Maternal Mental Health Concerns

Pregnancy mental health concerns include increased depressive or anxiety symptoms, ambivalence or reduced interest in becoming a mother, extreme anxiety or fears regarding the developing baby's health or possible miscarriage, lack of attachment to the pregnancy or feeling overwhelmed by this life change. Factors that may contribute to pregnancy concerns include previous infertility, pregnancy loss or birth trauma, prenatal testing results, partner relationship difficulties and lack of social support. Pregnancy may be a challenging time for women with a history of depression, anxiety, bipolar or OCD.

Baby blues are emotional or distressing feelings that naturally arise post-birth. Symptoms may include some feelings of anxiety or depression, a rise in moodiness and emotionality, tearfulness, feelings of frustration or disappointment and sleep concerns. Please know that the baby blues are experienced by the majority (80%) of new moms, appearing a few days after birth and resolving after a few weeks.

Postpartum depression is experienced by roughly 20% of new moms and ranges from mild to severe. Symptoms cause more distress than the baby blues, and include severe feelings of depression, increased mood swings, sadness, crying, strong feelings of shame and guilt, loss of interest in activities, feeling numb, difficulty concentrating, feeling overwhelmed, critical thoughts of being an inefficient mother and disconnection to the baby. Loss of sleep plays a role, along with isolation during maternity leave. 

Postpartum anxiety doesn't get much press but it's very real to many new moms. It happens when severe anxious thoughts become difficult to control. Many new moms are naturally in their heads a lot, but increased general anxiety around motherhood and infant care can become problematic. Often moms report nonstop excessive worry about everything, not being able to turn off thoughts, an inability to relax and irritability. Look for perfectionist traits and trying to do everything 'right' (when there is no right way to care for a new baby). Also look for anxious thoughts, especially around infant health, sleep or feeding, and a never ending to-do list. Racing thoughts may impact mom's sleep.

Postpartum panic disorder occurs when extreme fear and anxiety manifest somatically through panic attacks. Symptoms may include chest pain, heart palpitations, feeling faint, tingling, sweating, shaking and feeling out of control. Anxiety may increase as you begin to fear having more panic attacks.

Postpartum obsessive-compulsive disorder occurs as obsessive, intrusive thoughts completely take over. Symptoms include obsessive worry for the baby’s health, care or hygiene, or irrational fears around you or others causing harm to the baby. Many women create compulsive behaviors or rituals to compensate for intense thoughts.

Postpartum PTSD is often related to traumatic birth. Symptoms can include nightmares, flashbacks of birth or past trauma, feeling unsafe, avoidance, hypervigilance and a sense of unreality / out of one's body.

Postpartum bipolar disorder can manifest in women with a history of bipolar or major depressive disorder, and may also appear for the first time after childbirth. It typically presents initially with severe depressive symptoms. Manic symptoms include elevated mood, euphoria, decreased need for sleep, rapid speech and grandiose thought patterns.

Postpartum psychosis is the most severe postpartum concern and occurs rarely. Safety is an urgent concern. Symptoms include confusion, hallucinations, delusional thinking, odd speech patterns, paranoia, severe insomnia and extreme irritability. Psychotic symptoms have a rapid onset and require immediate medical attention.

Post-adoption depression affects up to 25% of adoptive parents. Symptoms may include depressed mood, increased anxiety, sleep or eating concerns, irritability, unrealistic expectations of motherhood, attachment concerns, self-doubt about parenting, lack of support, fear that the child will be taken away and feelings of disappointment, inadequacy or guilt. Mood concerns can be heightened by legal or societal stressors and previous infertility.


Resources

Postpartum Support International

Postpartum Progress Support Groups

The Other Postpartum Problem: Anxiety

Where Postpartum Depression Meets Adoption

The Lonely Terror of Postpartum  Anxiety

NICU Awareness

Prevention and Treatment of Traumatic Childbirth

Books:

Becoming a Calm Mom: How to Manage Stress & Enjoy the First Year of Motherhood, Deborah Roth Ledley 

This Isn’t What I Expected: Overcoming Postpartum Depression, Karen Kleiman and Valerie Raskin

Buddhism for Mothers: A Calm Approach to Caring for Yourself and Your Children, Sarah Napthali  

The Journey to Parenthood: Myths, Reality and What Really Matters, Diana Lynn Barnes, Leigh G. Balber

The Post-Adoption Blues: Overcoming the Unforeseen Challenges of Adoption, Karen Foli, John Thompson

Mindful Motherhood: Practical Tools for Staying Sane During Pregnancy and Your Child's First Year, Cassandra Vieten

The Pregnancy and Postpartum Anxiety Workbook: Practical Skills to Help Overcome Anxiety, Worry, Panic Attacks, Obsessions, and Compulsions, Kevin Gyoerkoe, Pamela Wiegartz, Laura Miller

SF Postpartum Support Groups:

The Afterglow Postpartum Support Group

Mama Support Group