benjamin Feingold, PsyD, PMH-C 

About Perinatal Mood and Anxiety Disorders

Perinatal mood and anxiety disorders (PMADs) are the most common complications of pregnancy and childbirth in the U.S, with 800,000 American families affected each year with mental health disorders surrounding childbirth. During the childbearing years, women are twice as likely as men to experience a clinical depression, with the postpartum period carrying an elevated risk of a major depressive disorder. Pre-existing mental health problems and stress add to this increased risk.

According to a 2022 study in Journal of Psychiatric Research, “there was a significant increase in postpartum depressive symptoms over the course of the pandemic timeframe.” The pre-pandemic incidence of PMAD is estimated to be 1 in 5 mothers experiencing postpartum depression and or anxiety disorders. These mental health problems can interfere with maternal functionality, infant health, and maternal-infant bonds, as well as the joy every woman wants to experience following the birth of a baby.

Although this debilitating diagnosis can cause havoc in a new mother’s life, the good news is that these conditions are treatable when diagnosed and treated by mental health professionals with perinatal expertise. Approximately 90% of women who have postpartum depression and/or anxiety can be treated successfully with a combination of psychotherapy, peer support, and medication.

About Seven Starling

Seven Starling is an online maternal mental health clinic that provides specialized support for women. We provide comprehensive therapeutic virtual care for PMADS that is accessible, affordable, convenient, and effective. Online care models are a powerful treatment option to overcome the treatment barriers that many new mothers face such as mobility, transportation, time constraints, stigma, and childcare concerns.

Our comprehensive approach to treating PMADs includes individual therapy, group therapy, and medication management. In addition to these services, our in-app self-guided exercises and reflections allow patients to engage in self-initiated coping strategies outside of their scheduled sessions.

At Seven Starling, patients receive personalized support from a dedicated Patient Care Advocate and a licensed therapist that specializes in perinatal mental health. Seven Starling therapists have years of experience supporting parents and are trained in the Seven Starling method.

Delivering culturally-diverse and congruent care is central to our values and priorities as an organization. Our therapist team is as diverse as our patient population - over 50% of our licensed therapists identify as BIPOC.

Who we treat

Seven Starling supports people who are experiencing Anxiety, Depression, or Trauma throughout:

• Fertility challenges
• Pregnancy
• Pregnancy loss and miscarriage
• Abortion
• Postpartum (up to two years)

How members can get started

Wondering how to sign up or refer a loved one to Seven Starling? Prospective patients can complete a free consult to get started. Click here to pick a time.

Most patients have their first appointment scheduled within 7 days of signing up.

Our Evidence-Based Approach

Research shows that both psychotherapy and other psychosocial interventions are effective in mitigating symptoms of Perinatal Mood and Anxiety Disorders (PMADs). Interpersonal psychotherapy, cognitive behavioral therapy, and other supportive interventions such as peer support or partner support are deemed highly effective.

INDIVIDUAL THERAPY

The vast majority of research surrounding the efficacy of individual therapy for treatment of PMADs highlights the theoretical orientations that Seven Starling therapists align with including interpersonal therapy and cognitive behavioral therapy. These modalities are found to be evidence-based and best practice for the treatment of PMADs.

A recent study found that the rate of recovery from PMADs through evidence-based therapy (69%) was significantly greater than that of the control group who did not receive therapy (38%) demonstrating the efficacy of individual therapy in treating PMADs. However, time and time again the combination of individual therapy coupled with peer support (ie. group therapy) presents itself in research as a recommendation for the highest standard of care.

At Seven Starling, postpartum patients rotate weekly between individual therapy and group therapy to ensure that they are receiving the highest quality care for positive treatment outcomes.

GROUP THERAPY

While group therapy is an optional component of the support we offer at Seven Starling, we strongly believe in the power of community. Group therapy has been found to be an effective modality for treatment of PMADs. Its effectiveness is amplified when coupled with individual therapy. Group therapy can offer increased social support, normalization of experiences, development of interpersonal skills in a group setting that can be translated to outside relationships, and minimization of stigma associated with diagnosis of a PMAD.

Additionally, epidemiological data has consistently identified inadequate social support as a risk factor for developing postpartum depression, raising the possibility of interventions aimed at increasing social support as a treatment option for perinatal depression.

Numerous studies demonstrate that individual therapy and group therapy are equally effective on their own. However, the combination of the two is highlighted as the gold standard for treatment.

With Seven Starling, new mothers are never alone. They are able to share judgment-free, build community, and normalize their experiences in group therapy sessions with other mothers and their licensed therapist.

MEDICATION MANAGEMENT

As part of our holistic approach to support at Seven Starling, we recommend an initial Medical Evaluation with our specialist team of Psychiatrists and Psychiatric Nurse Practitioners.

Hormonal changes and medical conditions such as thyroid issues can contribute to mood disorders like depression and anxiety. Understanding the full picture behind the way you're feeling is part of ensuring you have a personalized and comprehensive care plan. About 30% of women suffering from maternal mental health challenges can benefit from a combination of both therapy and medication.

‍Note: At this time we’re not able to offer medications to pregnant patients. If you’re pregnant and think you might benefit from medication, please consult your OB care provider.

SELF-GUIDED TOOLS

Seven Starling offers self-guided tools for patients to utilize between sessions with their licensed therapist. Research shows that the use of supplementary self-guided coping strategies and tools for women with a PMAD can support positive health outcomes.

New mothers can expect to find an array of self-guided tools in the Seven Starling app, ranging from exercises to build positive affirmations for oneself to diving into their own personal gratitude journal with built-in prompts. Additionally, an array of resources are available related to other topics like managing uncertainty and mindfulness exercises to promote relaxation.

Our Commitment to High Clinical Quality

Seven Starling is committed to delivering evidenced-based care and maintaining high standards of integrity and clinical quality. Using treatment techniques that are supported by research and evidence is core to our mission.

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SOURCES

Bajaj, M., Rodion, S., Zhaunova, L., & Payne, J. Rates of self-reported postpartum depressive symptoms in the United States before and after the start of the COVID-19 pandemic. Journal of Psychiatric Research. 2022; 151, 108-112.

Bradshaw, H., Riddle, J., Salmgaraev, R., Shaunova, L. & Payne, J. Risk factors associated with postpartum depressive symptoms: A multinational study. Journal of Affective Disorders, 2022; 301, 345-351.

Baumel, A., Tinkelman, A., Mathur, N., & Kane, J. M. (2018). Digital Peer-Support Platform (7Cups) as an Adjunct Treatment for Women With Postpartum Depression: Feasibility, Acceptability, and Preliminary Efficacy Study. JMIR mHealth and uHealth, 6(2), e38.

Duffecy, J., Grekin, R., Hinkel, H., Gallivan, N., Nelson, G., & O'Hara, M. W. (2019). A Group-Based Online Intervention to Prevent Postpartum Depression (Sunnyside): Feasibility Randomized Controlled Trial. JMIR mental health, 6(5), e10778.

Fitelson, E., Kim, S., Baker, A. S., & Leight, K. (2010). Treatment of postpartum depression: clinical, psychological and pharmacological options. International journal of women's health, 3, 1–14.

O’Mahen, H.A.; Woodford, J.; McGinley, J.; Warren, F.C.; Richards, D.; Lynch, T.; Taylor, R.S. Internet-based behavioral activation—Treatment for postnatal depression (Netmums): A randomized controlled trial. J. Affect. Disord.; 2013; 150, pp. 814-822.

Pugh, N.E.; Hadjistavropoulos, H.D.; Dirkse, D. A Randomised Controlled Trial of Therapist-Assisted, Internet-Delivered Cognitive Behavior Therapy for Women with Maternal Depression. PLoS ONE; 2016; 11, e0149186.

Simhi, M., Sarid, O., Rowe, H., Fisher, J., & Cwikel, J. (2021). A Cognitive—Behavioral Intervention for Postpartum Anxiety and Depression: Individual Phone vs. Group Format. Journal of Clinical Medicine, 10(24), 5952.

Shuman, C.J., A.F., Pareddy, N. et al (2022). Postpartum depression and associated risk factors during the COVID-19 pandemic. BMC Res Notes 15, 102.

Tandon SD, Johnson JK, Diebold A, Segovia M, Gollan JK, Degillio A, Zakieh D, Yeh C, Solano-Martinez J, Ciolino JD. (2021) Comparing the effectiveness of home visiting paraprofessionals and mental health professionals delivering a postpartum depression preventive intervention: a cluster-randomized non-inferiority clinical trial. Arch Womens Ment Health. 2021 Aug;24(4):629-640.

Tikotzky, L. (2016). Postpartum maternal sleep, maternal depressive symptoms and self-perceived mother-infant emotional relationship. Behavioral Sleep Medicine 14, 5-22.

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