Pregnancy, pandemic and mental health

Podcast: Dr. Lea Berentson talks women's mental health during trying times

Pregnancy, pandemic and mental health

Episode Transcript

Courtney Collen (Host): Hello and welcome to Her Kind of Healthy, a brand new health podcast series brought to you by Sanford Women’s. I’m your host, Courtney Collen with Sanford Health News. We want to start brand new conversations about age old topics from fertility and postpartum depression to managing stress, healthy living, and so much more. Her Kind of Healthy is designed to bring you honest conversations about self care, happiness and your overall well-being with our Sanford Health experts. We’re so excited to have you here, where we are talking all about women and mental health. And we are sitting down now with Dr. Lea Berentson, a Sanford Health clinical psychologist in Bismarck who specializes in perinatal mental health. Dr. Berentson, thank you so much for joining us.

Dr. Lea Berentson: Thank you for having me.

Host: So I want to learn a little bit more about you and your work. So if you can just tell us what you do?

Dr. Berentson: Right now, I’m located at Sanford Women’s Clinic in Bismarck, where I specialize in providing care to the women who are patients at that clinic. And a lot of that is focused on perinatal mental health, which is essentially the time before pregnancy, during pregnancy, and postpartum.

Host: This is a pretty unique scenario where you are at the clinic in Bismarck with Sanford Women’s, talk about the uniqueness of being one of the only psychologists embedded into a clinic and what you enjoy most about that so far, because you’re fairly new to the Sanford family. Is that right?

Dr. Berentson: Yeah. You know, it’s been a fantastic experience working so closely with other disciplines. I think traditionally the model is that behavioral health is in a separate location and, you know, although there is some interaction with other providers being embedded in the women’s clinic gives not only the patients better access to behavioral health services, but the providers as well. So one of the things that I’ve enjoyed most is being part of a team of physicians who are just so invested in the care of their patients, both mental and physical health. And then also, you know, reducing one of the barriers to accessing mental health care by having services right there in the clinic, and being able to get women in, in a timely manner.

Host: What are some of the more common sought after services and what are patients wanting from you right now?

Dr. Berentson: As a psychologist working in the women’s clinic, my primary job is to assess and treat a wide variety of mental health issues. And part of, I would say the, of what I’m doing now is in the perinatal mood and anxiety disorder realm. So again, we’re having a lot of women seeking services either before pregnancy, during pregnancy, or after pregnancy. And so what I do is I assess for things such as depression, anxiety, bipolar disorder, obsessive compulsive disorder, post-traumatic stress disorder, amongst other things. And so we’re seeing a lot of women even before pregnancy wanting some help with preconception planning even. So maybe they’ve had a history of mental health issues and they’re wondering, you know, can they stay on their medication? How did they treat their issues during pregnancy to create better outcomes? Or you may have a mom who’s, you know, during pregnancy starting to feel these things for the first time. So being able to meet that woman where she’s at in just different developmental stages of her life.

Host: So if a woman is seeking the services like these, but maybe she doesn’t live in a Bismarck area or the Bismarck region, where can she access services like this?

Dr. Berentson: I think a great place to start would be to visit Postpartum Support International’s Website. And that website is It’s a really great resource for all things related to perinatal mental health, and it’s really designed to help connect people to services in their area. So there’s a provider directory there there’s also especially if they are having any concerns about pregnancy or postpartum, there are a number of free online support groups that they offer through their website as well, that are trained by mental health professionals. So that would be a good place to start if they’re looking for information in this specific area.

Host: And if they are having complications and need that support, how important is it to find those resources in their community?

Dr. Berentson: It’s very important. I mean, we know through research how untreated depression, anxiety, and stress can impact the baby’s development, can impact postpartum outcomes, and so many things. So if a mom is feeling that something is not right, they should definitely start by talking to their OB or their primary care physician, their family practice doctor, the pediatrician. You know, really any medical provider that they can to just let know, you know, something doesn’t feel right, because there is treatment out there and treating, and just so important for short term and long term outcomes.

Host: Let’s shift to the COVID-19 pandemic now, which is top of mind for a lot of us. What are you hearing from women in your community about this pandemic and kind of give us an idea of what those more commonly asked questions are that you are receiving?

Dr. Berentson: I mean, I’ll start by saying that this is definitely a time where we’re seeing an increase in depression and anxiety, and we have some research to support that too. There was a recent study that came out, not too, I mean, just within the last few months out of the University of Calgary, which sampled 641 women, some of them were expecting and some already had children of various ages. And what they found was that almost 43% of women who had children between 18 months and four years were endorsing clinically significant levels of depression. So that’s a huge number. And I think that reflects what I’m seeing clinically too, is that there’s a ton of anxiety related to the unknowns of all the situations that we’re going through. You know, women are having to make some really hard decisions during this time and decisions in where, again, a lot of things are uncertain, but they have to make these decisions about their own health, their own families, financial strain. There’s just so much going on. So a lot of the things that moms want to know is, you know, how do I cope with the this anxiety in a world that’s so uncertain. And so then we talk about, you know, what can you do to help you feel like you have more control over your circumstances and then teaching them additional strategies to take care of their mental health during this very stressful time.

Host: Yeah. What are some of the things that we can do at home if we feel anxious, whether we are carrying a child, whether we are postpartum or just a woman in general, dealing with the stress and anxiety of what’s going on?

Dr. Berentson: I like to take a pretty integrative approach because I feel, you know, one size doesn’t fit all. And I really think that it’s good to have a wide variety of ways to cope with stress and anxiety. So for some women, you know physical exercise and getting out and doing yoga or cardio activities is really, really helpful. Although not everyone has time to do those things, especially if you are stuck at home taking care of your kids and don’t have those opportunities, but other things that we can do that are really helpful and good predictors of better mental health are maintaining healthy and positive relationships. So in this time, you know, we’re really having to be creative about what that looks like, and maybe it’s not, you know, going out necessarily, but it could be calling a friend or creating a zoom date with someone that you maybe haven’t talked to in a while. So just maintaining those positive relationships, doing things to help calm the nervous system.

I take a trauma focused approach in my work. And so I’m always thinking about, you know, how our bodies react physiologically distress and what we can do to calm our nervous system and regulate our nervous system again, because if we are feeling physically anxious, it’s very hard then to change our thinking about anxiety. So really have to start with changing how we feel in our bodies. And one very simple way of doing that is what we call paced breathing, or deep breathing, but there’s a particular way to do it. That will activate that part of our nervous system that we really want turned on. And so the technique is breathing in for four seconds and exhaling for at least eight seconds. And this way you’re giving your body a signal to relax. It reduces heart rate, and then you notice your blood circulation changes, and it’s a really effective strategy for managing anxiety.

Host: You know, I’m sure a lot of women could really find that useful right now. And I want to know Dr. Berentson, how did the pandemic overall impact your practice? Did you incorporate telehealth, telemedicine at all? Were you able to visit with your patients through video?

Dr. Berentson: Yes. Right now, I am working remotely, so I’m doing pretty much a hundred percent telemedicine right now, which has worked really, really well, especially in this particular population of patients that I see being able to safely access mental health care from the comfort of their home. Not having to worry about arranging childcare or risking going into you know, a different setting if we’re in the middle of a quarantine, for example. So it’s been, I think, a real asset for patients to be able to have that access and reduce that barrier. Given that there are very few people that specialize in this particular area, we are seeing patients from all over North Dakota. And so it’s nice for some of these patients who live in rural areas who don’t have to drive them three hours for an appointment. They can just log on through telehealth and get the help that they need. So that’s been really nice.

Host: Generally speaking in any stage of life, how important is it for us women to take notice and take control of our mental health?

Dr. Berentson: I’m glad you asked that because really the work that I do is not just related to perinatal. You know, I think women’s mental health is through our entire lifespan. You know, there are just different stages in our lives where we go through hormonal changes, social changes, role changes, and all of that contribute to our mental health. And I think women need to know that they deserve to feel well. And if they don’t feel like themselves, please speak up. You know, we are here to help you figure out what might be going on and to help get you feeling like your best self. You know, when we take care of women, I really believe that we are taking care of families and in the broader sense communities, you know, so we have to take care of our women.

Host: Such great information. And again, emphasize how women can find resources within the Sanford footprint. Maybe they don’t live in the Bismarck area specifically or in North Dakota, but they still want that Sanford Women’s connection. How can they do that and get the care?

Dr. Berentson: Starting with having them speak up and bring up any concerns they have with their doctor, whether it’s an OB/GYN, a family practice doctor, starting there and just letting them know, Hey, this is what’s going on. You know, Sanford has wonderful behavioral health providers throughout the footprint as well. So there are a lot of great clinicians out there that can help with things like depression and anxiety and any other concerns. Then there are more of those specific resources that, you know, if a person wants more information about the postpartum stuff, we talked about that website there. And if I’m missing something, you know, there are other places in North Dakota that maybe I’m not entirely familiar with what they have to offer, but again, starting with your provider and just speaking up is the first step.

Host: Wonderful. Well, we thank you so much for your time and your insight and expertise, as we all learn about your role with Sanford, embedded into that Sanford Women’s Clinic. And then of course, as we all navigate, COVID-19 Dr. Berentson, we appreciate your time and we thank you. Our audience as well for joining us. This has been another edition of the Sanford Women’s podcast, Her Kind of Healthy. And we thank you for being here. Stay well and have a great day.

Dr. Berentson: Thanks for having me.

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Posted In Behavioral Health, Bismarck, COVID-19, Leadership in Health Care, Parenting, Pregnancy, Specialty Care, Virtual Care, Women's