Trigger warning: This article discusses topics regarding self-harm, suicide, and birth trauma.Â
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. Â
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.Â
It can be lonely. But, you are not alone.Â
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.Â
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).Â
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!Â
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.Â
Perinatal Depression
1 out of every 5 women and 1 out of every 10 men may experience Perinatal Depression (Postpartum Support International, 2024b).Â
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).Â
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).Â
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)Â
With Perinatal Obsessive Compulsive Disorder, the obsessions and compulsions typically focus on the safety and of the health of the pregnancy and/or baby.Â
The Symptoms
Obsessions, intrusive thoughts, or mental images related to the pregnancy and/or the baby.Â
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.Â
They typically are not an indication that one would actually act on these thoughts. Seeking help with such thoughts is still recommended. Â
Compulsion to do a particular thing repeatedly to reduce anxiety, fear, and intrusive thoughts.  Â
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.  Â
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.Â
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).Â
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.Â
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 usualÂ
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.

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.Â
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). Â
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!
National Suicide Prevention Hotline: English and Spanish-speaking
Dial 988
Text 988
Maternal Mental Health Hotline
1-833-TLC-MAMA (852-6262)
Postpartum Support InternationalÂ
This is not a hotline and should not be used in an emergency
For support, basic information, and resources.
1-800-944-4773 for English and Spanish speaking
Text in English: 800-944-4773
Text en Español: 971-203-7773

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