Your Emotional Well-being Postpartum/Raising Awareness about Perinatal Mood and Anxiety Disorders:

Contributed by Dr. Laura Venuto, a psychologist in New York City specializing in maternal mental health.  She has a private practice on the Upper East Side.

Feeling exhausted? Irritable? Anxious? You’re not alone.  While the postpartum period can be a wonderful and exciting time for some mothers, for others, it is an emotionally challenging experience. Too often, this period of time is romanticized by the media and women whose children are grown, as they seem to have blocked out all of the memories of sleep deprivation, explosive diapers, financial and/or marital stress that often come with parenthood.  

The reality is that 15-20% of women experience perinatal mood and anxiety disorders (PMADs).  However, since mental health problems are often stigmatized in our culture, and motherhood is supposed to be a blessing, women are hesitant to share their experiences.  PMADS are treatable; if you’re suffering, you can get better.  The worst thing to do is ignore the symptoms as they can linger untreated, which isn’t good for you or baby.  

PMADs is a newer term being used in the maternal mental health community as it is more comprehensive than postpartum depression and reflective of the range of symptoms women can experience in the postpartum period. Up to 85% of all new mothers will experience the “baby blues”, a real condition that can last anywhere from a few hours to no more than 2 weeks. Women may feel: fatigued, weepy, have mood swings, anxious, irritable, and overwhelmed.  Tied to hormonal fluctuations after birth, this usually occurs no later than 2-3 weeks after giving birth. 

In contrast, PMADs are more severe; women experience symptoms of depression and/or anxiety at any point in the 1st year of their baby’s life.  These symptoms can begin during pregnancy. Many of the symptoms of PMADs overlap with baby blues, as women experience:  excessive weepiness, insomnia, fatigue, anxiety, lack of interest in the baby, irritability, loss of interest in things they used to enjoy, and feel overwhelmed for a period of several weeks or longer.  Many women are surprised that anxiety can be a major component of mental health difficulties in the postpartum period. Panic symptoms are common, as women may experience fear, waves of terror, combined with palpitations, chills, and numbness. Anxiety may also manifest itself in obsessive thoughts, such as recurrent fears about harm to baby, or adhering to feeding and nap schedules in an almost obsessional manner to provide some control in an unpredictable time. Postpartum psychosis is a rare condition which typically has a rapid onset in the weeks following birth. Women experiencing psychosis may have symptoms such as: hallucinations, delusions, paranoia, rapid fluctuations in mood and/or their need for sleep, and challenges articulating their thoughts. Again, these conditions are all treatable, but require the support of a mental health professional to diagnose, treat and aid in your recovery.

There are a number of factors that may exacerbate your risk for PMADs, and I highlight a few below:

1)      Perfectionism: Moms who try to do everything “right” are more susceptible to PMADs.  It’s crucial for women to recognize how social media can contribute to perfectionistic tendencies, as it’s easy to compare yourself to other mothers and feel judged.  While social media can provide support and useful information, the influx of opinions and information around the clock can be overwhelming and unhealthy.

2)      Unhelpful Thinking Patterns: Women who are struggling to see things accurately (because they’re exhausted, sad, frustrated, feeling guilty, etc.) can hold onto ideas that can harm one’s self-esteem. 

Some examples of unhelpful thoughts:

  • -I am a terrible mother because I couldn’t breastfeed.
  • -I didn’t get my baby to fall asleep for nap on schedule, so now he won’t sleep well for the next 24 hours.
  • -I am so gross; I’m 12 weeks postpartum and don’t have my old body back.

Here are some positive statements great for all mothers to keep as a mantra, whether or not you’re experiencing PMADs:

  • -I’m doing the best I can.
  • -This is going to take a long time, whether or not I try to speed it up.  I’m going to focus on taking things one day at a time.
  • -I cannot expect too much from myself right now.
  • -It’s ok to make mistakes.
  • -There will be good days and bad days.

3)      Poor communication with your partner/supports in your life: When partners lack awareness about postpartum struggles, they can experience feelings of anger, frustration, confusion, and disappointment that may only exacerbate your emotional distress.  It’s important to raise their awareness to diminish relationship tension, and normalize the experience. In addition, many new mothers feel overwhelmed by their new role, but feel guilty communicating it.  However, communication is key to gain the support you need; partners are not mind readers.  Lastly, it’s important to note that fathers/partners can suffer from mood and anxiety disorders after the birth of a child, and they require support and treatment as well to recover.

Tips for talking to your partner/support system:

  • -Try to find a time when there are minimal distractions, like nap time or during a meal on a weekend. 
  • -Use “I” statements to avoid conflict during the discussion. Some examples:
  •    -“I’m feeling exhausted waking up for night feeds; can we set a schedule to take turns?”
  •    -“I’m feeling anxious to the point I cannot sleep.”
  •    -“I am feeling badly that motherhood is harder to manage than I anticipated.” 
  •    -“I appreciate your efforts, but I’m in need of more support. I’m scared about what will happen if I don’t receive more support soon.”

Self-care is critical for women in the postpartum period.  Taking care of your baby means taking care of yourself.  To promote your well-being, consider meeting your needs in the following domains:

  1. 1. Healthy Eating: While you likely don’t have time to cook, you can have some nutritious snacks around the house like fruit, veggies, nuts, hummus, etc.
  2. 2. Rest: Even if you’re feeling too anxious to sleep, it’s better to rest in a quiet room, read a book or watch some TV rather than doing chores every time the baby sleeps. Even if it’s only for a short period, take time to relax.
  3. 3. Socialize: Have a friend over, join a new parent group, or just go out and buy a cup of coffee to have some human contact. 
  4. 4. Exercise: Take a walk with your baby, go to a mommy/baby yoga class, stretch, or find a 10 minute exercise video on the internet. 

If you are experiencing symptoms of PMADs, it’s crucial to seek help. While there are actions you can take to alleviate symptoms, it’s vital to work with a mental health professional to aid your recovery. This is a treatable condition, but it can be life threatening if ignored. In the words of Postpartum Support International, “You are not alone, it's not your fault, with help you can feel better; get some help today.”

Dr. Laura Venuto is a psychologist in New York City specializing in maternal mental health.  She has a private practice on the Upper East Side. Dr. Venuto also runs an 8 week group for mothers at the 92Y entitled, New Mother, New Baby; the next session starts Thursday, September 22. To learn more about Dr. Venuto, you can visit her website: www.drlauravenuto.com  To learn more about her group at the 92Y visit: http://www.92y.org/Uptown/Class/New-Mother-New-Baby

Resources for Mothers:

Visit postpartum.net for more information on PMADs as well as online support groups and a therapist directory.

Article Sources:

www.postpartum.net

Kleiman, Karen (2008). Therapy and the Postpartum Woman: Notes on Handling Postpartum Depression for Clinicians and the Women who Seek Their Help.

 

 

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