Postpartum Realness: Perinatal Mood and Anxiety Disorders
Updated: Jun 5
As this month begins not only Mental Health Awareness Month but also MATERNAL Mental Health Month, I find it important to provide as much information and resources as I can about the topic that means so much to me. Take a few minutes to read about Perinatal Mental Health, Perinatal Mood and Anxiety Disorders, and Frequently Asked Questions that I get a lot in my practice. You can also find this information on my "Perinatal Mental Health" tab on this website. If you read anything that may be helpful to another mom, please feel free to pass it along.
What is Perinatal Mental Health?
Perinatal Mental Health is the practice of supporting women, men and families through the pregnancy, delivery and postpartum period. The "perinatal period" is considered any time from conception to baby's first birthday (and sometimes beyond). Perinatal Mental Health specialists seek to support women and families around mental health needs related to this time period including but not limited to: *Fertility/infertility issues *Pregnancy Loss *Fear of giving birth (tokophobia....yes, it has a name!) *Pregnancy hormonal and mood changes *Birth Trauma *Perinatal Mood and Anxiety Disorders
Perinatal Mood and Anxiety Disorders (PMADs)
Perinatal Mood and Anxiety Disorders (or PMADs) are a set of mental health issues that can occur around the perinatal period. Commonly seen in women soon after giving birth, these can also affect women during pregnancy as well as non-biological mothers, fathers, and family members. They can range from lower level symptoms of distress to more rare, but serious, mental health crises. Below are some of the common conditions that may occur: Postpartum Depression can begin during the pregnancy or up to the first year postpartum. A woman with PPD might experience feelings of anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, throughs of hopeless and, sometimes, even thoughts of harming the baby or herself (Postpartum Support International, 2021).
Postpartum Anxiety may manifest as stress, overwhelm or fear around taking care of baby. A woman with PPA may experience extreme worries and fears, often over the health and safety of the baby. Some women have panic attacks and might feel shortness of breath, chest pain, dizziness, a feeling of losing control, and numbness and tingling (Postpartum Support International, 2021).
Postpartum OCD symptoms may look like repetitive, upsetting and unwanted thoughts or mental images (obsessions), and sometimes they need to do certain things over and over (compulsions) to reduce the anxiety caused by those thoughts. These moms find these thoughts very scary and unusual and are very unlikely to ever act on them (Postpartum Support International 2021).
Posttraumatic stress disorder relating to pregnancy or postpartum may be in relation to a traumatic event having to do with the pregnancy, childbirth or past trauma. Symptoms may include flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event (Postpartum Support International, 2021).
Bipolar depression is more severe than "mood swings" and can often be indicative of a mental health crisis or need for medication evaluation. Many women are diagnosed for the first time with bipolar depression or mania during pregnancy or postpartum. Bipolar mood disorder can appear as a severe depression; women need informed evaluation and follow-up on past and current mood changes and cycles to assess whether there is a bipolar dynamic (Postpartum Support International, 2021).
Postpartum psychosis often shows up within the first week or two after giving birth. Those who suffer from postpartum psychosis may experience hearing voices or seeing images that others may not. These hallucinations may cause mothers to think or believe bizarre or harmful things about themselves, their baby or those around them, sometimes to the point of behaving dangerously. Symptoms may include reported need for little to no sleep, rapid mood swings, paranoia or marked change in mood or affect. While this condition is often sensationalized and labeled as "Postpartum", it represents an extremely small population of postpartum women. Nevertheless, this is an extremely severe condition and warrants an immediate behavioral health evaluation. (Postpartum Support International, 2021).
Postpartum Depression (PPD)
Postpartum Anxiety (PPA)
Postpartum Obsessive-Compulsive Disorder (OCD)
Postpartum Post-Traumatic Stress Disorder (PTSD)
Postpartum Bipolar Disorder
Frequently Asked Questions Do I have a Perinatal Mood or Anxiety Disorder? Without proper assessment and evaluation, it is difficult to give an answer with diagnostic certainty. What I can say, however, is that becoming a parent is HARD. So are the feelings that can go along with it. While it is important to me from a clinical perspective to assess your individual situation and even diagnosis, it is more important to me to work alongside you to get you on a path to feeling well. If you are interested during the process to understand your diagnosis, I am more than happy to talk it through with you as some people feel better putting a name to what they are going through. More often, I will focus less on the specifics of a diagnosis and more on how to tailor therapeutic services and outside referrals to meet your needs. Is Postpartum Depression the same as the "Baby Blues"? Actually, no. While often used interchangeably, the "Baby Blues" and true Postpartum Depression are different. Upward of 80% of women who give birth experience hormonal changes and sleeplessness that can look like sadness, agitation, tearfulness, and feeling down. These are often present in the first few days after giving birth but typically subside after approximately 2 weeks. 20% of moms (and sometimes partners) go on to have a more severe, longer-lasting set of symptoms that are more indicative of clinical depression. What should I do if I suspect I or my family member is suffering from a PMAD? If you are worried that you or someone you know may be experiencing a PMAD (or any mental health condition), it is important to know that help is out there! Support in the way of therapy, medication, lifestyle changes, and community/family support are some ways that can help lessen or discontinue symptoms of PMADs. If you are unsure where to start, please give me a call. Even if I am unable to assist you, I am committed to helping you find the help you deserve. Can any therapist help me work through a PMAD? Some would say "any therapy is better than no therapy". While this may be true in some situations, it is important to find a provider who is familiar with and confident in treating your specific needs. PMADs are an area of mental health not always addressed in graduate schools or training programs and often require additional training and certification. Please feel comfortable asking your therapist about their knowledge and training in the areas in which you are needing help. How long will I need therapy before I start to feel better? You probably know what I'm about to say: It depends. My clients range from pre-pregnancy, to newly pregnant, to about to give birth, to postpartum and beyond. Depending on your current situation, symptoms and existing support system, therapy can range from a few sessions to a regular part of one's mental health regimen. Typically, in our first session we will discuss a tentative plan for frequency and duration of sessions, but this is often adjusted based on life stressors that can come with pregnancy and postpartum. Some clients require a few sessions to discuss their fears, wants or issues, gain coping skills to assist and discontinue. Some of those come back to brush up on skills or to work through newer issues. Others are looking to heal older wounds that come to the surface during the pregnancy or postpartum period (very common....."mother issues", anyone??) which can take some time. Additionally, a good percentage of clients understand the undertaking of caring for a new life and commit to therapy as an investment in their overall wellness and utilize it as a regular part of self-care or "me time" as they journey through parenthood. I am flexible and open to any and all situations so long as it fits in with your lifestyle, goals and ultimately, what is best for you and your family. ***None of the above information is a substitute for professional mental health treatment nor does it suffice for more complete and tailored answers I can give to your specific circumstances. Please reach out for more information, even if you are not ready to begin counseling. I am happy to field questions in a free 15-minute consultation format.