Maternal Mental Health

Perinatal Mood & Anxiety Disorders Overview

• Are you feeling sad or depressed?

• Do you feel more irritable or angry with those around you?

• Are you having difficulty bonding with your baby?

• Do you feel anxious or panicky?

• Are you having problems with eating or sleeping?

• Are you having upsetting thoughts that you can’t get out 

• of your mind?

• Do you feel as if you are “out of control” or “going crazy”?

• Do you feel like you never should have become a mother?

• Are you worried that you might hurt your baby or yourself?

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Any of these symptoms, and many more, could indicate that you have a form of perinatal mood or anxiety disorder, such as postpartum depression. While many women experience some mild mood changes during or after the birth of a child, 15 to 20% of women experience more significant symptoms of depression or anxiety. Please know that with informed care you can prevent a worsening of these symptoms and can fully recover. There is no reason to continue to suffer.

Women of every culture, age, income level and race can develop perinatal mood and anxiety disorders. Symptoms can appear any time during pregnancy and the first 12 months after childbirth. There are effective and well-researched treatment options to help you recover. Although the term “postpartum depression” is most often used, there are actually several forms of illness that women may experience, including:

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Pregnancy (also called antepartum) or Postpartum Depression. A woman with PPD might experience feelings of anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, thoughts of hopelessness and sometimes even thoughts of harming the baby or herself.

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Pregnancy (also called antepartum) or Postpartum Anxiety. A woman with PPA may experience extreme worries and fears, often over the health and safety of the baby. Some women have panic attacks and might feel shortness of breath, chest pain, dizziness, a feeling of losing control, and numbness and tingling.

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Pregnancy or Postpartum Obsessive-Compulsive Disorder. Women with PPOCD can have repetitive, upsetting and unwanted thoughts or mental images (obsessions), and sometimes they need to do certain things over and over (compulsions) to reduce the anxiety caused by those thoughts. These moms find these thoughts very scary and unusual and are very unlikely to ever act on them.

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Postpartum Post-Traumatic Stress Disorder. PPTSD is often caused by a traumatic or frightening childbirth, and symptoms may include flashbacks of the trauma with feelings of anxiety and the need to avoid things related to that event.

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Postpartum Psychosis. PPP sufferers sometimes see and hear voices or images that others can’t, called hallucinations. They may believe things that aren’t true and distrust those around them. They may also have periods of confusion and memory loss, and seem manic. This severe condition is dangerous so it is important to seek help immediately. 

(Post Partum Support International)

Miscarriage

Losing a child is one of the most traumatic experiences most people can imagine. Losing a pregnancy, on the other hand, is too often met with the societal equivalent of a shrug.

Perinatal loss is common—an estimated 10 percent to 20 percent of recognized pregnancies end in miscarriage, typically defined as the end of a pregnancy up to 20 weeks of gestation. A further 1 percent of pregnancies are lost to stillbirth, which occurs after 20 weeks. Such losses, though common, are often invisible. Many miscarriages occur early in pregnancy, before a woman has told friends or family members she’s expecting. Even when loved ones know about the pregnancy, people often fail to recognize the depth of the loss.

Following the loss of a pregnancy, women often experience:

• anguish

• desperation,

• feelings of shame

• inadequacy

• sense of failure

• self-blame

• loss of a part of yourself

We can work together to understand that your feelings are normal, and stop blaming yourself for what you see as a failure. We can rewrite your story to help bring you joy and a sense of meaning to your life.

Men, too, can experience distress after pregnancy loss.  They are less likely to grieve openly and may want to appear strong for their grieving partners.  This can lead to relationship conflict.  Couples therapy can decrease conflicts significantly by helping a woman to see that the loss is affecting their partners in a different way.

Infertility

Infertility is a major life crisis for 1 in 8 couples. For these women and men fighting the disease of infertility, the infertility experience involves many hidden losses for the individuals, their loved ones and society as a whole, including:

• Loss of the pregnancy and the birth experience;

• Loss of a genetic legacy and loss of future contributing citizens to the next generation;

• Loss of the parenting experience;

• Loss of a grandparent relationship;

• Low feelings of self-worth;

• Loss of stability in family and personal relationships;

• Loss of work productivity; and

• Loss of a sense of spirituality and sense of hope for the future.

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Because infertility often involves major personal life issues and decisions, it is often experienced as a private matter and is not ordinarily discussed in public forums. The personal nature of the infertility experience contributes to the failure of the public, politicians, healthcare professionals and the media to recognize infertility as a disease. This causes a lack of sound knowledge and available resources about infertility.

The Hidden Effects of Infertility on Self-Esteem and Relationships

Infertility has a strong impact on self-esteem. Suddenly your life, which may have been well-planned and successful, seems out-of-control. Not only is your physical body not responding as expected but it feels as if your entire life is on hold. Facing the disappointment of not becoming pregnant month after month can lead to depression for both you and your spouse. It’s important to understand the signs of depression.

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Depression symptoms include:

Feelings of sadness or unhappiness, Irritability or frustration, even over small matters, loss of interest or pleasure in normal activities, reduced sex drive, insomnia or excessive sleeping, changes in appetite, agitation or restlessness, irritability or angry outbursts, slowed thinking, speaking or body movements, indecisiveness, distractibility and decreased concentration, fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort.