What is Perinatal Mental Health?
Perinatal mental health is the mental well-being of women during pregnancy and up to one year after childbirth. It includes a range of mental health conditions, including depression, anxiety, PTSD, OCD, and substance use disorders. These disorders can emerge for the first time during the perinatal period or symptoms can worsen for someone with a pre-diagnosis. Postpartum symptoms affect not only the pregnant person, but also other family members, including fathers and partners.
For new mothers, it can be very upsetting and sometimes frightening to have feelings or thoughts about motherhood that don’t seem “right.” Perinatal symptoms can also be debilitating at times, and leave you feeling devastated during what should be one of the most happiest times in your life.
For some women, a morning run, a healthy diet, and receiving help and support from family and friends are sufficient enough to get through the initial adjustment period. For others though, talking to a therapist who specializes in new motherhood issues can be comforting, relieving, and needed.
Therapists who have extensive education and training in postpartum disorders understand that hormone changes, personal and family history, and social support are all vital factors in understanding and alleviating postpartum symptoms.
My Experience
I struggled with both perinatal depression and anxiety during the first trimester of my pregnancy. As things progressed my depression and anxiety symptoms seemed to decrease and I felt better. Aside from terrible morning sickness during my first trimester my pregnancy was almost perfect. I was healthy, my baby was healthy, and everything went as planned. Naturally I assumed the birth would go smooth as well. However, that is not what happened. I ended up having a traumatic birthing experience which resulted in my baby having to be in the NICU for about a week. By the grace of God everything was okay, but it was touch and go for awhile and I have never felt that scared in my life. After returning home I was right back in the trenches again feeling scared and struggling with my mood. With time and support from my very loving and understanding husband, things gradually got better.
I did not seek professional help. Why? Because I thought I didn't need it. Afterall I'm a therapist. I thought I knew about this stuff, but what I knew was nothing. I also felt ashamed and guilty for how I felt. Whenever I compared myself to other new moms I felt there was something wrong with me. There was no way I could talk to a professional about this. What if they judged me? What if they thought something was wrong with me? What if they thought I should know better because I'm a therapist? Looking back I feel very stupid for not seeking help immediately. However, I have to remind myself that I was naive and ignorant when it came to childbirth and postpartum issues. You don't know what you don't know. If I could do the experience over I would have sought treatment during my pregnancy and saved myself a lot of grief, but you can't look back.
Here is where I am today. I still have my very loving and supportive husband and a thriving five year old daughter. We have also added a dog and a few chickens to the mix, but everyone is happy and healthy. This experience made me realize that there are so many women and families who experience what I did, and like me they don't seek help. I believe that most women know something is not right, but they don't realize that it is a treatable issue. I decided to add perinatal mental health to my specialties because I GET IT and I would not wish what I went through on anyone.
If you are experiencing any of the symptoms below you are not alone. There is no reason you should suffer in silence; please reach out for help.
Perinatal Mental Health (PMH) conditions are the number one complication of childbearing.
Perinatal Depression:
- Feelings of anger, irritability and/or rage
- Lack of interest in the baby
- Disturbances of sleep or appetite
- Crying or feelings of sadness
- Feelings of guilt, shame or hopelessness
- Loss of interest or pleasure in things you used to enjoy
- Possible thoughts of harming the baby or yourself
Perinatal Anxiety:
- Constant worry
- Feeling that something bad might happen
- Racing thoughts
- Disturbances of sleep or appetite
- Inability to sit still
- Physical symptoms; such as; dizziness, hot flashes diarrhea and nausea
- Feelings of anger, irritability and/or rage
- Feeling nervous, on edge, anxious or having trouble relaxing
Perinatal Obsessive Compulsive Disorder (OCD):
- Obsessions; intrusive thoughts or mental images, which are persistent and repetitive and often related to the baby. These thoughts are very upsetting
- Compulsions; where you may do certain things over and over again to reduce your fears and obsessions. This may include; needing to clean constantly, checking things many times, counting or reordering things, and/or avoiding triggers
- A sense of horror about these thoughts
- Fear of being left alone with the infant
- Hypervigilance in protecting the infant
Perinatal Post Traumatic Stress Disorder (PTSD):
- Flashbacks of a past traumatic event (which in this case may have been the childbirth itself)
- Nightmares
- Avoidance of reminders associated with the event, including thoughts, feelings, people, places and details of the event
- Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
- Anxiety and panic attacks
- Feeling a sense of unreality and detachment
- Avoidance of aftercare following a birth trauma
Perinatal Bipolar Disorder:
Bipolar disorder can look like a severe depression or anxiety and can include symptoms such as:
- Periods of severely depressed mood and irritability
- Elevated mood, higher energy than normal.
- Rapid speech
- Little need for sleep
- Racing thoughts
- Trouble concentrating
- Overconfidence
- Impulsiveness
- Poor judgment
- Easily distracted
- Grandiose thoughts
- Inflated sense of self-importance
- In the most severe cases, delusions and/or hallucinations
- Childbirth may be a specific trigger for a manic episode, which could then be followed up by the onset of depression.
Perinatal/Postpartum Psychosis:
- Delusions or strange beliefs
- Hallucinations (seeing or hearing things that aren’t there)
- Feeling very agitated
- Hyperactivity or having more energy than usual
- Severe depression or lack of emotion
- Decreased need for or inability to sleep
- Paranoia and suspiciousness
- Rapid mood swings
- Difficulty communicating at times
Postpartum Support International (PSI) Help Line:
Text “Help” to 800-944-4773 (EN)
*The PSI Help Line does not handle emergencies. Help Line hours are 8am-11pm EST. Services are in English and Spanish. People in crisis should call the National Suicide and Crisis Line; 988 (call or text).