top of page

Unpacking Perinatal/Maternal Mental Health!

Writer's picture: Sarah FolchSarah Folch

Trigger warning: This article discusses topics regarding self-harm, suicide, and birth trauma. 


No more cramming it into the suitcase of silence! Discussing mental health can be difficult but we are here to break it down!

The negative perceptions surrounding mental wellness tend to outnumber those of physical health. Mental health is equally important though. On a day-to-day basis, we work in sync with our bodies and minds.


Throughout life, we also experience changes in the nature of our mental health. One of these changes happens during the journey of the perinatal period. The perinatal period is the time between trying for a baby through the first year postpartum.


This is a big job and one that our hearts and minds don’t always transition into smoothly. This does not mean there is something wrong with us, just that we need some extra nurturing.  


7 out of 10 birthing people downplay or hide their symptoms (World Maternal Mental Health Day, 2024a). Even for those with a history of depression, anxiety, and other forms of mental health disorders, this happens still. The lack of information and increase in shame can make it hard to seek help. But it is so important to do so. At the end of this article, a list of where you can begin to find that help is provided.


How Common Are Perinatal Mental Health Disorders?


5 out of every 10 birthing people experience some type of perinatal mood and/ or anxiety disorder (Postpartum Support International, 2024a). Out of every two birthing people in your family, your friends, and in your community, one of them has likely experienced some form or forms of perinatal mental health disorders. 


It can be lonely. But, you are not alone. 


The symptoms and disorders for Perinatal Mental Health can look a little different (Perinatal Anxiety Disorder versus General Anxiety Disorder). They revolve around a complex set of life changes...just like bringing a tiny human into your world - no matter their grand entrance!


Despite the specific name, Perinatal Mental Health Disorders can extend to fathers and adoptive parents. This is because the symptoms and disorders are not brought on solely by the physical changes in pregnancy. There are many factors that may lead to onset or increase chances of onset;


  • History of mental health disorders and/or family history of mental health disorders

  • Lack of personal support and support in caring for the baby

  • Fertility challenges

  • Complications in pregnancy, birth or lactation.

  • Pregnancy and/or infant loss

  • Unplanned or unwanted pregnancy

  • Childhood sexual abuse or any previous sexual trauma

  • Feelings of powerlessness and/or lack of support and reassurance during the delivery

  • Having an infant(s) in the Neonatal Intensive Care (NICU)

  • Traumatic or disappointing birth experience

  • Parents of Color

  • Military Families

  • Queer and Trans Families (Postpartum Support International, 2024b).


Why Does It Matter?


Perinatal Mental Health matters because it significantly impacts the person who is experiencing it. It also impacts their infant and can affect other significant relationships around the birthing person. In the following, consider how important it is for the mother experiencing Perinatal Depression to seek help. 


The mother experiences a significant decrease in her ability to take care of her basic needs and consume adequate nutrition. She also has an increase in excess weight gain, negative thoughts, substance use, self harm, and suicidal ideation (Muzik, M., & Borovska, S., 2010).


Socially, this mother has lower motivation to bond and interact with her baby. The mother and her baby’s mental health influences one another greatly. This influence, under severe depression, can increase the chance for an insecure attachment. It can also lower the extent that the mother is likely to reach out for support and in reverse, her family unit and social support network may reach out to her less (Muzik, M., & Borovska, S., 2010). 


The importance of perinatal mental health also extends to her baby directly. Severe depressive symptoms that the mother experienced during pregnancy can be correlated with low birth weights and preterm labor. Additionally, her baby’s hormone levels of cortisol, dopamine, and serotonin and their brain activity pattern all mimic that of her mother when depressed. This can lead to increased irritability and decreased activity, attentiveness, and facial expressions of her baby (Muzik, M., & Borovska, S., 2010).


In other words, perinatal health matters because you and your baby matter! 


The Types of Perinatal Mental Health Disorders


Depression is the most commonly known perinatal mental health disorder. However, there are many other equally important ones to know about. Keep in mind that these disorders can occur during pregnancy, post-lost (including miscarriage or medical or non-medical termination), and postpartum up to one year. More than one disorder also can occur at the same time. 


Perinatal Depression

1 out of every 5 women and 1 out of every 10 men may experience Perinatal Depression (Postpartum Support International, 2024b). 


The Symptoms

  • Anger, irritability and/or rage

  • Low interest in the baby

  • Negative sleep changes

  • Negative appetite changes

  • Loss of interest or joy

  • Crying and sadness

  • Guilt, shame and/or hopelessness

  • Decreased or lost pleasure in things you used to enjoy

  • Thoughts of possibly harming the baby or yourself (Postpartum Support International, 2024b)


Perinatal Anxiety

As with perinatal depression, perinatal anxiety occurs in 1 out of every 5 women and 1 out of every 10 men (Postpartum Support International, 2024b). 


The Symptoms

  • Continual worry

  • Feelings of nervousness, being on edge, and/or anxiety

  • Feeling that something bad may or will happen

  • Racing thoughts

  • Difficulty sitting still or trouble relaxing

  • Anger, irritability and/or rage

  • Sleep disturbances

  • Appetite changes

  • Physical symptoms of dizziness, hot flashes, diarrhea and/ or nausea (Postpartum Support International, 2024b). 


Perinatal Anxiety may also be accompanied by panic attacks. Typically lasting 5-7 minutes, a panic attack may present the following symptoms;

  • Shortness of breath

  • Dizziness

  • Chest pain

  • Heart palpitations

  • Numbness and tingling in the extremities (Postpartum Support International, 2024b)


Perinatal Obsessive Compulsive Disorder (OCD) 

With Perinatal Obsessive Compulsive Disorder, the obsessions and compulsions typically focus on the safety and of the health of the pregnancy and/or baby. 


The Symptoms

  • Obsessions, intrusive thoughts, or mental images related to the pregnancy and/or the baby. 

    • The thoughts are upsetting in nature and are repetitive and persistent.

    • While these thoughts and images can be terrifying, it is important to know that these are due to increased anxiety and not breaks in reality. 

    • They typically are not an indication that one would actually act on these thoughts. Seeking help with such thoughts is still recommended.  

  • Compulsion to do a particular thing repeatedly to reduce anxiety, fear, and intrusive thoughts.   

    • Examples of compulsions can range from checking things repeatedly to repurchasing particular items to cleaning.

  • A sense of horror about the obsessive thoughts

  • Hypervigilance in the baby’s protection

  • Fear of being alone with the baby (Postpartum Support International, 2024b)


Perinatal Post-Traumatic Stress Disorder (PTSD)

Traumas around pregnancy, birth, and/ or postpartum can vary widely. What one person may consider traumatic, another person may not- this does not diminish your experience. Trauma can also be a buildup of several different experiences and not one single event.   


The Symptoms

  • Flashbacks of traumatic event(s)

  • Avoidance of the event(s) reminders

    • This can be thoughts, feelings, people, places, and related details.

  • Avoidance of postpartum aftercare

  • Persistent increased arousal

    • Examples include irritability, hypervigilance, exaggerated startle response, and difficulty sleeping

  • Anxiety and panic attacks

  • Feeling a sense of unreality and detachment

  • Nightmares (Postpartum Support International, 2024b)


Bipolar Mood Disorders - Including Bipolar 1 and Bipolar 2

As much as 50% of birthing people who are diagnosed with either Bipolar 1 or 2 are diagnosed for the first time during the postpartum period. 


The Symptoms

  • Depressive symptoms as listed above in ‘Perinatal Depression’

    • Including irritability

  • Higher energy than normal

  • Elevated mood

  • Anxiety symptoms as listed above in ‘Perinatal Anxiety’

  • Rapid speech

  • Racing thoughts

  • Trouble concentrating

  • Distractibility

  • Little need for sleep

  • Overconfidence

  • Impulsiveness

  • Poor judgement

  • Grandiose thoughts

  • Inflated sense of self-importance

  • Delusions and/ or hallucinations in rate cases

  • Swinging from a high (i.e. racing thoughts, overconfidence, higher energy than normal) to a low (i.e. irritability, hopelessness, loss of interest in things you usually enjoy) in mood and symptoms (Postpartum Support International, 2024b). 



Perinatal/ Postpartum Psychosis

Special note: Any active or potential case of Perinatal Psychosis is considered an emergency. Reach out immediately to your local emergency department at 911 or the National Suicide Prevention Hotline at 988. 


The Symptoms

  • Strange beliefs or delusions

    • May take on many forms, but not necessarily destructive. However, due to the nature of such symptoms, immediate treatment is imperative for the safety of both the birthing person and the baby/ babies.

  • Hallucinations that include hearing or seeing things that are not there

  • Difficulty communicating sometimes

  • Feeling greatly agitated

  • Rapid mood swings

  • Suspiciousness and paranoia

  • Hyperactivity and having more energy than usual 

  • The inability or a decreased need to sleep

  • Severe depression

  • Lack of emotion


How to Take the Next Step

This is a lot of information, so how do you really know when to seek help?

Anytime you feel like something is off!

Follow your instincts, you know you best.

Pregnant women using telehealth.
Mountain Crest Counseling (and many other providers) offer online counseling. Your couch is the most comfy.

Do not hesitate to seek a second or third opinion. 75% of birthing people are not ever diagnosed or receive appropriate care (World Maternal Mental Health Day, 2024). Mental health is equally as important as physical health and can be equally as detrimental if not supported. 


Perinatal Mental Health disorders are responsible for 23% of maternal mortality. Suicide is the leading cause of death for new mothers, with the second being significantly lower at 14% for excessive bleeding (hemorrhaging). These numbers are even more prevalent among American Indians and Alaska Native peoples.  Maternal suicide and hemorrhaging account for 50% of all maternal mortality (Centers for Disease Control and Prevention, 2022).  


You never need a diagnosis to seek help. If you are experiencing any of the above symptoms or feel that something isn’t right, there are ways to find help!



Not every journey will look the same, but every journey deserves a loving witness.
Not every journey will look the same, but every journey deserves a loving witness.





35 views

Comments


Commenting has been turned off.

​​

© 2023 by Mountain Crest Counseling

bottom of page