Pregnancy, childbirth and after are a time of transition for women. When considering those changes, many think of the physical ones. However, emotional changes are often significant during this time, referred to as perinatal mental health.
Perinatal mental health is the emotional and psychological well-being of women during pregnancy and the first year after childbirth. It’s a time when many women struggle with their mental health for a variety of reasons.
If you’re dealing with any mental health issues during this time, make an appointment with your OB-GYN. However, if you are having a mental health crisis, call or text 988, the suicide and crisis lifeline.
How common are perinatal mental health issues?
Most people have heard of postpartum depression, or the “baby blues,” which can start anywhere from two days to two weeks after giving birth. But did you know other common mental health conditions can occur anytime from conception until a year after giving birth?
They’re more common than many think. In fact, 1 in 5 pregnant and postpartum women experience mental health issues, with depression and anxiety being the most common. These disorders, called perinatal mood and anxiety disorders (PMADs), impact daily life.
“As many as 60 to 80 percent of women will experience the baby blues,” Colleen Furey, PsyD, one of our Cincinnati market clinical psychologists with specialized training in perinatal mental health, explains. “With baby blues, though, people will still experience some feelings of happiness and there are typically no significant changes to their self-esteem.”
Common perinatal mental health conditions
While the baby blues may be the most recognizable condition, moms can develop a number of mental health issues before the baby is born and for months after.
Perinatal depression
Depression is one of the most common issues moms face during pregnancy or after birth. Symptoms can include feeling very sad, losing interest in things that normally bring joy, feeling tired all the time and feeling hopeless.
Without treatment, depression can affect the mother’s well-being and her ability to bond with her baby.
Anxiety
Anxiety is also common during this time. It can look like excessive worrying about health, the baby’s safety or even the pressures of motherhood. Some women also experience panic attacks or obsessive thoughts.
If you’ve struggled with anxiety before, it may get worse during pregnancy or after birth.
Postpartum psychosis
Unlike postpartum depression, postpartum psychosis is a rare but serious condition that can develop shortly after childbirth. It causes extreme mood swings, confusion, hallucinations and delusions.
Postpartum psychosis is a medical emergency and requires immediate treatment.
Post-traumatic stress disorder (PTSD)
Some women experience PTSD after a traumatic birth experience. This could happen if the delivery was complicated, if there were medical emergencies or if the woman felt out of control during labor.
PTSD can cause flashbacks, nightmares and extreme emotional distress.
Obsessive-compulsive disorder (OCD)
In some cases, new mothers may experience intrusive thoughts about harm coming to their baby or something bad happening to the baby. These thoughts can be upsetting but it’s important to know that these mothers don’t act on these thoughts.
“As many as 14 percent of women and 10 percent of men experience a PMAD, which can include perinatal depression, anxiety, panic, obsessive-compulsive disorder, post-traumatic stress syndrome and, more rarely, bipolar disorder or psychosis,” Dr. Furey says.
Why perinatal mental health is important
Mental health care during pregnancy and the first year of motherhood is crucial. If left untreated, mental health problems can have lasting effects not only on the mother’s well-being but also on the baby’s health.
When a mom struggles emotionally, it can be harder for her to bond with her baby, take care of herself or connect with others. While it can be difficult, Dr. Furey emphasizes the need for mothers to care for themselves and for those around them to help.
“Sleep when you can. Eat regularly, even if it’s only small amounts. Be kind to your body. Move and get outside when you can. Text, call or visit with friends and family,” Dr. Furey advises.
For babies, mental health issues in mothers can lead to developmental delays, behavioral problems and emotional challenges later in life. Studies show that maternal depression and anxiety can affect a child’s cognitive and emotional development.
Risk factors for perinatal mood and anxiety disorders
Dr. Furey treats patients experiencing perinatal mood and anxiety disorders (PMADs). She shares that the risk factors for developing a PMAD include:
- Previous PMADs or family history of PMADs
- Previous mood/anxiety disorder
- Significant or outsized mood reactions to hormonal changes
- Fertility difficulties
- Diabetes and/or thyroid problems
- Inadequate social support
- Financial stress
- Recent loss or move
- Barriers to care
- Interpersonal violence
- Sleep difficulties
However, if you are at risk for PMAD, there are steps you can take to lower your risk of developing it.
Known protective measures include:
- Having a postpartum plan that takes into consideration the support available to you
- Receiving information about PMADs in advance
- Utilizing your support systems
- Maintaining access to medical care
- Flexible thinking — “I am not Superwoman, I am a mom doing her best.”
- Being wary of social media and the “parent Influencers” that might represent unrealistic standards
PMADs affect not just women but also men during and after pregnancy.
“More and more, we are learning that dads and non-birthing partners can also develop PMADs,” Dr. Furey shares. “While in their case it’s not related to hormonal shifts, changes in routine and identity, the loss of their sex life and increased burdens around financial needs can be just some of the triggers for men and non-birthing partners to develop the condition.”
How to get support
As with any mental health condition, the first step to getting help is a diagnosis. Thus, our OB-GYNs and pediatricians make sure to screen new parents for perinatal depression.
“They call me in when a patient screens positive,” Dr. Furey explains.
Outside of routine screening, consider these other options for support:
- Talk to a doctor or health care provider: If you’re feeling depressed, anxious or overwhelmed, start by talking to your provider, like your obstetrician or primary care provider. They can listen to your concerns, evaluate your symptoms and suggest treatment options, like therapy or medication.
- Therapy and counseling: Talking to a therapist can be very helpful for managing depression and anxiety. Cognitive-behavioral therapy (CBT) is often used to help women reframe negative thoughts and manage stress.
- Medication: In some cases, medication may be a useful tool to help manage depression, anxiety or other mental health conditions. Some antidepressants, like SSRIs (selective serotonin reuptake inhibitors), are considered safe during pregnancy and breastfeeding, but always consult your doctor before starting any medication.
- Support groups: It can be helpful to connect with others who are going through similar experiences. Support groups for new moms, whether in person or online, can provide emotional support and reduce feelings of isolation.
- Self-care: While professional treatment is important, taking care of yourself is just as crucial. Simple things like getting enough sleep, eating well, taking short walks and finding moments of peace can help improve your mood.
“Treatment options include counseling and talk therapy, support groups, medication and referral to a reproductive psychiatrist when possible to prescribe appropriately to a woman who is pregnant or nursing,” Dr. Furey adds. “Stress reduction techniques, gentle exercise, massage and improvements in nutrition can also help alleviate some PMAD symptoms.”
How we can help
Many women feel ashamed to admit they’re struggling, but perinatal mental health problems are common and treatable. Reaching out for help is a sign of strength, not weakness.
If you recognize symptoms of a mental health issue or generally don’t feel like yourself, make an appointment with your provider or a mental health provider. Dr. Furey emphasizes that help from your OB/GYN, pediatrician and behavioral health consultants is always available to address your concerns.
“Remember, things will not go to plan,” she says. “Request, accept and embrace any support you can. Be flexible in your thinking. Don’t forget to do the things you love, even in small amounts.”
Learn more about the women’s health and mental health services we provide at Mercy Health.
