- Postpartum Depression and Anxiety
It is estimated that 6% of pregnant and 10% of postpartum women experience anxiety, and approximately 10% of pregnant and 15% of postpartum women experience depression. These percentages are estimated to be higher for women in poverty and teen mothers.
Am I at risk for a perinatal mood disorder?
The following list may help you determine if you are at risk:
- You or a family member has a history of:
- Bipolar disorder
- You have experienced:
- Premenstrual Syndrome
- Eating disorders
- Thyroid disease
- Traumatic birth
- Traumatic experience
- Unresolved loss of a child (miscarriage, abortion, etc.)
- Sexual abuse, physical abuse, and/or neglect
- Recent life stressors
- Relationship difficulties
- Your child has special needs or medical concerns
If you said “yes” to one or more of the above, you may be at higher risk for a perinatal mood disorder. In addition to seeing a counselor to help navigate these challenges, a list at the bottom of the page has been provided to help you understand and navigate your wellbeing.
What are the symptoms of postpartum depression or anxiety? How do they differ from “baby blues?”
Postpartum depression is often accompanied by:
Despair, hopelessness, anger, irritability, unusual sleep habits, loss of energy and interest, weight change, excessive crying/tearfulness, hypochondria, excessive worries, feelings of guilt/shame, and/or suicidal thoughts.
Postpartum anxiety is often accompanied by:
Shortness of breath, racing heartbeat, hyperventilation, nausea/vomiting, diarrhea, dizziness, chest pain, hot/cold flashes, tingling in hands/feet, agitation, fear of dying, irritability, anger or rage, fear of being alone, fears regarding baby’s health, feeling trapped or immobilized, muscle tension, and/or fear of “going crazy.”
“Baby Blues” differ from postpartum anxiety and depression based on intensity and duration. Up to 85% of new mothers experience baby blues, which typically last 2-3 weeks after the baby’s birth and can usually be resolved with self care habits and time. Symptoms exceeding 3 weeks or with increasing severity could be indicative of a more serious condition.
Perinatal Support, Washington (PS-WA) – “PS-WA is a statewide non-profit committed to shining a light on perinatal mental health to support all families and communities. We believe all parents should receive appropriate, timely, and culturally relevant care from conception to baby’s first birthday.”
- PS-WA: Creating a Wellness Plan
- PS-WA: Planning for Another Baby after Postpartum Depression or Anxiety
- PS-WA: Resources and Referrals for Dads
- PS-WA: Parent Corner – Dads Need Support Too!
- PS-WA: Resources and Referrals for Families of Color
Seleni – “We treat, train, support, and advocate to improve the emotional health of individuals and their families during the family-building years.”
National Institute of Mental Health – “Perinatal Depression”
National Child and Maternal Health Education Program – “Moms’ Mental Health Matters”
U.S. Department of Health and Human Services, Office on Women’s Health – “Postpartum Depression”
Federal Drug Administration, Free Publications for Women – “Medicine and Pregnancy”
National Institute of Mental Health – “’Baby Blues’ or Postpartum Depression?”
Center for Disease Control and Prevention – “Reproductive Health – Depression Among Women”
Postpartum Support International – “The purpose of the organization is to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum.”
The Blue Dot Project – “The purpose of the Blue Dot Project is to raise awareness of maternal mental health disorders, proliferate the blue dot as the symbol of solidarity and support, combat stigma and shame.”
- You or a family member has a history of:
- Additional Perinatal Mood Disorders
Perinatal mood disorders can be categorized as the number 1 complication of pregnancy, due to the estimate that 20% of mothers and 10% of fathers will experience one or more. Untreated disorders in parents are considered to increase the risk of child abuse, neglect, cognitive deficits, and behavioral problems. It can also impact parent-child bonding and create lasting effects in the relationship.
With treatment, such as therapy or support groups, the effects of perinatal mood disorders have been shown to decrease by 59%.
In addition to perinatal depression and anxiety, there are several other mood disorders associated with pregnancy and postpartum. Lesser known perinatal mood disorders include:
3-5% of mothers (and some fathers) will experience symptoms of obsessive/intrusive thoughts, compulsions to reduce the fears and obsessions, a fear of being left alone with the infant, or hypervigilance in protecting the infant. Postpartum-OCD is not the same as OCD, and it is temporary and treatable. You do not have to be diagnosed with OCD to have postpartum OCD.
An estimated 9 % of women experience Postpartum PTSD. Often these traumas include medical complications such as the baby having to stay in NICU, or birth trauma such as prolapsed cord, unplanned c-section, or postpartum hemorrhaging. Postpartum PTSD is experienced more often by those who have experienced previous trauma, including rape or sexual abuse. Symptoms may include flashbacks, nightmares, avoidance of details related to the event, anxiety and panic attacks, and feelings of detachment.
Bipolar Mood Disorders, while independent from pregnancy, can be characterized as related to perinatal mood disorders because many women are first diagnosed with bipolar during or after pregnancy. Bipolar is characterized by two phases, mania (highs) and depression (lows), with symptoms that impact daily functioning and interpersonal relationships persisting for longer than four days. Mania is defined by a period of bettered mood, rapid speech, decreased need for sleep, overconfidence, risky behaviors, impulsiveness, and racing thoughts. Depression often results in symptoms such as excessive fatigue, frequent mood changes, change in appetite, loss of pleasure, feelings of worthlessness, and thoughts of death.
In postpartum bipolar disorder, symptoms may appear closer to severe depression and increased anxiety. Monitoring of moods and overall health are important in recognizing these cycling patterns.
The rarest of perinatal mood disorders, postpartum psychosis is found in approximately 0.1-.02% of mothers, and quickly onsets after giving birth. Symptoms include delusions – including irrational judgement, hallucinations, paranoia, hyperactivity, a decreased need for sleep, and rapid mood swings. Risk factors include a family history of bipolar disorder or a previous psychotic episode. Postpartum psychosis is temporary and treatable, but can be dangerous if left unmonitored. If you are concerned that you may have postpartum psychosis, contact your doctor right away.
Counseling before, during, and after pregnancy can help reduce symptoms, duration, and severity of perinatal mood disorders.
Pregnancy and birth are a time of change, and therapy helps provide tools to handle changes, both seen and unforeseen. It also provides an objective party as support throughout the process.
Infertility, the inability to conceive or carry a child to term, can be one of the biggest challenges to face as an individual, couple, or family.
It’s not a challenge that needs to be faced alone.
From discussing treatment options and processes, to learning how to ask for support from extended family, to adjusting how you communicate with your partner, a therapist can be an impartial part of your support system.
Counseling can be most beneficial if you are experiencing symptoms such as:
Strained interpersonal relationships
Increase in conflict
Thoughts of suicide or death
Resources for Additional Support:
Seleni – Infertility articles, posts, and stories
The National Infertility Association – “Resolve”
National Fertility Support Center – “Infertility Support”
- Grief and Perinatal Loss
- Transition to Parenthood
The period of transitioning to parenthood, sometimes referred to as the “fourth trimester,” is rife with changes and struggles. Counseling can help you prepare for and deal with challenges as they come to maximize the wellbeing of you and your family.
Transitions include changes in:
- Hormonal changes
- Women – Pregnancy hormones, postpartum hormones, increases in cortisol (stress hormone)
- Men – Decreases in testosterone, increases in cortisol (stress hormone)
- Neuroplasticity – As the adult brain prepares for new developmental milestones, the neurons reorganize in both parents
- The hypothalamus, substantia nigra, and amygdala increase in size
- Cortex mediating social processes decrease in size
- Health behavior
- Eating patterns – With a new baby in the mix, parents often change what and when they eat. First time postpartum women have been shown to have a higher carb and saturated fat intake than non-mothers of the same age.
- Physical activity – New parents often have less time to exercise and/or participate in less intensive exercise than non-parents.
- Significant sleep disruption – New parents are estimated to lose ~80 hours of sleep per year for the first few years of a child’s life
- Loss of sleep may result in daytime sleepiness which interferes with daily functioning
- Hormonal changes
- Self-concept and self esteem changes are common in new parents
- Daily routines – Incorporating a baby into your daily life causes an upheaval in previously established daily practices that requires adjustment
Counseling can help:
- Social roles – As new parents, it may take time and effort to adjust to the concept of being a stay-at-home parent or a working parent. Gender roles in the home are often reevaluated and renegotiated during this time of transition.
- Psychosocial stress – Socializing may take on a different role in your life after having a child. Adapting to these changing interactions and social responsibilities often causes unanticipated stress.
- Relationship changes – Marital or parental relationships take on a huge responsibility with the birth of a child. Changing priorities, time management, levels of energy, and self-perception can all cause changes in your relationship.
- Create reasonable expectations for parenthood before and after birth including:
- Personal happiness
- Marital quality
- Division of household labor
- Parental involvement and roles
- Improve self-esteem and self-image
- Set goals
- Manage time and priorities
- Handle conflict
- Bond with the baby
- Cope with exhaustion, stress, and social pressure
- Maintain personal health – mental and physical
- Understand biological changes
- Baby-Proofing Your Relationship
Content coming soon!