What is Perinatal Mental Health and Why is it Important?
Perinatal Mental Health refers to a woman’s mental health during pregnancy and the postpartum period. Most care of babies takes place in the home, and the care of a nurturing family can easily be compromised by mental health conditions that may surface when a child is born. Help with parenting, as well as timely individual mental health treatment as needed, are both important to address this sobering failure and the toll that perinatal mental health conditions take on American babies, mothers, fathers, and the entire family unit.
Risk Factors for Perinatal Mood and Anxiety Disorders (PMADs)
Some women are at greater risk for developing PMADs because they have one or more risk factors, such as:
- Symptoms of depression during or after a previous pregnancy
- Infertility treatments
- Previous experience with depression or bipolar disorder at another time in her life
- A family member who has been diagnosed with depression or other mental illness
- A stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness
- Medical complications during childbirth, including premature delivery or having a baby with medical problems (including a NICU stay)
- Mixed feelings about the pregnancy, whether it was planned or unplanned
- A lack of strong emotional support from her spouse, partner, family, or friends
- Alcohol or other drug abuse problems.
- High expectations, particularly about breastfeeding
- Certain personality traits, including perfectionist tendencies or difficulty handling transitions
- Colicky, difficult, or demanding baby
Postpartum depression can affect any woman regardless of age, race, ethnicity, or economic status. Some women may experience a PMAD even without any of the risk factors mentioned.
More than Just Postpartum Depression
Perinatal mental health disorders are much broader than depressive symptoms alone, though too often the term “postpartum depression” is used to generalize these conditions. The spectrum of disorders includes:
- Antenatal depression and anxiety
- Postpartum depression and anxiety
- Postpartum anxiety/panic disorder
- Postpartum obsessive compulsive disorder
- Postpartum post-traumatic stress disorder
- Postpartum psychosis.
Signs and Symptoms to look for...
- Feeling sad or worthless
- Sleeping difficulties
- Loss of appetite or over-eating
- Withdrawing from friends or family
- Crying excessively
- Anger or rage
- Intrusive or scary thoughts
- Excessive worry
- Confusion or “brain fog”
- Fatigue or loss of energy
- Loss of interest in activities
- Inability to concentrate
- Physical complaints
- Feelings of guilt or inadequacy
- Loss of sex drive
Diagnosis and Treatment
Only a health care provider can diagnose a woman with a perinatal mental health challenge. Because symptoms of this condition are broad and may vary between women, a health care provider can help a woman figure out whether the symptoms she is feeling are due to postpartum depression or something else. A woman who experiences symptoms should see a health care provider.
PMADS are treatable conditions, and there are effective treatments. A woman’s health care provider can help her choose the best treatment, which may include:
- Counseling/Talk Therapy: This treatment involves talking one-on-one with a mental health professional (a counselor, therapist, psychologist, psychiatrist, or social worker). Two types of counseling shown to be particularly effective in treating perinatal mood and anxiety disorders are:
- Cognitive behavioral therapy (CBT), which helps people recognize and change their negative thoughts and behaviors; and
- Interpersonal therapy (IPT), which helps people understand and work through problematic personal relationships.
- Medication: Antidepressant medications act on the brain chemicals that are involved in mood regulation. Many antidepressants take a few weeks to be most effective. While these medications are generally considered safe to use during breastfeeding, a woman should talk to her health care provider about the risks and benefits to both herself and her baby.
These treatment methods can be used alone or together.
Tips if you're struggling...
Having a baby is stressful—no matter how much you’ve looked forward to it or how much you love your child. Considering the sleep deprivation, new responsibilities, and lack of time for yourself, it’s no surprise that a lot of new moms feel like they’re on an emotional roller coaster. The baby blues are pretty normal, but if your symptoms don’t go away after one to two weeks or get worse, you may be suffering from a perinatal mood or anxiety disorder, like postpartum depression or anxiety. There’s plenty you can do to feel better, though, and get back on the road to happy and healthy motherhood.
- Follow up with your doctor to discuss your symptoms, be open and honest
- Remind your doctor of the consult line through Postpartum Support International (PSI: 1-800-944-4773 Option 4)
- Know that it’s ok to ask for help
- Find a local support group (there are also online groups through PSI and Bloom)
- Lean on others for help and support
- Go to therapy
- Take care of yourself
- Don’t forget about your favorite hobbies and activities and do them
- Make time for your relationship with your partner
- Accept help when it is offered or ask for it when needed
- Untreated PMADs have been associated with serious consequences, most notably impaired mother-infant bonding and long term effects on emotional and cognitive skills
- Combined productivity and medical costs of untreated PMADs is $33,000 per mother/child
- When children grow up in an environment of mental illness, it affects their brain development and ability to learn
- PMADs affect up to 1 in 5 women and are more common than gestational diabetes, preterm labor and low birth weight
- Without treatment, postpartum depression can last for months or years. In addition to affecting the mother’s health, it can interfere with her ability to connect with and care for her baby and may cause the baby to have problems with sleeping, eating, and behavior as he or she grows.
Cherished Mom Powered by Yomingo – anytime, anywhere parent education!
Postpartum Support International – Warmline – 1-800-944-4773
If you or someone you know is in crisis or thinking of suicide, get help quickly.
- Call your doctor.
- Call 911 for emergency services or go to the nearest emergency room.
- Call the toll-free 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889).