Did you know that women are especially vulnerable to mental health problems during pregnancy and postpartum? This may seem surprising since we like to focus on the aspects of those times that are joyous and fulfilling. But even under ideal circumstances, the experience of pregnancy, giving birth and mothering an infant bring profound physical, mental and social changes, adjustments and challenges. As a psychotherapist, I know this time in a woman’s life is powerfully evocative of unresolved psychological issues. This creates an amazing opportunity for healing and growth, while also bringing challenges and risks for a women’s emotional and mental stability.
Up to 80% of women experience the “baby blues”, a normal passage of feeling weepy, moody, and irritable that occurs in the first weeks after birth and resolves on it’s own. But 15-20% experience more problematic and persistent symptoms, that may include persistent depression, anxiety, insomnia, inability to enjoy life, or feelings of guilt or worthlessness. Troubling thoughts are also very common and can be repetitive and intrusive. Although postpartum depression is the most well known label, it may be more accurate to use the term perinatal mood disorders, which can begin during pregnancy and include depression or anxiety disorders, obsessive compulsive disorder, and post traumatic stress. These disorders do not necessarily resolve on their own and in fact, may worsen over time. However, they are very treatable!
Many complex factors can contribute to a woman’s risk for a perinatal mood disorder. The following are risk factors that can make individual women more vulnerable:
- previous history of depression and anxiety
- sensitivity to hormonal changes (including PMS)
- lack of social support
- other life stressors, i.e. moves, financial or relationship difficulties, etc.
- history of childhood abuse or trauma
- previous experience of birth trauma
- Postpartum psychosis is much more rare, affecting less than 1% of women and is characterized by confusion, delusions and being out of touch with reality. Postpartum psychoses is what generates headlines and sometimes makes women afraid to seek help for the much more common symptoms discussed above. Women should know that postpartum psychoses is a separate illness from postpartum depression or anxiety disorder and these more common disorders do not “turn into” psychoses.
Unfortunately, there are still strong barriers for women to admit they need help. Many women feel internal and external pressure to present themselves as competent, cheerful, and well-functioning, particularly in their roles as mothers. It can be hard enough anytime to identify oneself as depressed or anxious because of continuing stigma about mental health problems. But to do so during pregnancy or postpartum is often doubly challenging. Women are afraid of being judged or even seen as unfit mothers. We need to change this by speaking more freely of our struggles. Healthcare providers need to be more aware and take the time to find out how women are really doing, beyond the initial “I’m fine” which may be very inaccurate.
Women need and deserve help for perinatal mental health problems. Help can include increased support from friends or family, support groups, individual psychotherapy and/or medication. Family and friends can help by listeningwithout judgment, not offering unsolicited advice and encouraging women to reach out for help. Counseling for the couple may be appropriate and by the way, men are more vulnerable to depression and anxiety during the transition and adjustment to fatherhood, as well.
At Thrive, we offer a variety of enriching services for pregnant and postpartum women, including a support group for women who are struggling with depression and anxiety, as well as individual, couple or family counseling.
I facilitate our ongoing Friday morning group, “Surviving and Thriving through Postpartum Depression and Anxiety”. Topics include tools for self-care, mindful awareness of self-talk, and acceptance of imperfection. Together we create a safe space for sharing feelings, questions, and experiences. Women can join at any time, drop-ins are welcome and the first meeting is free.
If you a mother of a baby or toddler and are struggling to cope with worries, irritability, fatigue, sleep deprivation, difficulty enjoying your baby, or feeling bad about yourself, give yourself the gift of reaching out for support.
Try not to worry as much about questions like “do I have postpartum depression?” and just focus on “do I need or want some help and support?” You are not alone and we can help!
Call us or visit our website for more information. Or feel free to drop in on any Friday morning at 10:30 a.m.