As we focus on mental health for the month of May, I wanted to take some time to talk about mental health in mothers, specifically in pregnancy and immediately postpartum. Perinatal mood disorders are more common than people may think. This topic is dear to my heart as someone who suffers from a perinatal mood disorder. As we jump into this post, I want to remind you that you are worthy of being happy and healthy. Please don’t wait until you feel like life is pointless to talk to a professional about your mental health. If you suspect at any time during your pregnancy or postpartum period that you may be struggling with a perinatal mood disorder, contact your provider immediately. 

 

What are perinatal mood disorders? 

 

Perinatal mood disorders are anxiety and depression-based disorders that can develop during the perinatal period. This blog post will give you a good idea of what that time looks like. We are also going to dive into what the symptoms of some of these disorders can look like. It’s crucial to understand that symptoms of these disorders can happen gradually or very suddenly. As you navigate the perinatal period, be as self-aware as possible to keep your mental health in the best shape. 

 

What is the perinatal time frame? 

 

First, let’s talk about the length of the perinatal period is. According to Women’s College Hospital (WCH), the perinatal period is the duration of pregnancy and about one month postpartum. However, most people refer to the postpartum period up to 12 months after giving birth. 

 

 

When people think of perinatal mood disorders, they often think of postpartum depression and anxiety. What’s important to remember is that perinatal mood disorders can appear during pregnancy as well. This is the case for me. I thought I was broken because I developed severe depression during both of my pregnancies. In my first pregnancy, I was sure it would go away when I gave birth, so I did not receive the help that I should have. During my second pregnancy, I worked with my providers to receive support to be a happy, functioning mother to my toddler at home. I was at the point where I truly felt like I could not care for my daughter without the help of my partner. I can tell you that asking for help is the best thing I have ever done. There is a night and day difference between my experiences. 

 

Baby Blues 

 

I want to talk about baby blues for a minute. Up to roughly 80% of new moms will experience baby blues due to the massive drop in hormones from pregnancy and birth. Baby blues are mood swings that can include: 

 

• Crying 
• Irritability 
• Difficulty sleeping 
• Concentration issues
• Minor anxiety

 

These symptoms should clear up within the first 1-2 months of giving birth. However, about 10-20% of moms develop perinatal depression, which requires treatment from a professional. 

 

What causes depression during pregnancy/postpartum? 

 

According to the North Carolina School of Medicine, depression during pregnancy and up to 12 months postpartum are one of the most common complications regarding childbirth. Some things that can increase the likelihood of depression are 

 

• History of mental health issues 
• Substance abuse 
• Inadequate social support
• Complications during pregnancy with mother or baby 
• A birth that ends with complications with mom or baby (NICU stay) 
• Trouble with breastfeeding 
• Financial problems 
• Relationship struggles 
• Age 
• Changes in self-esteem/body image 

 

Although it is normal to experience some anxiety, tiredness, and hormonal changes during pregnancy, it is crucial to stay aware of how these feelings affect your ability to function through everyday life. If symptoms stick around for more than 2-3 weeks or hinder you from enjoying life, it is usually a sign that it’s time to get help. It’s important to remember that not receiving support during pregnancy could lead to more severe symptoms during the postpartum period. 

 

The signs to look for in pregnancy that could be indicators of perinatal mood disorders are: 

 

• Feeling sad more often than not 
• Lack of interest in motherhood 
• Intense feelings of guilt about your ability to be a good mother
• Anxiety about making decisions
• Sleep problems
• Thoughts of hurting yourself or others 
• Having thoughts of not wanting to be alive 
• Constant low energy 
• Trouble focusing 
• Feeling restless more often than not 
• Having body aches, headaches, or other physical issues 

 

These symptoms are very similar to postpartum depression. Added symptoms that PPD have may include:

 

• The inability to connect with your child 
• Feeling inadequate as a mother 
• Excessive worry or anxiety about caring for yourself or your family 
• Suicidal thoughts

 

I want to reiterate that if you’re having these feelings for two or more weeks, it’s time to seek help. The two-week time frame is a good indicator that you’re experiencing a perinatal mood disorder rather than a typical hormonal shift. 

 

 

Postpartum psychosis (PPP)

 

It’s essential for me to briefly cover a more severe disorder that is less talked about; postpartum psychosis. Postpartum psychosis (PPP) symptoms can include: 

 

• Delusions 
• Hallucinations
• Intense irritability 
• Hyperactivity and sensitivity 
• Inability to sleep 
• Paranoia 
• Rapid mood swings
• Difficulty communicating thoughts and feelings 

 

 Postpartum Support International (PSI) states that this disorder occurs in about two deliveries out every 1,000 and happens very quickly, usually up to two weeks post-delivery. Those who are most at risk for this disorder have a personal or family history of bipolar or other severe mood disorders. Although mothers who suffer from this disorder are usually not an immediate risk to themselves or others, it is crucial to get help as soon as possible. This is because delusions can be detrimental. 

 

PSI offers an online support group for this disorder. Scroll down to the bottom of the page to register. 

 

What should you do if you suspect that you or a loved one may be suffering from a perinatal mood disorder? 

 

As I have stressed throughout this post, be as transparent as possible with your support system and medical team. Do not wait for things to get better magically. At your prenatal appointments, be upfront with how you’re feeling and thinking. Ask your loved ones to check in with you. One thing that gave me the final push to seek help from my medical providers was my husband asking me if I felt like I could be a better mom by getting help. He said that if my answer was yes to any degree, it was the right decision. If your loved one is suffering from a perinatal mood disorder, be an encouragement in any way that’s possible for you. Raising children truly takes a village- locally and from afar. Some ways that you can support a mom during her perinatal period include: 

 

• Cooking meals or bringing food to the new mom/family 
• Offering to go out and do something together 
• Praying for and with a new mom 
• Offering to be an emotional support person at appointments (Even if that means just driving with her) 
• Pop by to do 1-2 small chores 
• Hire a doula (postpartum doulas exist!) 
• Take photos of the new mom and her baby (Seriously… this is a big one) 
• Text the new mom with words of affirmation and encouragement 

 

I know there was a lot of information in this post. However, I want the main takeaway to be that perinatal mood disorders can happen at any time. We need to know how to offer support to new moms and help them prioritize their mental health. We live in a culture that often forgets about moms when the baby is born. This has to change. We must help mothers feel just as important as the baby during this change in their life.

 

 

Written by Rebecca Kochanek, Intern Coordinator. To read more SHIM blog articles, go here: https://safeharborim.com/articles/