Postpartum Depression and Anxiety: This Isn’t What I Expected
Pregnancy is often a time of hopes, dreams, and anticipation. We set our hearts on what we view as ideals for motherhood. I remember during my first pregnancy imagining what our son might look like, what his personality might be, and how he would fill out our family to a count of three. It was all so exciting. I also remember imagining the type of mother I wanted to be… I wanted to make all the “right” choices. I wanted to breastfeed through the first year, give him the healthiest foods, devote my time and attention to his healthy development, love selflessly, and celebrate this new person in our family. What I did not imagine was the tidal wave of intense and mixed emotions that would wash over me following his birth.
This experience is true for many women. New mothers are often surprised by the emotional challenges that come along with the adjustment to motherhood and there is just no way to anticipate the emotional impact of the hormonal and chemical changes that occur in a woman’s body after childbirth. These emotional challenges during the postpartum time period fall on a continuum and range from what are described as the “baby blues” to mental health concerns that are more severe and need professional treatment.
What Are Perinatal Mood Disorders?
The majority of women have a baby blues experience that includes intense emotions, both high and low, and sometimes moving between them within just a few minutes. While the predominant emotion during this time is joy over the birth of their child, women with the baby blues may find themselves crumbling into tears with no warning. For women who view themselves as typically emotionally steady, this emotional unpredictability can be unnerving, but is not necessarily abnormal or unhealthy. A key aspect of the baby blues is that this experience is short-lived, starts in the first couple of days after the baby is born and resolves by about 2 weeks after delivery.
What is little known or discussed in our culture is that a sizeable minority of women, approximately 20%, experience much more significant emotional difficulties both during pregnancy and following childbirth in the postpartum window. These emotional difficulties are referred to as perinatal mood disorders and are comprised of things like postpartum depression, anxiety, mania, intrusive thoughts, obsessive-compulsive disorder and, more rarely, delusions or hallucinations. This statistic of 20% is surprisingly high and makes perinatal mental health problems the most common complication of childbirth. Postpartum depression is the most common of these issues, comprising approximately 12% of postpartum women. A woman who experiences these issues may begin to notice that something does not “feel right” as early as a few days after childbirth or she may notice amplification of symptoms months later. Some women begin to experience mood changes even while still pregnant. What is so hard about perinatal mental health problems is that a new mother often feels so much fear, guilt, or shame about them that she is unable to talk about her experience, even to her loved ones, and therefore she often does not receive treatment that could make an enormous difference to her mental health and to her experience as a new mother. Untreated perinatal mood disorders have a negative impact on the health of both the mother and ultimately the baby.
I Think This Might Be Me
If you are a pregnant or new mother and you find that several weeks or even months after your delivery you still just do not feel like yourself, you may wonder if you fall into this 20% category. You may feel ashamed because you cannot feel any joy about this new baby in your life, or you feel disconnected or alienated from your baby, or you feel sad and hopeless about your life and have shattered dreams and expectations of what new motherhood would be like. Perhaps you are afraid because you are having thoughts that are distressing, thoughts of harming yourself, or intrusive and scary thoughts about harm coming to your baby. You need to know that you are not alone. Many, many other women have had these experiences too. Be encouraged, because help is available. These issues can be treated and overcome with professional support. You are NOT a bad mother. You are NOT defective. You ARE capable of healing and stepping back into your life in the ways that you dreamed of before your baby was born!
What Should I Do?
The first step towards healing is to tell someone that you trust what is happening to you and to ask them to help you find the professional support you need. That person may be a spouse or partner, another family member, or a friend. If it is hard for you to think of a person in your life that you can trust, reach out to a mental health professional directly. That person will be a safe landing place for you and will not be shocked by your experiences. You will be on your way to healing!
I Think This Might Be Someone I Love
Perhaps you are a husband or partner, family member, or friend to someone who just gave birth and you are growing concerned about her. Bless you for noticing and for caring enough to do some research about perinatal mood disorders. Your support to your loved one can make all the difference in the world right now.
If you have noticed unusual behaviors in your loved one, signs of depression, an amplification of anxiety or OCD behaviors, avoidance in the participation in the care of her child, fear of being alone with the baby, or just anything that causes you to have that gut feeling that something is not right, you can be the first line of support to getting your loved one the help she needs. Be encouraged that these issues can be treated and life can return to a new normal. But right now, your loved one may very much need your help.
What Should I Do?
Be a safe and non-reactive place for her to tell you what is happening inside. Women with perinatal mood disorders are often fearful and ashamed. If you provide a non-reactive, non-judgmental environment to discuss what is happening, your loved one will be able to lean on you and trust you to help her to connect with the care that she needs to heal. Make sure she knows that you believe in her.
Be proactive in reaching out to help your loved one get the professional care that she needs. Help her to research mental health providers in your area and offer to accompany her to the first appointment. You may feel divided between providing needed care for the new baby or providing care for your loved one. Perhaps ask for help from trusted friends or family members to help care for the baby, while you help Mom get the care that she needs. Your support can make a huge difference in her recovery process, which will also have a positive impact on the well being of her/your child.
While perinatal mood disorders can be overwhelming and even frightening for both the pregnant/new moms involved and for their loved ones, the good news is that these concerns are highly treatable with very successful outcomes. Family and social support combined with mental health care and, sometimes, medication create a potent and holistic approach to healing that can yield fantastic results. What is most important is that women are activated to take that first step towards healing by asking for help.
For further information or resources about perinatal mood disorders, visit Postpartum Support International.
Seyfried, L. S., & Marcus, S. M. (2003). Postpartum mood disorders. International Review of Psychiatry,15(3), 231-242. doi:10.1080/09540260305196
National Institute of Mental Health. Postpartum Depression Facts[Brochure]. Retrieved June 2017 from https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/postpartum-depression-brochure_146657.pdf
Michelle Schaefer, LCPC, PMH-C, has experience working with adults, couples, teens, families, and groups. Michelle has an advanced certification in Perinatal Mental Health and specialized training in Emotionally Focused Therapy for couples and families. Michelle strives to create a secure client-therapist alliance in order to support people as they navigate life challenges and heal relationships.
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