The first few weeks, months or years of motherhood can be incredibly overwhelming — often more so than we expect. The combination of healing from childbirth, a lack of sleep, nutrient and vitamin deficiencies, changing hormones, a new body image, shifting identities, and old or changing dynamics with friends, family, and partners can be unexpected and emotionally draining.
Up to 85% of mothers will experience the Baby Blues, lasting up to 2-3 weeks. This is a time of fluctuating emotion, tearfulness, stress, vulnerability, worry, lack of concentration, and loneliness. The Baby Blues are considered a normal stage during the postpartum period.
15-20% mothers will struggle with a Perinatal Mood and Anxiety Disorder (PMAD) such as Postpartum Depression (PPD). There is a spectrum of Postpartum Mood and Anxiety Disorders including postpartum depression, postpartum anxiety, postpartum panic disorder, postpartum OCD, postpartum PTSD, and postpartum psychosis. The symptoms of many PMADs are similar to the Baby Blues except that they last longer than 2-3 weeks and typically become more severe over time.Along with the symptoms listed above, PMADs may also include the following: hopelessness, sleep difficulties, irritability and/or rage, excessive anxiety, worry, changes in appetite, guilt, inability to experience pleasure, low self esteem or feelings of worthlessness, physical problems with no apparent cause, intrusive negative thoughts or images, and obsessive worries. Postpartum psychosis, the rarest form of a Postpartum Mood and Anxiety Disorder, affects .1-.2 % mothers, and is characterized by depression and mania with psychotic features such as hallucinations, delusions, and paranoia. Women with a prior history of bi-polar disorder are at highest risk for developing postpartum psychosis. This very serious form of a PMAD is considered a medical emergency. All Postpartum Mood and Anxiety Disorders, including postpartum psychosis, are treatable.
The cause of Postpartum Mood and Anxiety Disorders is unknown, but research has shown that PMAD’s are most likely caused by disruptions in a Mom’s biology, psychology, and social system.
- biology: changing hormones following childbirth, nutrient depletion, sleep deprivation
- psychology: changing body image, changing identity, loss of control, challenging thought patterns and negative thinking, preexisting mental illness, stress
- social systems: family and partner dynamics, lacking social support, isolation.
The good news is that Postpartum Mood and Anxiety Disorders do not need to last for a long time. Struggling with PPD and other disorders is not a reflection of a mom’s desire to care for and love her children, but it does interfere with her ability to enjoy the months following birth. It is important to obtain adequate support during this time, as long untreated PMAD’s can have significant negative effects on infant development and family relationships. Numerous studies have identified psychotherapy as one of the leading treatment options for PPD.
Note: It is important to note that any of the above mood disorders can also exist in pregnancy. Women who are depressed or anxious during pregnancy are 50% more likely to develop a mood disorder after birth. There are many support systems that can be put into place early to reduce the risks of a postpartum mood disorder for these moms and early support and treatment is imperative.
Preterm and Neonatal Loss Support
Losing a baby through miscarriage, elective termination, childbirth, SIDS, or after a NICU experience is one of the most difficult traumas that a woman and her family can experience. While every mom’s process of grieving and eventual healing is different, there are commonalities that many, many women experience together. Support through this very challenging time is an important part of the process for most women and families as they negotiate the ways to incorporate their loss into their lives.