By Taylor Oberhelman-McLeod, PLPC, MA, NCC
Whether you are adding your first child or your third into your family, expanding your family is a life changing event that can be filled with so many conflicting emotions. One minute you may be feeling overwhelmed with joy and the next with overwhelming sadness or worry. You may wonder, “Is this normal?” Many of your family and friends might have told you along the way that the transition to parenthood is hard and dismiss the feelings you are having, when really there is something much larger at play.
What is Perinatal Mental Health?
Perinatal mental health disorders are complications that may occur in pregnancy and in the postpartum period. Today, we use the term PMAD, which stands for perinatal mood and anxiety disorders, to describe the mental health conditions that can develop during pregnancy in postpartum. Perinatal mental health conditions do not discriminate; the prevalence of PMAD impacts one in five to seven women and one in ten men. Currently, PMAD is the most under diagnosed obstetrics complication in America.
Recognizing PMAD
Antepartum and Postpartum Depression (PPD):
If you are pregnant or postpartum and having thoughts like:
- “I’m X weeks pregnant, everyone around me is happy for me, I should be happy, but I’m not.”
- “I don’t feel connected to my baby”
- “Having a baby is exhausting and challenging, but this is how all moms feel.”
Symptoms might include:
- Anger or irritability
- Lack of interest in the baby
- Isolation or social withdrawal
- Difficulty bonding with the baby
- Sleep disturbance
- Crying or sadness
- Feelings of guilt, shame and hopelessness
- Loss of pleasure or joy
- Thoughts of self-harm.
As with any life changing event, there is always an adjustment period. Some of these symptoms can be challenging to distinguish between the adjustment to a schedule change of waking up in the middle of the night to feed your baby and a mental health disorder. So while some exhaustion and low energy is par for the course when you bring home a baby, if these feelings last longer than two weeks after giving birth and tend to be a bit more extreme in nature where they are disrupting your ability to feel connected with the baby, feel like yourself, or to cope, you might have postpartum depression.
Perinatal Anxiety:
It is not uncommon to feel some anxiety while waiting nine months – or less – to add a little one to your family; your life is about to change in a big way! It’s also perfectly natural to feel some anxiety when they have made their debut, and you are in the midst of adjusting to a new normal. However, when the worry becomes difficult to control and interferes with your ability to function, it might be time to consider addressing it.
Symptoms for anxiety in Pregnancy and Postpartum may include:
- Consistent worry
- Racing thoughts
- Difficulty sitting still
- Sleep disturbance
- Changes in appetite
- Feeling like something bad will happen
- Physical symptoms: nausea, dizzy, hot flashes
Perinatal Obsessive Compulsive Disorder (OCD):
Perinatal OCD is composed of two parts: obsessions and compulsions. Obsessions are unwelcome distressing thoughts that are repetitive and difficult to control. Compulsions are engaging in repetitive behaviors to help reduce the intrusive thoughts. It’s normal to feel worried about your pregnancy or new baby, it becomes an issue when the obsessions and compulsions interfere with your daily life. Some parents-to-be or new parents may experience:
- Intrusive thoughts about fear of harming your baby or sexually abusing them
- Fear of giving your baby a disease or illness
- Distress about making the correct decisions for your baby health and safety
While these thoughts do seem intimidating, keep in mind that parents that have perinatal anxiety are typically experiencing them out of a place of anxiety and there is actually a very low risk of these anxieties being acted on. Typically the compulsions are performed to keep them from the thoughts that they fear (such as washing the bottles 5 times to keep the baby from getting a disease).
Symptoms you might experience if experiencing Perinatal OCD:
- Intrusive thoughts that are persistent and repetitive
- Following through with compulsions to reduce intrusive thoughts
- Sense of horror about intrusive thoughts
- Fear of being left with baby
- Hyper vigilance in protecting the baby
Post Traumatic Stress Disorder (PTSD):
Not only is giving birth incredibly hard on a person’s body physically, but it can also be a very emotional experience as well. There are situations that can arise during the pregnancy and during and after birth that are unpredictable and are not what you or your partner hoped would happen. Your risks of experiencing PTSD from childbirth could increase if you or your partner experience real or perceived trauma such as your baby spending time in the NICU, unplanned cesarean delivery, poor communication, feelings of powerlessness, history of sexual assault, and unexpected physical complications.
Symptoms you might experience if experiencing PTSD include:
- Flashbacks of the traumatic event
- Avoidance of stimuli associated with the event
- Anxiety and panic attacks
- Feeling a sense of detachment
- Trouble sleeping
- Exaggerated startle response
- Hypervigilance
Experiencing birth trauma can be a very painful experience to navigate, and it’s important to remember that much of what happens during birth is outside of your control and not your fault.
Seeking Help:
If you or your partner are struggling with perinatal mental health, reach out to your support network, OB/GYN or family medicine physician, therapist, local moms group, or virtual group offered by Postpartum Support International. If you are seeking therapy in Missouri, I am happy to offer support virtually or in person. Click here to fill out the form & learn more. I’d love to help you navigate the journey of parenthood.
