Maternal Mental Health
Can you relate to any of the scenarios below?
A first-time mom, 2 months postpartum, has been encouraged by her husband to seek treatment. She won’t let anybody, except for her husband, hold the baby. When she walks while holding the baby she has intense images of dropping the baby accidentally. These images make her so uncomfortable that she refuses to walk with the baby in her arms when she is outside the house, instead the baby must be secured in a carrier or stroller. This mom also wakes several times a night to check on her baby and make sure he is still breathing.
A mom, 4 months postpartum, just doesn’t feel “like herself.” She became pregnant after multiple fertility treatments and feels guilty that she’s not happier now that she finally has the baby that she tried for years to have. She didn’t fall instantly “in love” with the baby as she expected. She finds the baby to be much more work than she had anticipated and sometimes resents the baby for taking away her freedom. At times, she fantasizes about starting a new life and leaving her family behind.
A second time mom, 6 months postpartum, doesn’t feel like she has anybody she can talk to. She has found the adjustment after her second baby to be much more difficult than the first time around. She feels so overwhelmed by the constant demands her two little ones place on her daily. She has a hard time organizing her day. She cannot keep up with housework, laundry, etc. and feels like she is “failing as a mom.” She complains about feeling “exhausted, overwhelmed, and alone” and as though she is struggling to “make it through each day.” She is often irritable and finds herself yelling at her toddler and husband. She cries at night when she worries about how her behavior is impacting her relationships.
These are all examples of moms with postpartum depression and/or anxiety disorders. These disorders can occur anytime in the first year following a baby’s birth and have been found to affect 1 in 8 moms. She is likely suffering in silence due to the shame and stigma attached to this condition. Moms are reluctant to reach out for help or to tell others how they are feeling for fear of being judged or misunderstood. Sometimes when women do disclose their feelings to others, it results in their experience being invalidatede.g. “That’s what all moms go through” “You need to just snap out of it.” Or “You should be happy you have a healthy baby”
Symptoms of postpartum depression and anxiety include sadness, tearfulness, feeling overwhelmed , excessive guilt, inability to sleep when baby is sleeping, appetite disturbance, irritability, and not enjoying time with baby. Depressive symptoms often co-occur with anxiety. Moms with anxiety may also experience panic attacks, frequent worries regarding baby care, safety, health etc., upsetting or scary thoughts or images and may check on the baby frequently. Some people confuse postpartum mood disorders with the “baby blues” which affects up to 80% of new moms. Symptoms of baby blues can be similar to PPD, though they first present a couple of days after delivery and usually subside within 2-4 weeks. If a mother is continuing to experience these symptoms or if her symptoms are significantly impacting her daily functioning she may be having an episode of postpartum depression or anxiety.
There are certain risk factors for developing postpartum mood and anxiety disorders including having a personal or family history of mood or anxiety disorders, low social support, marital conflict, infertility, problems with labor & delivery, neonatal complications, stressful life events around delivery (e.g. move or job loss), and a tendency toward high standards or perfectionism.
There are steps moms can take too reduce risk of adjustment difficulties after the birth of a baby.
Sleep- Enlist help to make sure you get a solid 5-6 hour stretch of sleep (e.g. pump during day and have family member give bottle at night, each partner can take “shift” during the night, consider hiring a night nanny). Sleep is vital for mental health, and some moms find that their mood improves when they are able to get additional sleep.
Nutrition- Be sure to stay hydrated and eat healthy snacks throughout the day, even if you don’t feel hungry. Have a family member make sure the kitchen always has easy one-handed meals/snacks (e.g. sandwiches, trail mix, smoothies)
Exercise- Take care of your body, even just a 5 minute walk around the block will be beneficial or do some gentle stretching.
Support- Join a playgroup through your local parents club or other new mom-baby group. (e.g. Mills Hospital, Kaiser, Sequoia Hospital all have new parent support groups). Keep in touch with friends. Don’t isolate yourself.
Accept help from others- Ask a friend to hold your baby so that you can take a nice, long shower, take a nap, or enjoy a hot cup of tea. Have a friend run to the grocery store to grab that milk that you need, or bring takeout. It takes a village, you don’t have to do it alone.
Structure- Try to get out of the house at least once a day. Schedule a playdate, go to a mom & baby yoga class or other group. Having a planned activity once a day can really help those long days go by faster and get you some much needed social contact.
Realistic Expectations & Self-Compassion- Having a baby is hard. Your house may not be as clean as it was before the baby, you may not be able to cook dinner every night, and that’s ok. Be kind to yourself and give yourself the same compassion you would give to a friend.
If you believe you may be experiencing depression or anxiety, reach out to your ob/gyn, who will be able to screen for symptoms and provide referrals for treatment. Your doctor may refer you for an evaluation for medication, individual or couples counseling, or to a support group. You can also find more information and referrals through Postpartum Support International .
Know that you are not alone in what you are experiencing, there is help, and you will feel like yourself again.
Paternal Postnatal Depression
It isn't just women who are more vulnerable to mood and anxiety disorders following the birth of a baby. Research has found that 1 in 10 men experience depression during the postpartum period.
Dads Get Postpartum Depression, Too
Is Dad Stressed or Experiencing Paternal Postnatal Depression?
Adjusting to parenthood, as a couple
Gottman