Learning More about Pregnancy and Postpartum Mental Health
What if you are not feeling like yourself, or if you don't like how you are feeling? People may be telling you this is the happiest time of your life, but what if it's not?
Are you feeling sad or depressed?
Do you feel more irritable or angry with those around you?
Are you having difficulty bonding with your baby?
Do you feel anxious or panicky?
Are you having problems with eating or sleeping?
Are you having upsetting thoughts that you can’t get out of your mind?
Do you feel as if you are “out of control” or “going crazy”?
Do you feel like you never should have become a mother?
Are you worried that you might hurt your baby or yourself?
(Perinatal Mood & Anxiety Disorders Overview from Postpartum Support International)
If so, you may be suffering from anxiety or depression. Everyone experiences anxiety and sadness sometimes. However, it's important to be aware of the signs and symptoms of perinatal mood disorders, including depression and anxiety. We want you to know that Perinatal Mood Disorders are treatable. If you or someone you love is suffering from anxiety or depression during pregnancy or after the baby is born, please reach out for help. Talking with your medical provider is a good place to start, or use the resources listed in this directory.
Is this "Baby Blues"?
The term Baby Blues is a common term used for the symptoms that up to 80% of mothers will experience following their delivery. Symptoms usually start within a few days of delivery and can last up to three weeks. Symptoms mimic those of postpartum depression but are not present the entire day, every day. Mothers often feel a sense of being overwhelmed, anxious, irritable, difficulty sleeping, tearful/crying spells etc. The Baby Blues are temporary, they are not an illness, and symptoms typically go away after a few weeks.
What is Postpartum Depression?
Approximately 15-20% of new moms experience depression. Symptoms of depression include sadness or crying, feeling irritable or angry, difficulty concentrating, lack of interest in things once enjoyed, withdrawal from others, feeling detached or having difficulty bonding with the baby. These symptoms can begin anytime within the first year following childbirth. 10% of women experience depression during pregnancy. Perinatal depression is the most common complication of childbirth.
Could this be Postpartum Anxiety?
Symptoms of perinatal anxiety include constant or extreme worry about the baby, physical symptoms like nausea or headache, panic attacks, restlessness, and difficulty sleeping or eating. According to PSI, approximately 6% of pregnant women and 10% of postpartum women develop anxiety. Sometimes they experience anxiety alone, and sometimes they experience it in addition to depression.
What about Postpartum OCD?
Postpartum OCD is often misunderstood. This condition often presents as having intrusive and unwanted thoughts about your baby. OCD is an anxiety disorder that many women may have prior to pregnancy and can intensify with the pregnancy and after the birth of the baby. It is estimated that as many as 3-5% of new mothers and some new fathers will experience these symptoms. The repetitive, intrusive images and thoughts can be very scary and can begin out of nowhere. The Postpartum Stress Center lists the following as examples of common thoughts that mothers and or fathers may experience;
“What if I drop my baby down the steps?”
“What if I burn the baby in the bathtub?”
“I’m afraid I might take one of the knives in my kitchen and stab the baby” Or, “What if I slip and one of the knives falls on my baby”
“I can picture myself driving off the road with my baby in the car”
“I think my family would be better off without me”
“I can see terrible graphic violent things happening to my baby.”
As distressing as it is to have these thoughts, the feeling of distress is reassurance that you are not going to act on these thoughts. According to PSI, research has shown that these images are anxious in nature, not delusional, and have very low risk of being acted upon. Working with a therapist can help you develop and utilize coping skills to manage and decrease these thoughts.
What is Postpartum Psychosis?
The following information is from the PSI website: According to PSI, Postpartum Psychosis is rare compared to postpartum depression and anxiety, occurring in approximately .1 -.2% of births. Postpartum Psychosis presents within a few days to two weeks after delivery. Symptoms include delusions, hallucinations, extreme irritability, hyperactivity, inability to sleep, paranoia, rapid mood swings, and difficulty communicating at times. The most significant risk factors for postpartum psychosis are a personal or family history of bipolar disorder, or a previous psychotic episode. PSI reports that of the women who develop a postpartum psychosis, research has suggested that there is approximately a 5% suicide rate and a 4% infanticide rate associated with the illness. This is because the woman experiencing psychosis is experiencing a break from reality. In her psychotic state, the delusions and beliefs make sense to her; they feel very real to her and are often religious. Immediate treatment for a woman going through psychosis is imperative. Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and this is why women with this illness must be quickly assessed, treated, and carefully monitored by a trained healthcare perinatal mental health professional. Postpartum psychosis is temporary and treatable with professional help, but it is an emergency and it is essential that you receive immediate help. Call your doctor or an emergency crisis hotline right away so that you can get the help you need.
Why do perinatal mood and anxiety disorders occur?
No one can say for sure why some women develop maternal depression and anxiety and some don't, but here is what we know to be factors that increase risk.
Family history or prior personal history of postpartum mood disorders
Anxiety and depression during pregnancy increases risk of postpartum depression and anxiety
Personal or family history of depression, anxiety, bipolar disorder, eating disorder, or OCD
History of significant mood reactions to hormonal changes during puberty, PMS, hormonal birth control, or a pregnancy loss
Medical issues such as thyroid problems, anemia, or side effects of medications can contribute to anxiety, depression, and mood swings
Social factors such as inadequate social supports, interpersonal violence, financial stress, poverty, and high stress parenting situations such as military families, teen moms, and moms of multiples
Complications during pregnancy or the birth, and issues related to breast feeding
A tendency toward perfectionism and high personal expectations
Is there a way to screen myself for postpartum mental health concerns?
An effective way to screen for postpartum depression and anxiety is by using the Edinburgh Postnatal Depression Scale (EPDS). This is a quick, 10 item questionnaire that pregnant or postpartum moms can take. It asks about the severity of symptoms you have had in the past 7 days. This is a screening tool and not a substitute for proper diagnosis or treatment. You can share the results of this screening with your doctor or mental health provider to help further assess your symptoms and devise a plan or care to help you start feeling better. Click here to screen yourself using the EPDS.
What can I do to help myself?
· Talk with your OB or medical provider. Your provider is trained and knowledgeable when it comes to the care of women in pregnancy and postpartum. They understand what's happening. They will help you get help!
· Consider seeing a counselor. There are professionals in this community who are specially trained to help with perinatal mood and anxiety disorders, and they can help you sort through what is normal and what is not. They can offer information, reassurance, and support without judgment. They will help you develop a plan so that you can start to feel better as soon as possible!
· Try to practice good self care. Are you able to fall asleep at night or take naps when you can? Are you eating nutritious meals in a way that fuels your body, or could you add in some healthy snacks? Are you making time to exercise if possible, or at least get some fresh air outside of your house? Are you giving yourself time to relax, spend time with family or friends, and have fun? These are all elements of good self care and they are all important!
· Reach out to your support system and let people help you. Consider a support group. Try to be realistic about life - no one is perfect! Be kind to yourself as you recover. With help and support you will be well!
· If you are having thoughts of wanting to harm yourself or your child, or if your thoughts seem bizarre or out of touch with reality (see section on postpartum psychosis) please note that this is a medical emergency and needs to be addressed immediately. In this circumstance it is necessary to consult with your OBGYN or other medical or mental health professional immediately. If you are in imminent danger please go to the nearest emergency room, or call Crisis Services of Erie County at 834-3131.
WNY Postpartum Connection, Inc. condemns racism and hate in all forms. We stand in solidarity with Black, Indigenous, and People of Color locally and nationally who are calling for change. We stand with the individuals, families, and communities that have been impacted by the trauma of racially motivated murders, violence, and discrimination. We advocate for equity, inclusion, and access to care for underserved members of our community and work to remove barriers to mental health services.