Perinatal Mood Disorders and Maternal Mental Health

May is Maternal Mental Health Month!

This month, there are several things planned to help bring awareness to this important topic- webinars, live events on social media, and new blog posts! We’ll cover mental health issues that impact various stages of motherhood, from pregnancy through empty nesting. You’re sure to learn something new, so check back often for more details!

Week One: Perinatal Mood and Anxiety Disorders (PMADs)

Most people have heard of Postpartum Depression- PPD, but did you know that there are actually five more mood disorders that can present during or as a result of pregnancy? It’s true! Many of these are perinatal conditions, meaning they can take place anytime during the perinatal period- that is, from conception through one year after birth. Here’s a little information about the other PMADs and what to do if you or someone you love is showing signs of one of them.

Perinatal Anxiety

Perinatal anxiety can show up anytime during pregnancy or within the year following birth. In fact, about 6% of pregnant women and 10% of postpartum women develop this disorder, sometimes in addition to perinatal depression. Women with a personal or family history of anxiety, previous perinatal depression or anxiety, or thyroid imbalance are more at risk of developing this condition. Specific forms of Perinatal Anxiety can result in Postpartum Panic Disorder, which causes recurrent panic attacks.

Perinatal Obsessive-Compulsive Disorder

A subset of perinatal anxiety, perinatal OCD impacts 3%- 5% of women. With Perinatal OCD, a mom may have obsessions (repetitive, upsetting, and unwanted thoughts or mental images) and/or compulsions (the need to do certain things over and over) to reduce the anxiety caused by those obsessive thoughts. It is important to note that moms with postpartum OCD find their thoughts scary and weird and are very unlikely to ever act on them. Risk factors include a personal or family history of anxiety or OCD.

Postpartum Post-Traumatic Stress Disorder

PPTSD is often caused as a result of a traumatic birth (including NICU experiences), stillbirth, or infant loss. Moms who experience this may have flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event. Women who have experienced past trauma of other forms may be more likely to develop this condition.

Perinatal Bipolar Mood Disorders

Bipolar disorders can look like severe depression or anxiety. They are categorized by severe mood swings (not normal pregnancy mood swings) with symptoms lasting longer than four days and interfering with the woman’s ability to function at home, at work, or in relationships. There are two types with similar symptoms but with varying intensity (Bipolar I is more intense than Bipolar II), and it is important that this be diagnosed by a professional because it’s often misclassified as depression or anxiety and treating for only depression/anxiety can actually increase symptoms. Risk factors include having a family or personal history of bipolar mood disorder (also called manic-depression).

Postpartum Psychosis

Postpartum psychosis is a serious condition requiring immediate, emergency treatment. Although it usually shows up within the first two weeks after birth, it can show up later in the postpartum period. PPP sufferers may experience hallucinations and altered reality- believing things that aren’t true. They may distrust those around them and appear confused, manic, or have lapses of memory. Moms with postpartum psychosis are experiencing a break from reality. Although this condition is uncommon- impacting 0.1%- 0.2% of moms- if left untreated, the result can be disastrous, and 5% of moms with PPP complete suicide and 4% complete infanticide. In this state, the delusions and hallucinations seem real to her, which is why immediate treatment is required.

Perinatal Depression

The most prevalent of all of the PMADs, Perinatal Depression impacts 10% of pregnant women and 15% of postpartum women. These percentages are higher for teen moms and women who are impoverished. Symptoms can be different for different women, but usually include (but are not limited to) some amount of anger or irritability; feelings of guilt, shame, or hopelessness; crying and sadness; appetite and sleep disturbances; and a loss of interest in activities. There are several risk factors, including a personal or family history of depression, anxiety, or postpartum depression; PMDD or PMS, lack of support during pregnancy or after birth; financial or marital stress; or pregnancy complications.

Baby Blues

Although not a true depression, it is important to note that the Baby Blues are a real occurrence. The “baby blues” occur during the first two weeks after birth only, and are marked by crying and sadness, frustration, and irritability. This is believed to be due to the changing hormones in a woman’s body after giving birth and should pass by the end of the second week. If a woman is still experiencing symptoms after two weeks have passed it is not the baby blues, it is postpartum depression and professional help should be secured.

So What Can We Do?

It is important to note that all of these PMADs can be treated, but only if help is sought out. Often, moms don’t recognize the symptoms or the intensity of the symptoms in themselves, so it is important for those who are offering support to know the signs and symptoms. If you notice any of these symptoms in yourself or in a pregnant or new mom, encourage her to mention it to her OBGYN or her baby’s pediatrician. If you are a caregiver, you can also email or call the doctor yourself to share your concerns- they may not be able to discuss their patient with you, but you can certainly pass along information to them. And if you are not sure, it is always better to err on the side of caution and make the call anyway. You can also make an appointment with a therapist that has experience with PMADs. Postpartum Support International has several resources to help, including a hotline for people who are struggling or in crisis; therapist directory; and support groups. With a little more knowledge and a little care, we can help ALL moms have a mentally healthy pregnancy and postpartum period- which is best for babies!

Want to learn more about PMADS? Click here!