Perinatal Mood and Anxiety Disorders: What You Should Know
There is no doubt that bringing a new baby into the world is a life-changing event. For some, this time is full of joy, excitement, and deep love. For some, it is a time of stress, overwhelm, fear, and uncertainty. For everyone, it is a mix of these feelings and more.
In our society, the perinatal time (throughout pregnancy and up to a year postpartum) is met with a lot of expectations. Most often, that it will be beautiful, you will be glowing, and you will seamlessly learn the needs of your new baby when you are sent home from the hospital. We expect parents to navigate this new world with little support from the people and systems around them. As a perinatal mental health therapist, one of the most common phrases I hear is “this is nothing like what I thought. Why didn’t anyone tell me about this?”
The answer is simple: stigma. As we learn more about Perinatal Mood and Anxiety Disorders (PMADs), we know how common they are. Between 15-20% of women and 10% of men will experience significant symptoms of anxiety or depression after birth. That number skyrockets to 80% when we discuss the baby blues, a term used to describe the tearfulness, overwhelm, and mood swings that can accompany the first 2-3 weeks after birth. Still, a majority of these cases go without treatment. There are many reasons for this including lack of awareness, trouble accessing services, cultural and racial bias in our healthcare system, and shame asking for help. In order to break the stigma, it’s important that we talk about PMADs, how to identify them, and how to get help if you or someone you know may be struggling in pregnancy or postpartum.
What to look out for
Symptoms of PMADs can vary, but common symptoms include:
feeling sad, anxious, or irritable
having trouble sleeping or eating
feeling guilty or worthless
little interest in connecting with or taking care of your baby
excessive worrying about your baby’s sleep, breathing, eating, etc.
having thoughts of harming oneself or the baby
In non-birthing partners and fathers, symptoms often look like anger, irritability, or disengagement from the baby or the birthing partner.
The differences between baby blues and and postpartum depression include onset (baby blues typically begin a couple of days after birth and can last 2-3 weeks), severity (postpartum depression includes more severe symptoms), and duration (baby blues typically resolves on its own while postpartum depression typically resolves only with treatment). It's worth noting that the line between baby blues and PPD can sometimes be blurry, and it's not uncommon for baby blues to develop into PPD if left untreated. Therefore, it's crucial to be aware of the symptoms and seek help if needed.
When and how to get help
It can be difficult to determine when and how to reach out for support. If your symptoms aren’t resolving 2-3 weeks after birth or are getting worse, it’s a good time to get in touch with a professional to talk about treatment options. If you are experiencing thoughts of harming yourself or your baby, it is crucial to seek help immediately. Remember, there is no shame in asking for help, and getting the support you need can make a significant difference in your well-being and the well-being of your baby.
There are many places you can reach out to for support if you are experiencing mental health concerns in pregnancy or postpartum. A great first step is reaching out to your OBGYN, who can help determine what treatment would be helpful based on your symptoms. Everyone should be screened for PMADs at their six-week postpartum checkup, so be sure to request this screening if your doctor doesn’t provide it for you at your follow up visit.
Additionally, a great online resource is Postpartum Support International. PSI provides a host of great resources, including a support line, online chat with an expert, daily online support groups, and a directory of therapists who are certified in perinatal mental health.
If you are experiencing a mental health emergency, go to your nearest emergency room or call 911. If you are having thoughts of hurting yourself contact the crisis and suicide lifeline at 988.
What does treatment look like?
Here’s the good news: PMADs are very treatable. Most PMADs resolve with proper treatment from a professional. Treatment of PMADs can vary depending on the severity of the symptoms and the individual's specific needs. Here are some common treatment options:
Therapy: Talk therapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT), can be highly effective in treating PMADs. These therapies help individuals identify and change negative thought patterns, develop coping strategies, and improve communication and relationships. When you are looking for a therapist, make sure to ask if your therapist is certified in perinatal mental health or has experience treating PMADs, as this treatment can look different than treatment for typical depression or anxiety.
Medication: In some cases, medication may be prescribed to help manage the symptoms of PMADs. Antidepressants, anti-anxiety medications, or mood stabilizers may be used, depending on the specific diagnosis and individual needs. It's important to consult with a healthcare professional to determine the best course of treatment.
Support groups: Joining a support group can provide a sense of community and understanding for individuals experiencing PMADs. Sharing experiences, receiving support, and learning from others can be incredibly helpful in the recovery process.
Lifestyle changes: Making certain lifestyle changes can also contribute to the treatment of PMADs. This may include getting regular exercise, practicing relaxation techniques (such as deep breathing or meditation), maintaining a healthy diet, and ensuring adequate sleep.
Social support: Having a strong support system is crucial for individuals with PMADs. This can involve reaching out to family and friends for help, delegating tasks, and seeking emotional support. It's important to communicate your needs and not hesitate to ask for assistance.
Remember, treatment for PMADs is not a one-size-fits-all approach. It's essential to work closely with healthcare professionals to develop a personalized treatment plan that addresses your specific needs and circumstances. Seeking help early on can greatly improve outcomes and help you on your journey to recovery.
Is there anything I can do to prevent PMADs?
While there are no ways to guarantee that you won’t experience a PMAD, there are steps that you can take that can lower your risk. The most important thing you can do in pregnancy and postpartum is to prioritize self-care! This doesn’t have to be elaborate spa days and hour-long yoga classes. Keep it simple. Focus on getting as much quality sleep as you can (which might mean asking for help so you can take naps or get longer stretches of sleep), eating nutritious meals and snacks throughout the day, staying hydrated, and getting some exercise. Again, be realistic about what you can do. Exercise may look like some light stretching or a 10-15 minute walk rather than a high intensity workout at the gym. Any body movement (that is approved by your doctor) is a great way to prioritize your mental health.
Building a strong support system of family, friends, and healthcare professionals can also be beneficial. Talk to the people around you about how you are feeling and allow others to support you. Remember, 1 in 5 women will experience a PMAD, so chances are you know someone who has experienced something similar to what you are going through. Lastly, finding local prenatal classes, support groups, or parent meet-up groups can provide valuable information and resources. Remember, PMADs can still occur even if you take these preventive measures, so seeking help and support if you experience any symptoms is crucial.
TLDR
Perinatal Mood and Anxiety disorders are extremely common, and can be successfully resolved with help from a professional. Symptoms vary but often look like feeling sad or anxious, having trouble taking care of yourself, and having little interest in connecting with your baby. There are various treatments that can help, including therapy, medication, and lifestyle changes. It’s important to reach out to a professional if you think you or someone you know may be experiencing a PMAD.
You are not alone. You are not to blame. With help, you will be well.
