Perinatal Mood Disorders
Fluctuations in mood, especially feelings of sadness, among new mothers during the first couple of weeks postpartum are common and expected. Often referred to as the “baby blues,” these feelings generally begin the first few days postpartum and can last a few weeks. Beyond this point, however, it is prudent to speak with your doctor to rule out postpartum depression (PPD) or other perinatal mood disorders. While the symptoms of “baby blues” and perinatal mood disorders overlap, perinatal mood disorders are much more severe and linger longer. For some women, these emotions are manageable without much intervention. For others, however, many resources are available, and seeking professional help is highly encouraged.
Many women who experience perinatal mood disorders are unaware of what they are even experiencing and why. While it is reported that postpartum depression affects 1 in 7 women, this number is likely higher due to underdiagnosis. In addition, PPD is not the only perinatal mood disorder affecting new mothers. Postpartum anxiety and postpartum OCD are also more common than we realize.
This week I invited a special guest, Dr. Amber Adkins, clinical psychologist, yoga teacher, and colleague at Sattva Health and Wellness in Lakewood, CO to lead a conversation on the topic of perinatal mood disorders. You can hear our full conversation on the Rebel Roots Nutrition podcast HERE!
When talking about addressing mood disorders, we are really talking about balancing the nervous system. With the fluctuating emotions, ensuing “baby blues,” and lack of sleep mentioned above, this can be a confusing time, and it may be difficult even to recognize oneself. If possible, it is important to take a step back and check in with yourself or your partner. Asking what your baseline looked like before your new baby arrived helps you identify whether your current state is more or less reactive if your nervous system is operating too high (agitated, aggressive, angry, scared) or too low (slow, numb, sad, unmotivated).
For new moms, being on high alert, experiencing some degree of anxiety, and feelings of sadness are relatively normal. The problem is that mild symptoms of anxiety and depression if left unchecked can evolve into severe mood disorders. The line between what is normal and what is beyond normal can be a fine one, which is why getting a professional evaluation is important. Some obstetricians screen for these mood disorders during pregnancy and can quickly refer you to the proper mental health professional.
However, sometimes we need to self-refer to a mental health expert. Most mental health professionals will use specific guidelines to determine whether a new mother is just having a couple of off days, versus experiencing a more serious condition. This includes particular symptoms and a certain number of these present for a specific time. So what are these symptoms?
Some of these symptoms include:
Disinterested in things that used to interest you
Withdrawal from life
Everything feels effortful
Don't want to get out of bed
Feeling of wanting to disappear
Low energy and fatigue
Sad for much of the day
Thoughts feel challenging
Racing thoughts
Obsessive, intrusive thoughts that feel scary or disturbing
Compulsive behavior
Elevated agitation
Feeling jumpy
Anxiety/panic attacks
Feelings of paranoia
Struggle with sleeping because you’re worrying
Negative self-talk
Impulsivity
This list is by no means an exhaustive list of the symptoms to look for. Postpartum psychosis includes more severe symptoms such as thoughts of suicide, thoughts of harming the baby, severe insomnia, and even hallucination requiring immediate attention and should be treated as a medical emergency. It is also important to recognize that birth can be a traumatic experience for some mothers and this can trigger past trauma.
Several risk factors are involved in the development of perinatal mood disorders. A pre-existing mental health disorder is the number one risk factor for developing a postpartum mood disorder. Preparing a plan with your mental health professional during pregnancy or immediately postpartum is a powerful preventative tool. A weak support system is another risk factor at the top of the list. Getting clear on each partner’s expectations and responsibilities and considering couples counseling can help mitigate support-related factors. If it is within the budget, a postpartum doula is a trained professional whose main focus is the support of the mother. Make a list of your support team (OB, doula, parents, friends, pediatrician, therapist, lactation consultant, etc.) along with their contacts and brainstorm how you can expand this list with your partner.
Strong support not only benefits mom but ultimately serves the whole family unit. A recent study reported that 15% of dads experience postpartum mood issues. It is not a surprise considering they are also experiencing a lack of sleep, increased responsibility, and decreased attention from their partner.
So how do we begin to get the proper support or evaluation for prenatal mood disorders? Visiting your healthcare provider to receive a screening is a great start. Although these screenings can be insufficient, they are often a free resource to start the mental health conversation. Asking for, and remaining open to honest feedback from family and friends can also really bring awareness to any changes in your mental state. Talk about this before giving birth when possible so you can be prepared to receive feedback rather than take it as criticism. Connect with other moms and parents through online forums or in-person support groups. Visit Postpartum International Support for more information on locating the right group.
If you or a loved one displays signs of a perinatal mood disorder, please contact your local healthcare provider or Postpartum Support International for additional resources. For severe symptoms such as suicidal thoughts or thoughts of hurting someone else, call the National Suicide Prevention Lifeline at 1-800-273-8255, call 911 or go to the Emergency room.
For Nutritional Therapy support contact
Carla at rebelrootsnutrition@gmail.com,
https://www.rebelrootsnutrition.com/
To find out more about Dr. Amber Adkins:
https://www.lovesattva.com/servicesproviders, www.dramberadkins.com