mama: it’s okay to say You’re not okay.
ALL ABOUT POSTPARTUM ANXIETY AND DEPRESSION
Mama, the first step towards mental wellness as a mom is understanding if what you are feeling or experiencing is normal or not. This is difficult as a new mom because you’re so busy navigating your new life and keeping another human alive! It’s hard to time time to think about yourself and how you’re feeling. Having awareness is important because it allows you or your partner to understand when or who to reach out to if you need help.
What is a PMAD?
• Perinatal (during your pregnancy or postpartum period)
• Mood (depression, bipolar, psychosis)
• Anxiety (GAD-Generalized Anxiety Disorder, panic, OCD-Obsessive Compulsive Disorder, PTSD-Post Traumatic Stress Disorder)
• Disorder (gets in the way of daily functioning)
Postpartum is technically defined as the first year after birth, but many medical professionals, especially experts in psychology, hormonal health, and functional medicine, consider this time period to be much longer.
Who do PMADs affect and how many people really suffer with mental health issues postpartum?
PMADs affect anyone and everyone. Perinatal depression affects as many as 1 in 7 women. Postpartum depression affects 1 in 10 new fathers. Chances are this number is MUCH higher as mental health conditions are highly UNDERTREATED and UNDERDIAGNOSED. Although postpartum depression is studied the most, postpartum anxiety is just as common, if not more common. Depression also has an anxiety component.
Moms are DIFFERENT - How your brain and physiology changes during the perinatal period
Studies show that when a woman becomes a mother, her brain is literally rewired. A mother’s nervous system and hormones are hardwired to think about ‘herself and the baby’ vs. only ‘herself.’
Your brain shrinks when you are pregnant by 5%. Brains of moms versus brains of maidens (women who have never been moms) look completely different. When comparing brains with mental health issues, moms’ brains and maidens’ brains also look different. (Serrallach, 2019)
Postpartum women have heightened nervous systems, which is why it’s important to minimize stress as much as possible in the postpartum period. Your body doesn’t know the difference between an unsafe situation and a stressful situation. Your body and physiology responds similarly - no matter the situation (i.e. being chased by a tiger vs. a baby crying or toddler screaming). This bodily response is okay temporarily, but over time, this can wreck havoc on all your body systems and contribute to poor mental and hormonal health.
Exacerbating Factors for PMADs
-Pain
-Lack of sleep
-Abrupt discontinuation of breastfeeding
-Childcare stress
-Relationship stress
-Losses - miscarriage, neonatal death, stillbirth, etc.
-Unresolved grief
-History of childhood sexual abuse
-Complications of pregnancy, birth, or breastfeeding
-Health challenges in baby or parents
-Temperament of baby
-Age related stressors (adolescence, perimenopause)
-Climate stressors: seasonal depression or mania
-Perfectionism/high expectations (“Superwoman Syndrome” and/or returning to work)
(Postpartum Support International, 2020)
Recognizing PMADs
Why is it difficult to recognize or admit perinatal depression or anxiety?
-One of the largest adjustment or transition periods for new parents, especially the mother
-Difficulty determining “new mom stuff” vs. symptoms of perinatal mood disorders
-Feeling ashamed or embarrassed
-Don’t want to be labeled as a complainer or not able to handle motherhood
-Didn’t think it would happen to us
-Unique situation and symptoms for each woman
-Different feelings: sad, teary, overwhelm, irritability, difficulty bonding with baby vs. bonding well with baby, insomnia vs. sleeping more often
(Pacific Postpartum Support Society, 2020)
“The up-and-down nature of symptoms makes it difficult to recognize or admit perinatal depression or anxiety. We tend to blame ourselves for not being able to handle things instead of realizing that this is a medical condition and not a sign of failure.” -Postpartum Support International
“During my own postpartum experience, we received a handout from the hospital titled, ‘Postpartum Depression Test.’ My husband said he actually thought ‘Oh, we won’t need this. We can just throw that away.’ We were wrong. However, we were not given adequate resources to determine what exactly was going on with me during my postpartum time period. I didn’t have depression, I had anxiety, rage, and possibly bipolar disorder/mania. My family and I were not given the education, tools, or resources to know HOW to get help. I took the test, but I didn't score high enough because it was anxiety, not depression. Many doctors are not screening moms' mental health adequately in the postpartum period.” -Dr. Logan
Recognizing Symptoms
Standardized, validated questionnaires can be used to give yourself more awareness into what you are experiencing; however, ideally these questionnaires should be interpreted by a health care provider or perinatal counselor/psychologist. Postpartum mood disorder questionnaires include the Edinburgh Postnatal Depression Scale, the Perinatal Anxiety Screening Scale, Generalized Anxiety Scale, and the Patent Health Questionnaire.
“If you or your partner have a “gut feeling” that something is “off” mentally or emotionally, you must communicate to determine the best way and time to seek help. Mamas are SO sensitive during this time period due to significant physiological changes. The last thing a mama wants is to be labeled or diagnosed by someone who is not a health care provider.” -Dr. Logan
How do I get help?
1. If you are in a crisis, text the National Crisis Text Line. Text HOME to 741741. If you or a loved one is having suicidal thoughts, please call the National Suicide Prevention hotline at 1-800-273- 8255.
2. If you are not in a crisis, call the Postpartum Support International Helpline - 1-800-944-4773. A trained professional is available 24 hours per day to help point you in the right direction.
3. Use the Postpartum Support International Directory to locate a support group and psychologists who are specialized in perinatal mental health. It is important to choose a psychologist who is specialized in perinatal mental health specifically.
4. Contact your health care provider (OB/GYN, midwife, primary care doctor, etc.).
5. Consider treatments based on the recommendations of your health care provider. Be aware that there are many consequences for leaving a PMAD untreated.
6. Understand that there are many conventional treatments for postpartum mental health issues that work well, but it is equally important to know that many important wellness principles should be in place to allow yourself to recover and maintain your mental wellness throughout your postpartum and motherhood journey.
Management of PMADs
-Implement wellness practices including sleep/rest, nutrition, self care, exercise, and supplements
-Counseling with a psychologist who is specialized in the perinatal period
-Consider any previously unresolved trauma
-Consider medications
-See a functional medicine doctor, naturopath, functional nutritionist, or osteopathic physician who can run tests to determine the “root cause” of your mental health issues
-Aromatherapy can offer short term support - Lavender, Stress Away, and Valor by Young Living are a few of my favorites!
-Join a support group
-Accept help from partner and/or family and friends
-Hang with your mama friends (If you don’t have any friends who are moms, find some on the Peanut app - there’s an app for everything these days, and moms love friends!)
Steps to Mental Health Awareness while Breastfeeding
-Surround yourself with people who have been successful with breastfeeding. Excellent resources include La Leche League, Kelly Mom, lactation consultants, and other moms who are or have been successful with breastfeeding.
-See a lactation consultant, chiropractor, or osteopathic physician.
-Have awareness that breastfeeding and mental health issues have a bidirectional relationship due to the hormones involved when breastfeeding.
-Understand that breastfeeding can take a toll on your ability to get adequate sleep.
-Know that you have the right to choose not to breastfeed without guilt or judgement.
Mama, if you’re struggling with your mental or emotional wellness, or if you’re just not feeling yourself, please reach out as I’d love to help you feel better and get you the resources you need to heal!