Perinatal Mental Health: Baby Blues and Beyond
When you think about pregnancy and parenthood, what comes to mind? For many people, it might be images of serene, glowing mothers cradling their newborns in a sea of soft pastels, like something out of a Johnson & Johnson commercial. Or maybe it’s that family feel-good movie where the baby is sleeping soundly, the doctor tells the birthing caregiver they may experience some sadness after delivery, and everyone settles into their new identity with ease and a smile.
While these depictions certainly seem nice, they are not portraying the complete, complicated, and very real lived experience of countless caregivers.
Perinatal mental health is often an overlooked and under-discussed aspect of the parenthood journey. In this blog, we will dive into what perinatal mental health is, the range of experiences it covers, and how to recognize when it may be time to seek help. Grab the car seat, because we’re about to go on a journey!
What is perinatal mental health and who is impacted by it?
Perinatal mental health (sometimes called maternal mental health) is all about how women and birthing people are feeling emotionally and mentally during the perinatal period. This time typically includes pregnancy and the first year after birth, but it can also cover the journey through fertility and conception. This phase is a whirlwind of changes and adjustments, so having the right mental health support is crucial for both caregiver and baby.
A lot more people are affected by perinatal mental health issues than you might think! According to the World Health Organization, 1 in 5 women and 1 in 10 men face Perinatal Mood and Anxiety Disorders (known as PMADs), regardless of culture, age, income, or ethnicity. These numbers show just how important it is to be aware of perinatal mental health as it could impact you or a loved one.
If you’re struggling with these challenges, remember this: your feelings are valid, you are not alone, and support is available.
Common Challenges in the Perinatal Period
During the perinatal period, caregivers often encounter a range of unique challenges and significant identity shifts that can feel overwhelming and may impact mental health. While these challenges are not classified as PMADs, they deserve support and are important to address since they can make a huge difference in your overall well-being.
Hormonal Changes: The fluctuations in hormones during pregnancy and postpartum can significantly affect mood and feelings of emotional stability.
Sleep Deprivation: Lack of sleep, which is common with newborns, can exacerbate feelings of anxiety and depression.
Adjustment to Parenting: The responsibilities and demands of caring for a newborn can be overwhelming, for first-time caregivers, or for caregivers who already have children.
Relationship Changes: Adjustments in relationships with partners, family, or friends can contribute to additional stress during this period.
Past Trauma: Previous experiences of trauma, including childhood trauma or past pregnancy loss, can resurface and influence emotional well-being.
Social Isolation: Feelings of loneliness or isolation, particularly if the caregiver lacks a strong support system, can contribute to mental health challenges.
Loss of Identity: You might feel like you’ve lost touch with who you were before becoming a caregiver. It’s common to struggle with finding your new identity in this role.
Support for Perinatal Mental Health
Being familiar with and able to recognize common challenges during the perinatal period is a great first step toward being able to effectively manage them. The next step is to develop a thoughtful and proactive support plan tailored to your unique needs. It can serve as a roadmap while navigating such a transformative, and at times turbulent, journey. This can be done with a partner, trusted friend, or therapist who specializes in perinatal mental health.
Here are some examples of practical strategies you can add to your support plan:
Education and Awareness: Understanding the signs and symptoms of perinatal mental health conditions is the first step in seeking help. I encourage you to learn about these conditions and have open discussions regarding mental health with your providers.
Build a Support Network: Connect with other caregivers, join support groups (Ensemble runs various groups throughout the year; you can see what’s currently available here), or lean on family and friends for support. Another great support person after delivery is a doula! (I’ll be writing another blog about support people for caregivers in the fall, keep an eye out!)
Prioritize Self-Care: Activities such as adequate sleep, regular exercise, and hobbies that promote relaxation and well-being are good for you, and therefore, good for the baby. I know, prioritizing yourself might feel impossible while adjusting to caring for a new baby, but it’s essential! Building a support network can help ensure you get those precious moments of rest or alone time.
Professional Help: Seek professional support from therapists or counselors who specialize in perinatal mental health. A designation you can look out for is PMH-C, which means they are Perinatal Mental Health Certified by Postpartum Support International (PSI). Therapy can provide a safe space to explore emotions and develop coping strategies. Did you know Ensemble provides services specifically for perinatal clients including individual therapy? You can learn more about our services here.
Medication: In some cases, medication prescribed by a healthcare provider may be necessary and safe during pregnancy or while breastfeeding. These are important conversations to have with your OBGYN during pregnancy.
While a self-care plan is helpful for navigating the perinatal period, it’s crucial to recognize that some caregivers may face specific mental health challenges despite their best efforts. PMADs encompass a range of conditions that can affect individuals during pregnancy and the postpartum period. These disorders are typically more severe and persistent than the more common “baby blues,” and understanding them is helpful when seeking appropriate support.
Understanding Perinatal Mood and Anxiety Disorders (PMADs)
Baby Blues (not a PMAD)
A common, mild form of mood fluctuation that affects many new caregivers beginning 1-3 days after childbirth. Symptoms can include feeling tearful, irritable, or overwhelmed, and these feelings usually resolve within two weeks as the body adjusts to hormonal changes and the new demands of parenting. Symptoms that continue beyond the two-week mark are signs of a possible PMAD.
Postpartum Depression
More intense than the baby blues, postpartum depression can last for months and significantly impact daily functioning. Symptoms may include persistent sadness, hopelessness, severe fatigue, changes in appetite or sleep patterns, and difficulty bonding with the baby. It’s important to seek help if these symptoms persist beyond the initial weeks.
Postpartum Anxiety
This condition involves intense and excessive worry that can interfere with daily life. Symptoms may include constant worry about the baby’s health, panic attacks, or intrusive thoughts. This anxiety can be overwhelming and needs appropriate treatment.
Postpartum Panic Disorder
This involves sudden and intense episodes of fear or discomfort, known as panic attacks. Symptoms can include heart palpitations, shortness of breath, dizziness, and a feeling of losing control. These panic attacks can be debilitating and often require therapeutic interventions to manage.
Postpartum Obsessive-Compulsive Disorder
Characterized by distressing, intrusive thoughts about harming the baby or the self, postpartum OCD involves compulsive behaviors to alleviate these fears. While the thoughts can be distressing and feel unspeakable, seeking help from appropriately trained providers is crucial to managing the symptoms effectively.
Postpartum Post-Traumatic Stress Disorder
This can occur following a traumatic childbirth experience, such as an emergency delivery or complications. Symptoms may include flashbacks, nightmares, severe anxiety, and avoidance of reminders of the trauma. PTSD can significantly impact a caregiver’s ability to function and bond with the baby, making professional support essential.
Postpartum Psychosis
This is a rare but severe condition that may involve hallucinations, delusions, or severe disorientation. It requires immediate medical attention as it can pose risks to both the caregiver and the baby.
Understanding these conditions helps in recognizing when to seek professional help. If you or someone you know is struggling with these symptoms, reaching out to a mental health professional is a vital step toward recovery and well-being. (It may feel scary to do so especially if you’re experiencing intrusive thoughts, but I want to assure you, good moms have scary thoughts – Karen Kleiman, MSW even wrote a book about it!)
When to Seek Help: Recognizing Symptoms of PMADs
Let me be clear, symptoms for a PMAD are not a prerequisite for asking for help! Every caregiver’s journey into parenthood is unique, complicated, and can benefit from a mental health professional who specializes in supporting clients during this vulnerable phase of life.
However, It’s important to recognize the more serious signs of PMADs and know when it’s time to seek professional support. If you or someone you know is experiencing any of the following symptoms, reaching out for help is crucial.
Persistent Sadness or Hopelessness: Feeling overwhelmingly sad, empty, or hopeless for more than two weeks.
Severe Fatigue: Constant exhaustion that doesn’t improve with rest.
Changes in Appetite or Sleep Patterns: Significant changes in eating habits or difficulty sleeping, even when the baby is asleep.
Difficulty Bonding with the Baby: Feeling disconnected or unable to bond with the baby.
Intense Worry or Anxiety: Excessive worry about the baby’s health or safety that interferes with daily life.
Panic Attacks: Experiencing sudden episodes of intense fear, heart palpitations, shortness of breath, or dizziness.
Intrusive Thoughts: Distressing thoughts about harming the baby or oneself.
Flashbacks or Nightmares: Reliving traumatic experiences related to childbirth.
Avoidance: Avoiding places, people, or activities that remind you of the trauma.
Hallucinations or Delusions: Seeing or hearing things that aren’t there or having beliefs that are out of touch with reality.
Severe Mood Swings: Experiencing extreme highs and lows in mood.
Social Withdrawal: Pulling away from family and friends or losing interest in activities you once enjoyed.
Navigating the perinatal period is a journey filled with both joy and challenges unique to each caregiver, and understanding perinatal mental health and the potential difficulties can empower you to seek the support you need. By prioritizing your mental health, you are taking an active role in nurturing both yourself and your child. Remember, you are not alone in this journey, and your well-being matters!
Additional Resources:
Kristi’s List - PMH Provider Directory
Policy Center for Maternal Mental Health
Postpartum Support International (PSI)
Nurtured TX (previously Pregnancy and Postpartum Health Alliance of Texas)
Reproductive Psychiatry & Counseling
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WRITTEN BY Jami Lewis, LPC-Associate
I'm Jami Lewis, a Licensed Professional Counselor Associate (LPC-A) and a National Certified Counselor (NCC), under the supervision of Jaclyn N Sepp, MA, LPC-S, RPT-S™, NCC, RYT200, and Leah Gilbert, MEd, LPC-S, NCC. I earned my Master’s Degree in Professional Counseling from Texas State University, which is known for its excellence in training counselors. I also hold a Bachelor’s Degree in Psychology and am a Registered Play Therapist™ (RPT™) and Perinatal Mental Health Certified (PMH-C) candidate.
