May is Maternal Mental Health Month
by Jasmine Reed MSW, LSW (PMH-C in progress)
Perinatal Depression and Anxiety
1 in 5 mothers will experience depression or anxiety related to their pregnancy. The symptoms are similar to unipolar depression and generalized anxiety disorder. Someone with perinatal depression may not have an interest in their baby or find joy in being around their baby. Perinatal Mood and Anxiety Disorders (PMADs) can occur during pregnancy, postpartum, or after a loss (example: miscarriage or stillbirth). PMADs are not limited to depression or anxiety. They include Bipolar Disorder, Perinatal OCD, Perinatal PTSD, and Postpartum Psychosis. Below are some tips, symptoms, and information on these disorders that are not as well known.
Bipolar Disorder
About HALF of women diagnosed with bipolar are FIRST diagnosed within the postpartum period. Childbirth can propel someone into a manic episode, although depression is still the most common presentation of bipolar disorder in the peripartum. Symptoms are not specific to perinatal populations but keep in mind risk factors such as lack of sleep (typically unavoidable with an infant), substance use, and family/individual history of bipolar. If you know a client has bipolar, you should be working with their support person to ensure they are getting enough sleep (6+ hours uninterrupted) and taking their medications as prescribed.
Perinatal OCD
Compared to general OCD, obsessions and compulsions tend to be focused on the baby or pregnancy. They may have intrusive thoughts about harming their baby physically or sexually, and they may not disclose due to fear of Child Protective Services (CPS) involvement. This doesn’t mean they desire to harm their baby, and it does NOT increase risk of abuse/violence towards the baby. Perinatal OCD symptoms also include hypervigilance about the baby and avoidance of the baby.
Perinatal PTSD/Birth Trauma
We often think of birth as a joyous experience but some births can cause long lasting trauma. Some risk factors include: an unexpected outcome of a birth such as a premature birth, death of the baby, NICU stay, emergency cesarean section, complications, and lack of support. How do you know if someone is experiencing perinatal Post-Traumatic Stress Disorder (PTSD)? They will have similar symptoms as PTSD except it will be focused on their birth experience and pregnancy. They may avoid postpartum appointments, the hospital, and fear getting pregnant in the future.
Postpartum Psychosis
Typically occurs within two weeks postpartum. This is an emergency that needs IMMEDIATE treatment. They have an increased risk of harming themselves or their baby. Keep in mind that many survivors never harmed anyone. Symptoms of postpartum psychosis include delusions, hallucinations, agitation, confusion, waxing/waning, increased energy, lack of emotion, paranoia, rapid mood swings, trouble communicating, and decreased need for sleep/difficulty sleeping.
Treatment options for PMADs include but are not limited to the following:
Therapy (Search for someone trained or experienced with perinatal mental health)
Medication (Many psychiatric medications are safe or low risk!)
Support groups
Group therapy geared towards mothers
Couples therapy
Here are some great local, national, and international resources:
Postpartum Support International (support groups and trainings)
MGH Center for Women’s Mental Health (tons of information and research on medications and treatment options)
University Hospitals Perinatal Intensive Outpatient Program (local perinatal IOP) or River Root Counseling IOP in Uniontown
Centering Pregnancy/Parenting (parenting/pregnancy groups)
Mamahood (local peer groups and activities)
Cornerstone of Hope (local perinatal grief/loss groups)
Marcé Society (research, trainings, groups)
Sources:
postpartumsupport.net
https://womensmentalhealth.org
Jasmine Reed MSW, LSW (PMH-C in progress) specializes in working with people in all phases of family planning such as infertility, pregnancy loss, pregnancy, and postpartum.