What we treat
Psychiatric care during pregnancy, postpartum, and the first year of parenthood
Perinatal psychiatry addresses mental health during pregnancy and the first year after delivery. Perinatal mood and anxiety disorders affect up to 1 in 5 women, yet they remain underdiagnosed and undertreated. At MindMED, Dr. Fredes provides perinatal psychiatric care in Southlake, TX for mothers facing these conditions. She is board-certified in psychiatry (ABPN), and care during pregnancy and after birth is one area of her adult practice.
Pregnancy and the postpartum period are not always happy, glowing times. Women may experience intense anxiety, persistent sadness, intrusive thoughts, or a sense of disconnection from their baby. These are medical conditions, and they are treatable. Whether symptoms started during pregnancy or after childbirth, you are weighing medication while breastfeeding, or you are grieving a pregnancy loss, you deserve care that accounts for both you and your baby.
Fear about medication safety is one of the biggest barriers to perinatal treatment. Many women stop psychiatric medication when planning to conceive or on learning they are pregnant, hoping to protect the baby. That choice carries its own risks: untreated depression or anxiety in pregnancy is associated with higher rates of miscarriage, preterm delivery, low birth weight, and postpartum depression. The question is how to treat safely.
Dr. Fredes focuses on evidence-based medication management during pregnancy and breastfeeding. The research is now strong enough to support individualized decisions. Some medications are considered lower-risk in pregnancy, and several SSRIs are commonly used as first-line options. Others carry modest risks that may be outweighed by the risks of untreated illness. Many psychiatric medications also pass minimally into breast milk, which opens further options while breastfeeding.
The approach is shared decision-making. Dr. Fredes will go over your specific medication, the condition being treated, your pregnancy or breastfeeding plans, and the best available evidence on risks and benefits. Your values and circumstances shape the decision; she brings the evidence and looks out for both you and your baby.
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It can be hard to tell normal adjustment from a perinatal mood disorder, especially when you are exhausted. The "baby blues" (mild mood swings, crying, and anxiety in the first 1-2 weeks after delivery) are common and pass on their own. If you notice any of the following, reach out:
Treatment is available, and earlier is better. You deserve support.
Baby blues occur in the first 1-2 weeks after delivery: mood swings, crying, anxiety, irritability, and sleep disruption. They affect 50-80% of new mothers and resolve on their own. Postpartum depression persists beyond 2 weeks, with persistent sadness, hopelessness, difficulty bonding, loss of interest, and difficulty functioning. It is a medical condition that needs treatment.
It depends on your medication, your condition, and the stage of pregnancy. Some SSRIs are considered first-line in pregnancy. Untreated depression or anxiety carries real risks to both mother and baby, including preterm delivery and low birth weight, and those risks often outweigh the risks of medication. Dr. Fredes can go over your situation with you.
Often, yes. Many psychiatric medications pass into breast milk in very small amounts and are considered safe. Not all are, and the choice depends on the specific drug, dose, and your baby's age and health. Dr. Fredes can go over the options with you.
No. Postpartum OCD involves intrusive, distressing thoughts and compulsive behaviors, with insight preserved: you know the thoughts are not real. Postpartum psychosis involves delusions or hallucinations and a loss of touch with reality. Both need treatment, but postpartum psychosis is a psychiatric emergency.
Not necessarily. A history of postpartum depression raises the risk, but recurrence is not inevitable. Dr. Fredes can work with you before your next pregnancy on a prevention plan, which may include medication, close monitoring, and support. With a plan in place, some women avoid recurrence or have milder symptoms the second time.
This is a mental health crisis requiring immediate attention. Call 911, go to your nearest emergency room, or call the 988 Suicide & Crisis Lifeline (call or text 988). These thoughts are a symptom of a treatable psychiatric condition. Getting help now is the right step, and urgent treatment saves lives.
Yes, in some cases. Some women's mood worsens with hormonal contraceptives. If you are struggling with postpartum depression or anxiety, discuss contraceptive options, including non-hormonal methods, with both your psychiatrist and your OB/GYN.
Bring it up directly: "I'm concerned about my mental health and would like a psychiatric evaluation," or "I'm on an antidepressant and want to talk about whether to continue it during pregnancy." Many OB/GYNs are familiar with perinatal mood disorders and can refer you to a psychiatrist who treats patients during pregnancy and after birth, such as Dr. Fredes. Your obstetric and psychiatric care should work together.
Schedule a consultation with Dr. Fredes to discuss your care.