(This is also an episode of The Birth Lounge Podcast, listen here for part 1 of this series!)
The transition to motherhood is an exciting time, but what’s often not talked about in our culture is how scary and lonely that transition into the unknown can be. In this two part series, we’re going to be going into the nitty of gritty of perinatal mood and anxiety disorders in hopes of erasing the stigma and increasing your awareness of these postpartum possibilities.
Jess Vanderwier is a mental health therapist and mother who experienced a pretty rough transition to motherhood herself. She had a pretty normal pregnancy until about 22 weeks, when she started feeling some really strong cramping. In the emergency room, she found out she was at high risk for preterm labor and her life quickly transitioned from one of a busy, working woman finishing up graduate school to someone stuck on bed rest. While she thankfully carried the baby to full term, she was then quickly hit with the struggles of being a new mom, especially in terms of sleep and breastfeeding issues all while having no family nearby. As a counselor, she couldn’t believe that she herself didn’t know how difficult the postpartum period could be. After about 4 months, she ended up telling a doctor about her struggles and got support by building up her village. She’s now passionate about supporting and informing other moms about these struggles so they can be aware of and prepared for them before they even have the chance to go through them and is here to help educate us today!
In North America, 1 in 5 people will be diagnosed with a mental illness at some point in their lives - and that’s just the recorded cases. When looking at perinatal women (pregnancy to postpartum) the research shows that somewhere between 1 in 5 to 1 in 7 women will be diagnosed with a perinatal mood or anxiety disorder. They are the number one complication of pregnancy/birth, so even though they’re not screened for as much as things like gestational diabetes, they happen even more often.
How can two women have a similar perinatal experience but then two different very mental health outcomes? It really all comes down to risk factors - the whole pregnancy experience doesn’t happen in isolation as there are so many other factors that influence your experience. Biological factors play a big part, such as a history of mental health issues in yourself or your family. If you experienced bad PMS before the baby, that could put you at risk as well because of the hormonal link. Thyroid issues are also something to look out for, as these are often developed after pregnancy and can mimic anxiety and depression.Your social structure can also play a big role - are you living in a town with just you and your partner? If you don’t have a solid social support system in place, the transition to motherhood can be really tough.
There are a number of other factors that can put you at risk. If you’ve had a complicated pregnancy, previous pregnancy losses, or a history of sexual trauma and abuse, you may experience difficult perinatal emotions. If you’re a perfectionist with a type A personality like Jess, the postpartum period can be very triggering as everything in life can suddenly feel out of your control. Everything from financial stressors to your relationship with your partner to your baby’s sleep patterns can play a role in your emotional experience.
You may be feeling overwhelmed by all these risk factors, but we don’t want to scare you - we want to empower you! By being aware, you can reach out for support before you’re deep in the trenches.
So what are the different ways that perinatal mood and anxiety disorders can manifest? We’ll start with what it’s not: the “baby blues.” This is a normal part of the postpartum experience, with the height of it occurring usually 3-5 days after birth as a result of the release of a bunch of hormones. You might feel weepy and anxious, but it’s just your body adjusting to these hormones. It shouldn’t last more than 10 days postpartum, but people tend to blame mood issues on the baby blues months after baby is born.
Now for the disorders - perinatal anxiety can make you very irritable and put you into the throws of excessive concern about baby and baby’s health. You may be afraid to take baby outside or have difficulty sleeping because you’re having racing, spiraling thoughts. You may also feel physical symptoms such as shortness of breath, a racing heart and appetite changes.
With perinatal depression, you could experience a deep sense of hopelessness and a fear that you’re never going to feel like yourself again, never going to sleep again, or maybe even never love your baby like other moms seem to love theirs. You may feel overwhelming rage or guilt and shame, and physical symptoms such as appetite changes and difficulty concentrating and sleeping.
Perinatal OCD involves experiencing intrusive, repetitive thoughts, usually about harming baby or yourself - but you don’t have the urge to actually act on these thoughts. For example, you may experience the thought that you’re going to drop baby onto the tile floor - you know you’re not going to do it and you’re scared by the thought, but it still continues to pop up in your mind. You may experience guilt and shame about these thoughts, hypervigilance, and a fear of being alone with baby.
Finally, perinatal psychosis is a medical emergency and if you or someone you know is experiencing symptoms, medical help should be sought immediately. You can experience thoughts similar to those of OCD, but you may feel like you actually have to act on them. 1-2 out of 1000 postpartum women experience these symptoms, which include suicidal thoughts, delusions, hallucinations, extreme insomnia, and rapid mood swings.
Every birth, child, and pregnancy is different - so you can experience a perinatal mood or anxiety disorder even if you’ve had babies before with a fine postpartum experience. This applies vice versa - if you had a bad experience the first time, you’re not doomed to have it with your pregnancy.
Again, while this can all be scary and overwhelming, the goal of this information is to empower you, ensure you that you’re not alone and encourage you to find your tribe and love them hard to take this on! Next time, we’ll be back to continue the conversation with more information from Jess on postpartum challenges and getting and giving support.