Everything You Need to Know About Perinatal Mental Health Disorders

It’s no secret that having a baby isn’t as easy as we used to think (and if it was still a secret, we’re spilling all the beans)! We have everything you need to know about perinatal mental health disorders, and how it’s probably way more common than you thought.

Becoming a new parent brings a mixed bag of emotions: excitement, worry, joy, exhaustion, nervousness, happiness, and everything in between.

What is difficult is trying to sort through those emotions to figure out if it’s just a normal part of becoming a parent and adjusting to this new life, or if it’s something beyond that.

Those first weeks of becoming a mom were…well honestly I don’t remember. It’s all kind of a fog many years later.

I have pictures and videos, and there are tons of things that I DO remember about that special time, but I also remember I was experiencing a level of tiredness that I didn’t know even existed.

And if I’m being honest, I feel a little jaded that no one bothered to fill me in on what I was about to experience before the baby came.

However, all these years later, I actually get it. There is absolutely no amount of words to accurately describe what all-consuming exhaustion with emotional overload is going to feel like. And even if there were words that conveyed that, there’s no way to know the impact until you’re knee deep in an explosive 2am diaper for it to really resonate.

And if you’re not a parent quite yet, don’t be scared. I’m not a fan of fear mongering, but I’m a huge fan of transparency and truthfully, we owe it to each other to be more honest about what it’s like to become a parent and mother.

First step. Stop blaming it all on the hormones. I mean, don’t get me wrong, the hormones are going to be absolutely whack, kind of like a sweaty rave that you aren’t allowed to leave, but there is so much more that we know in 2023 that isn’t just your hormones fault.

During the first 2 to 3 weeks postpartum, “most mothers- about 80%- will experience mood swings [that were somehow cutely named] the “baby blues.”

The problem we encounter as mothers is knowing when baby blues aren’t in fact the baby blues, but something more. It truly is tough to recognize what is normal, and when there may be symptoms present that indicate that something bigger is happening.

Actually 15-20% of women experience more severe symptoms of depression and anxiety after giving birth. Did you gasp at that statistic? Let’s put that in context. According to the NIH, around 1 in 7 women can develop postpartum depression.

And if that’s not staggering enough, symptoms of depression and anxiety postpartum can be experienced up to a YEAR after the birth of the child.

With these two pieces of information, it is so important to be honest during those postpartum screenings with your OBGYN or Pediatrician concerning ANY symptoms that you may be experiencing.

What Causes Perinatal Mood Disorder?

Good news? There is no cause for perinatal mood and anxiety disorders (PMAD).

Bad news? Moms are still out here blaming themselves when they have it.

When the research and science and all the nerdy stuff I love says “no cause”, it literally means NO cause. New mothers (well all mothers honestly) tend to put the blame on themselves when things feel out of hand. This is an easy default when there’s no true answer behind the “why” of something.

Mom-shame is the biggest thief of joy. There I said it.

While science can’t point to a specific cause, we do know that PMADs are result of a combination of stressors like:

Psychological stressors
Social stressors
Biological stressors

And hot take, PMAD is not limited to only mothers. Spouses can experience PMAD as well. In fact, about “10% of spouses experience postpartum depression or anxiety, and they experience similar symptoms as the new mother.2”

There also more risk factors to consider for PMAD:

Personal or family history of depression and anxiety
Previous history of postpartum depression
Premenstrual dysphoric disorder (PMDD)
Inadequate support in caring for baby
Financial Stress
Marital Stress
Complications during birth or breastfeeding
Infants in the NICU
Mothers of multiples
Socioeconomic status
Women who have gone through fertility treatments

Types of PMAD

Not all instances of PMAD look alike. There are actually several different types including:

Perinatal anxiety
Perinatal depression
Perinatal obsessive-compulsive disorder
Bipolar mood disorders
Postpartum psychosis

Let’s take a deeper look at these (so you can avoid the Google rabbit hole).

Perinatal Depression (Most Common)

Incidence: approximately 15% of women (either during or after childbirth).

Symptoms: A person experiencing perinatal depression during pregnancy or the first year postpartum might have social withdrawal and feelings of:

Anger,
Sadness,
Irritability,
Guilt,
Lack of interest in the baby,
Changes in eating and sleeping habits,
Trouble concentrating, and
Feelings of hopelessness.

Quick Fact. In more severe cases, feelings can escalate to thoughts of harming the baby or themselves.

Perinatal Anxiety

Incidence: approximately 6% of pregnant women and 10% of postpartum women.

Symptoms:

Extreme worries or fears, often over the health and safety of the baby and experience insomnia as a result.
Panic attacks with accompanying symptoms such as shortness of breath, chest pain, dizziness, feeling of losing control, numbness and tingling.
More severe anxiety cases may develop postpartum panic disorder. This form of anxiety is paired with recurring panic attacks.

Quick Fact. If panic attacks are experienced, they may be irregular, and it’s essential to remember that they will pass and cannot hurt you.

Perinatal Obsessive-Compulsive Disorder

Incidence: Between a 3-5% chance that a new mother and some new fathers will experience OCD symptoms

Symptoms:

Intrusive thoughts related to the baby,
Compulsions to reduce fears and obsessions,
Fear of being left alone with the baby, and
Hypervigilance in protecting the baby.

Quick Fact. Parents that experience OCD symptoms postpartum are very unlikely to ever act on thoughts they are having.

Bipolar Mood Disorders

Many women are diagnosed for the first time with bipolar depression or mania during pregnancy or postpartum. Bipolar mood disorders are characterized by intense cycling of highs and lows.

In pregnant or postpartum women, the cycles and emotional states are more than the typical and expected moodiness that accompany hormonal changes.

Postpartum Psychosis

Incidence: approximately 1 to 2 out of every 1,000 deliveries

Symptoms:

Delusions,
Hallucinations
Feeling very irritated
Hyperactivity
Severe depression
Inability to sleep
Paranoia
Rapid mood swings, and
Difficulty communicating at times.

Quick Fact. Postpartum psychosis occurs suddenly, typically within the first two weeks after childbirth, but can appear any time in the first year.

There is an assumption or stereotype that postpartum psychosis leads to suicide or harming the baby. Contrary to what many people think of when they hear postpartum psychosis, most survivors of postpartum psychosis never experienced delusions that lead them to becoming violent. The majority of new mothers who experience postpartum psychosis do not harm themselves or others. There is always that risk of danger, so immediate treatment and monitoring is necessary.

Treatment Options and What You Should Do

ALL perinatal mood and anxiety disorders are treatable with professional help.

Above anything else you take from this blog and yes I’m repeating myself, it is not your fault.

If you feel you have a perinatal mood or anxiety disorder, reach out to someone for support as soon as you can, such as your primary care physician or OBGYN. Your health professional can provide a proper screening to diagnose a perinatal mood or anxiety disorder.

If you need immediate care, please call the National Maternal Health Hotline number at 1-833-TLC-MAMA (1-833-852-6262).

There are many different treatments for perinatal mood and anxiety disorders, such as cognitive behavioral therapy or interpersonal therapy, but supplemental implementation of exercise and good nutrition can support recovery too.

It is also crucial to build social support. Finding a “village” results in new parents feeling less alone and more supported when they are around others that are going through similar experiences. You may even find that taking time to enjoy things that you did pre-baby is another healing tool. Find ways to help get out of your head and get a break from your symptoms. Easier said than done, I know.

Take small steps and know that if trying to get out feels too overwhelming that there are online support groups, community support groups, and advocacy organizations that provide you the opportunity to gain support.

Calming Waters is Here for You

The support of mental health during pregnancy and after childbirth is something that needs to be advocated more. The expectation that parenthood has to blissful all the time is wreckless and misleading. Bombarding mothers and mothers-to-be with messages about how they SHOULD think and feel is leading to a growing number of mothers and parents who feel shameful when their experience doesn’t meet the mass media “standards.”

Our focus at Calming Waters is to normalize and destigmatize these disorders for new mothers and their significant others. We have two providers on our team, Katie Fontana, LCMHCA and Megan Fischetti, LCSWA, who have obtained special certifications in caring for the mental health of mothers and their partners and whose passion it is to see mothers find fulfillment and purpose, free of shame and guilt, in their motherhood journey. Visit our About tab to read the bios of those two providers (and all of our other providers), and our Contact page to reach out for more information and support.

How Do We Know All This Stuff

Well we do think we are pretty smart about all things maternal mental health, but we aren’t statisticians and did do some research to help drive home these important points. Here are our resources in case you’d like to read further.

Postpartum support international – psi. Postpartum Support International (PSI). (2023, April 26). Retrieved May 4, 2023, from https://www.postpartum.net/
New fathers and mental health problems. CAMH. (n.d.). Retrieved May 4, 2023, from https://www.camh.ca/en/professionals/treating-conditions-and-disorders/perinatal-mood-and-anxiety-disorders/new-fathers-and-mental-health-problems
Best, S. (2015, September 17). How to help women with perinatal mood and anxiety disorders. Psychology Today. Retrieved May 4, 2023, from https://www.psychologytoday.com/us/blog/women-s-mental-health-matters/201509/how-help-women-perinatal-mood-and-anxiety-disorde