Perinatal Mood Disorders

Woman with Depression

What are perinatal mood disorders?

Pregnancy and the postpartum period are life-changing times when emotions can run high. It’s common to feel anxious or overwhelmed as your due date gets closer or during the tiring early months with a newborn. Hormonal surges and drops can also cause rollercoaster mood swings. But for some pregnant and postpartum people, the rough patch doesn’t pass. About 20% develop a perinatal mood disorder like depression, anxiety, or post-traumatic stress, either during pregnancy or in the 12 months after birth. For people of color, the risks can be much higher, and some medical studies have found depression rates up to 50% among Black and Latina women soon after giving birth.

Perinatal mood disorders can be linked to a past history of psychiatric issues, stressful life events, medical complications for you or your baby, birth trauma, or a lack of emotional support. They can also happen without any obvious cause at all. If you’re not feeling like yourself, don’t keep quiet. Untreated mental health issues are harmful for both you and your baby. Your doula can help connect you with mental health resources and effective treatments, so you can recover your balance and joy.

Symptoms to know

It’s useful to know the symptoms of perinatal mood disorders and share them with your partner, family, or friends. Assessing yourself can be hard, especially when you are tired or overwhelmed, so allow people you trust to tell you what they are seeing.  Keep track of time so you don’t confuse these signs with the “baby blues,” the common mood swings or weepiness after giving birth. If your symptoms last longer than two or three weeks, it’s time to get help.  

  • Depression During Pregnancy or Postpartum: Sadness, anger, irritability, guilt, hopelessness, lack of interest or trouble bonding with your baby, changes in eating or sleeping habits, trouble concentrating, thoughts of harming yourself or your baby
  • Anxiety During Pregnancy or Postpartum: Extreme worries or fears, terror about baby’s health or safety, intrusive thoughts, panic attacks, shortness of breath, chest pain, dizziness or numbness, avoiding feared situations or activities
  • Obsessive Compulsive Disorder: Repetitive and upsetting thoughts or mental images, repeating specific rituals or checks to reduce anxiety, perfectionism, seeking constant reassurance, avoiding feared situations or activities
  • Post-traumatic stress disorder: (linked to birth trauma or past trauma) vivid flashbacks, intrusive thoughts, nightmares, fear of trauma reminders, panic, sweating, nausea, extreme alertness, trouble sleeping, feeling detached
  • Postpartum psychosis: (rare and dangerous) hallucinations, mania, severe confusion, paranoia, memory loss, requires immediate treatment

What you can do

The first step in treating a perinatal mood disorder is recognizing it. As a new parent, it can be hard to tell what is normal, and even experienced mamas are often afraid to admit they are struggling. The shame and stigma around mental illness is real, along with the social ideal of being a “strong mother.” There is also a legitimate concern in Black and brown communities about discrimination from health care providers, being labeled as “unfit,” or involving social services. Remember that asking for help is not complaining or weakness. Your baby needs a healthy parent to thrive as much as you need to feel better.

Next, connect with a mental health provider who understands perinatal mood disorders. Your OB-GYN, midwife, or doula may know providers in your area. Treatment plans are different for everyone. Talk therapy, self-care, diet and exercise, support groups, or spiritual practice can help. Taking medication for depression or anxiety may also be important for recovery. If you are pregnant or breastfeeding, your provider can recommend drugs that are safe. The right approach is the one that works for you.

Mental health during COVID-19

Right now, COVID-19 is adding extra stress for pregnant and postpartum people and their families, especially in the communities most impacted by the pandemic. Isolation, worry, job losses, lack of childcare and other issues are causing widespread mental health symptoms. Maternity care and support also look very different. Prenatal visits are happening through video and phone. Hospitals have limited the number of visitors and support people. And parents may not have help from family and friends as they adjust to a new baby.

But the pandemic has also expanded the ways that you can access mental health support and treatment. With more focus on remote health care, it may be easier to speak with doctors or counselors when leaving the house with a baby is tough. As always, be persistent and advocate for the help you need.

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