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SIGECAPS criteria: (1) feeling weepy/overwhelmed, (2) fatigue/irritability, (3) anhedonia, (4) difficulty sleeping, (5) "I feel guilty...", for a period of 6 weeks = meets the criteria for a depressive episode, and since this was in the post partum period, may be post partum depression.
Next best step is to screen for suicidal ideation/thoughts of harming the child.
"Has it come as a surprise to you how hard parenting is? Many people feel that way." I don't think this validates their feelings, and it would make someone feel badly if you said "hey everyone deals with this shit". Also this answer focused on parenting, rather than the psychiatric concern (postpartum depression).
"im concerned about how bad you've been feeling lately". I think this does acknowledge their feelings, and does show that the physician is engaged. Yes, its blunt. But at its worst, its still more complete than the other ones.
Tough question based on you're reading style.
I totally get how asking about suicide, and asking about it directly is important. But my confusion is how this answer doesn't provide any good segue. I went with "has it come as a surprise..." because i figured that would lend itself nicely to the patient opening up. When i feel it is appripriate, i would then bring up the conversation about self-harm, harming the baby, and suicide. But as its written, the patient tells you they feel shitty, and the physician very directly says "wow you feel pretty shitty". Seems very insensitive and not optimal for honest communication.