One of a kind UNC center aims to reduce new mothers' depression before and after birth

CORRECTION: An earlier version of this article incorrectly identified Dr. Samantha Meltzer-Brody as Samantha Meltzer. Additionally, it did not include that she is the principal investigator on the brexanolone trials and first author on the paper. The article has been updated with the correct information. The Daily Tar Heel apologizes for this error. 

UNC medical professionals are at the forefront of fighting perinatal depression in women with the UNC Perinatal Psychiatry Program of the UNC Center for Women’s Mood Disorders.

The program was founded in 2004 by Dr. Samantha Meltzer-Brody, the director of the UNC Perinatal Psychiatry Program. Meltzer-Brody serves as the director of the clinical and research aspects of the program, which helps identify and treat perinatal depression. 

“There was a huge unmet need for reproductive mood disorders to be diagnosed and treated,” Meltzer-Brody said. 

The program helps mothers who are struggling with perinatal mood or anxiety disorders. Meltzer-Brody said that during the perinatal stage, which is immediately before and after birth, women can experience low mood, ruminating thoughts or anxiety, loss of enjoyment, changes in appetite and suicidal ideation. 

“Women's mood disorders in the perinatal period are considered one of the greatest medical complications of the perinatal period,” she said. 

Consequently in 2011, Meltzer-Brody opened the Perinatal Psychiatry Inpatient Unit, a five-bed inpatient center for women suffering from severe anxiety and suicidal thoughts, one of the only programs of its kind in the country. The average stay is seven to 10 days. Dr. Mary Kimmel, a psychiatry professor, is the medical director for the perinatal psychiatry inpatient unit. 

Kimmel does research on pregnant and postpartum women. Her research helps to identify symptoms of depression and treat those symptoms. She works with a team of occupational and recreational therapists, nurses and yoga specialists to improve perinatal mood and anxiety. 

Part of Kimmel’s focus and concern is postpartum psychosis, which is depression or anxiety that occurs after birth. Kimmel said that medical professionals believe that 0.2 percent of women experience postpartum psychosis, but she believes that number is too low. 

“I think we are really underreporting,” Kimmel said. 

Kimmel said that anxiety and depression can be a spectrum, so it is hard to diagnose. Women cope with a lot during the perinatal stage, especially concerns about the baby developing properly. 

Kimmel said that women can have acute suicidal thoughts or anxiety so significant that they can’t function. This can be detrimental to the health of the mom and the baby. Kimmel’s goal is to reduce these health risks through the perinatal psychiatry inpatient unity. 

“Mom is important,” Kimmel said. “It is important to the baby’s development.” 

UNC was also one of the primary sites for trials on brexanolone, a medicine designed to decrease anxiety and depression for postpartum moms, pending a FDA decision by March 19. Meltzer-Brody serves as the principal investigator and the first author on the paper. UNC completed all three phases of the trial. The Lancet, an international medical journal, published clinically significant findings. 

“Our results suggest that brexanolone injection is a novel therapeutic drug for postpartum depression that has the potential to improve treatment options for women with this disorder,” The Lancet article said. 

Brexanalone could potentially become a popular drug for treating postpartum depression if it is approved by the FDA. 

Depression and psychiatric care is still not seen as a norm in society. So, women who need treatment do not always seek it out. 

“There is a stigma to psychiatric care in general,” Kimmel said. 

Kimmel said that some patients hesitate to seek treatment because they worry about what other people think, but both Meltzer-Brody and Kimmel want the program to continue helping moms and to serve as a national model. 

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