Here's What You Need to Know
As your family expands to include children, so many emotions rise to the surface.
When thinking of having a child, many people think of emotions such as joy, excitement, and love. Yet, other emotions like fear, anxiety, and overwhelm are present as well.
It’s important to know that all emotions are expected as you navigate through the postpartum period. The impact of having a child and becoming a parent opens you up emotionally in ways you can only imagine. Your life is changing so rapidly that it feels hard to catch your breath at times. The downside is – this whirlwind of a transition can be very disruptive.
Most parents experience all of these feelings on the same day or even at the same moment. Yet, the unease or disruption of anxiety and fear can cause some parents to withdraw or feel shame.
For some parents, these emotions might evolve into a type of maternal mental illness causing suffering. This is more common than you may realize, with as many as 1 in 5 women experiencing perinatal mental health illness.1 The perinatal period covers the time while pregnant or in the first year after giving birth.
No one should suffer from a perinatal mood disorder. I want you to know if you are feeling anxious or depressed after becoming a parent – you’re not alone.
There’s an entire community out there waiting to support you through this transitional time.
Is It Perinatal Mood Disorder or Baby Blues?
Nearly 50-80% of women experience mood swings or “baby blues” within the first few weeks after birth.2 Baby blues include signs of:
Weepiness
Fatigue
Trouble sleeping
Feelings of nervousness around your new baby
With baby blues, these symptoms usually disappear by the third-week post-birth.
So what’s the difference between perinatal mood disorder and baby blues?
Baby blues can only occur post-birth. When symptoms continue 3 weeks after birth, increase in severity, or begin to interfere with everyday life – you might be experiencing a form of perinatal mood disorder.
Perinatal mood disorder (PMD) can occur during pregnancy or up to a year after birth. And it is more common than people think – 1 in 7 women experience a perinatal mood disorder, and an average of 15.8% of women are diagnosed with perinatal mood anxiety disorder. 3
This can change with each pregnancy for women – meaning the same woman might experience PMD with one pregnancy and not another. Yet, certain factors such as previous mental health history, genetics, life events, and support contribute to experiencing a perinatal mood disorder.
It’s important to note that the onset and symptoms of perinatal mood disorders are very different.
For example, postpartum OCD typically presents with intrusive thoughts that can be very disturbing. Yet the person having the thoughts understands the thoughts are terrible and is often fearful and aware of them.
Whereas with postpartum psychosis, the person is in mania or is paranoid. The person experiencing psychosis believes they’re "called" to act to "save" their children and their soul. Psychosis is a short period of insanity that once is over, and treatment is received, it is possible to fully recover.
Other forms of perinatal mood disorders are –
Prenatal Depression or Anxiety
Major Postpartum Depression
Postpartum Anxiety or Panic Disorder
Post-Traumatic Stress
Perinatal OCD
Bipolar Disorders
Postpartum Psychosis
Symptoms of Perinatal Mood Disorder
There is no one cause of maternal mental illness or perinatal mood disorder. It can affect both men and women – parents with healthy babies and parents that have spent time in the NICU. Symptoms can also be present in first-time parents, or parents that have multiple children.4
While every mother has a unique postpartum experience, there are certain symptoms of perinatal mood disorder to look out for.
Women or men experiencing perinatal mood disorder might have:
Frequent mood swings
Feelings of hopelessness
Irritability
Crying
Depression
Anxiety
Changes in appetite
Trouble sleeping
Intrusive thoughts
It’s important to know that if you’re experiencing any or all of these symptoms, there is relief available. Parents that have perinatal mood disorders can access treatment to help heal and adjust to their new roles.
In the past, there’s been stigma and shame around women who experienced perinatal mood disorder. There was a story told to women that once they became pregnant and then mothers – that they would feel only happiness. While this may be true for some women, it greatly affects the majority of women who have a wide range of emotions around transitioning to motherhood.
When signs and symptoms of perinatal mood disorder and postpartum depression are ignored and go untreated in women – the results can be tragic. Over the years, there have been stories of women diagnosed with psychosis from postpartum depression only after committing unthinkable acts toward their children and their families.
Recently, one mother, Lindsay Clancy, was found in a zombie-like state after strangling her children and trying to commit suicide.5 In the Lindsay Clancy case, it’s suspected her actions were due to being in a state of postpartum psychosis. It’s important to bring to light that though rare, postpartum psychosis occurs in only 1 to 2 births out of 1,000. Infanticide, homicide, and or suicidal ideation are not uncommon in people experiencing this diagnosis. In fact, suicide is the third leading cause of maternal death.6
And it’s not only women who are affected by postpartum depression and mood disorders – 1 out of 10 men report suffering from postpartum depression.7
The most devastating fact about all of these tragedies is that if the parents had received access to help and routine care needed, a lot of these deaths and events could have been avoided.
That is why it’s imperative that we talk openly about how common perinatal mood disorders can be and how to receive treatment.
PMAD affects 21% of people, yet we are more likely to be screened regularly during pregnancy for Gestational diabetes, which affects 6% of people.8 Screening must become more prevalent to help with treatment and prevention.
What’s the Treatment for PMD?
In order to receive treatment, you need to talk about your reality. As disruptive as these feelings and vulnerability can be – it’s the only way to take a step toward relief. Talk to your healthcare provider openly and explain your current experience.
Remember, your care team and loved ones want you to be healthy and feel like you again.
Your doctor can help you move forward and discuss options to receive help. These options include creating a collaborative care team comprised of your doctors and counselors. They discuss your situation with you and decide on the best form of treatment. Then after your needs and experience are assessed, your team comes up with a unique plan for you.
A treatment plan for perinatal mood disorder can range from therapy to medication, to lifestyle changes. Some plans may have a combination of one or two types of treatment. There’s room to pivot, so you discover the best treatment for you that helps you thrive.
The birth of a new baby is such a vulnerable time for women and can bring up a mixture of emotions. Treatment for women who are experiencing postpartum depression is essential. Therapy can help women express and communicate their emotions, so they’re able to receive the support they need.
-Danielle DiCamillo, LCSW9
For pregnant women with mild to moderate symptoms – therapy is usually the first plan of action. There have been promising results for women who are experiencing perinatal mood disorder and undergo:
Interpersonal psychotherapy
Partner-assisted interpersonal psychotherapy
Cognitive behavioral therapy
Group therapy10
Women who are experiencing more severe symptoms of perinatal mood disorder usually need the help of medications to manage their mental well-being. These medications can be temporary or ongoing, depending on the needs of the patient.
Finding Care for Perinatal Mood Disorder
Connecting with the right care provider is crucial to getting help and maintaining mental health. In order to do this, you need to discover who you feel comfortable around to be completely honest about your well-being. When I service clients, I invite consideration of having a baseline taken from a licensed mental health professional, that way, care is established if and when they need follow-up or intervention.
For some, it may be a few professionals, including community and spiritual leaders, that work together to maintain your relief and healthy mindset. While other women may find comfort and relief in working with a perinatal mental health doula.
The advantage of working with a perinatal mental health doula is that they specialize in perinatal mood disorders.
Doulas are trained and skilled professionals that work alongside parents supporting their emotional, mental, and physical needs while in an intimate setting. Doulas with perinatal mental health certification, have the extra skills to be alongside you during your entire pregnancy and the postpartum period. By having the same doula around you for your entire journey, you create a relationship and comforting rhythm.
Whether you desire to find a perinatal mood disorder professional, a supportive community, or like-minded parents – the Collaborative Circle is the answer you’ve been searching for.
The Collaborative Circle is an online based community full of professionals and parents that are looking to share their wisdom and guidance with a thoughtful and supportive village.
If you’re searching for your village, join us at the Collaborative Circle.
Resources
1. Maternal Mental Health - Women’s Voices. Royal College of Obstetrians and Gynaecologists https://www.rcog.org.uk/for-the-public/rcog-engagement-listening-to-patients/maternal-mental-health-womens-voices/#:~:text=As%20many%20as%20one%20in,the%20first%20year%20after%20birth.
2. Perinatal or Postpartum Mood and Anxiety Disorders. Children’s Hospital of Philadelphia
3. Fairbrother N, Janssen P, Antony MM, Tucker E, Young AH. Perinatal anxiety disorder prevalence and incidence. J Affect Disord. 2016 Aug;200:148-55. doi: 10.1016/j.jad.2015.12.082. Epub 2016 Apr 14. PMID: 27131505. https://pubmed.ncbi.nlm.nih.gov/27131505/
4. 2. Perinatal or Postpartum Mood and Anxiety Disorders. Children’s Hospital of Philadelphia
5. McShane, Julianne, Chuck, Elizabeth. Massachusetts Mom was Having ‘One of Her Best Days’ Before She Allegedly Strangled 3 Children, Husband Told Police. NBC News. February, 7, 2023.
6. Facts About Maternal Suicide. 20/20 Mom. August 2021
7. Leiferman JA, Farewell CV, Jewell J, Rachael Lacy, Walls J, Harnke B, Paulson JF. Anxiety Among Fathers During The Prenatal and Postpartum Period: A Meta-Analysis. J Psychosom Obstet Gynaecol. 2021 Jun;42(2):152-161. doi: 10.1080/0167482X.2021.1885025. Epub 2021 Feb 25. PMID: 33632067.https://pubmed.ncbi.nlm.nih.gov/33632067/
8. Postpartum Support International Perinatal Mood and Anxiety Disorders FACT SHEET https://www.postpartum.net/wp-content/uploads/2014/11/PSI-PMD-FACT-SHEET-2015.pdf
9. DiCamillo, Danielle. 2023 www.ddicamillotherapy.com
10. Meltzer-Brody S, Jones I. Optimizing the treatment of mood disorders in the perinatal period. Dialogues Clin Neurosci. 2015 Jun;17(2):207-18. doi: 10.31887/DCNS.2015.17.2/smeltzerbrody. PMID: 26246794; PMCID: PMC4518703.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518703/
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