Episode 18: Holistic Psychiatry for New Mothers with Dr Rebecca Moore

Dr Rebecca Moore is a Perinatal Psychiatrist with over 20 years of clinical experience working with women during pregnancy and the postpartum period. She specializes in working with women with depression, anxiety, birth trauma or PTSD, OCD and psychosis. She also works with women with PMDD and through the menopause or through infertility. Rebecca is the co-founder of the Make Birth Better campaign and is an advocate of the use of medical cannabis.

In this episode we talked about:

Rebecca Moore describes herself as a Holistic Psychiatrist - seeing someone in all aspects of their health including diet, exercise, supplements, blood tests, understanding their family, social networks, spirituality, hobbies alongside therapy and medication.
Choices need to be tailored to the unique individual
Interplay between physical and mental health
Building a therapeutic relationship by having a genuine interest in the person’s life
It can be difficult to know when you need help if you are a new mother
If something feels like an issue most days, for most of the day, it’s likely to be more than just a transition to new motherhood
Not all postnatal illness is depression: it might be anxiety, traumatic birth or OCD
The onus can’t always be on women to reach out. We need to reach out to them
Fear of being judged or criticized
Fear of telling someone in case the baby is taken away
More than 50% of women who are having issues in the perinatal period don’t seek help, because of fear
It’s possible to be a good mother and be anxious
Lots of support available to keep families well and together
Medication: can feel frightening regarding starting and stopping, it is a good choice for some women. It should always be a choice so you feel informed and empowered
Staff in busy teams are often traumatised themselves - they are so burnt out that they can’t give the support that women need
Staff are the lynchpin of care and need to be supported including protected breaks, access to good food, getting off the unit, space to process
Compassion fatigue can be as harmful as receiving overtly negative care
NHS England will fund more mental health services for dads next year https://www.independent.co.uk/life-style/health-and-families/nhs-mental-health-fathers-anxiety-depression-parent-a8664611.html
The idea of a family review rather than just a maternal review
Dads can be traumatized by birth and have mental health issues, but are often less likely to ask for help
Issues of short paternity and the impact of connection - greater shared parental leave could help
Helping to hear what you want, by drowning out the external noise
Hear your gut instinct by finding quiet moments of pause
Body-based approaches such as breathing or yoga
It’s common to feel very disconnected from the body after birth
The narrative “you can have it all” - often at the expense of themselves
The mother and baby are equal parts- it’s not just about the baby so both need to be nourished in order to thrive
Couples can keep connecting with hugs, making each other tea
CBD and medical cannabis for anxiety, sleep, low mood, Post-Traumatic Stress Disorder, offering another choice for people
The potential use of CBD in pregnancy e.g. for nausea symptoms
Research into psychedelics including mushrooms, LSD and ketamine
Ketamine is licensed for depression in the U.S
Always medication alongside something else such as yoga, exercise or meditation as a prescribed activity
Exercise is proven to be as effective as antidepressants for people with depression