Certain factors may increase a mother’s risk of perinatal mood and anxiety disorders (PMADs) during and after pregnancy. Identifying risk factors early can be critical to engage in prevention and mitigation strategies. Possible risk factors include:
- A personal history of depression, substance abuse, or another mental health diagnosis
- A family history of depression, substance abuse, or another mental health diagnosis
- A lack of social support from family and friends
- Women who have an unplanned pregnancy
- Previous pregnancy, birth, or postpartum difficulties
- Adolescent mothers
- Sleep deprivation
- Women who have difficulty breastfeeding
- Low confidence as a parent
- Health problems with the baby
- A major life change at the same time as the birth of the baby
Symptoms of Postpartum Depression
The following signs or symptoms of postpartum depression may mean that a mother is experiencing something more serious than the baby blues. Multiple symptoms that don’t go away or thoughts of suicide may mean the mother could need an evaluation by a physician or mental health professional.
- Increased crying or irritability
- Hopelessness and sadness
- Uncontrollable mood swings
- Feeling overwhelmed or unable to cope
- Fear of harming the baby, her partner or herself
- Fear of being alone
- Not having any interest in the baby or overly concerned for it
- Poor self-care
- Loss of interest or pleasure in activities
- Decreased energy and motivation
- Withdrawal or isolation from friends and family
- Inability to think clearly or make decisions
- Exhaustion, sluggishness and fatigue
- Sleep and appetite disturbances not related to care of the baby
- Headaches, chest pains, hyperventilation, heart palpitations
Baby Blues vs Postpartum Depression
Baby Blues and PPD share many of the same symptoms: Irritability, insomnia, change in appetite, sadness, mood swings, less energy, increased crying, persistent anger/rage.
However, Baby Blues differs from PPD in severity and onset. Baby blues should not last longer than two to three weeks after delivery and will impact most mothers (70%) whereas Postpartum Depression will be more intense, and most importantly will result in significantly impaired functioning (i.e; crying more often vs crying all day for multiple days)and makes getting through your day much more difficult. 15-20% of new mothers in the U.S. experience symptoms of postpartum depression. The most distinct symptom from Baby Blues are intrusive thoughts. These are ideas or images that feel like they are invading your brain. For new moms, these thoughts often include accidentally—or intentionally—harming the baby. For example, some mothers report bathing their baby and suddenly thinking, “What if I just walked away for a minute? Or even, What would happen if I put her head under the water?” Intrusive thoughts are a common symptom of postpartum depression and anxiety. Surprisingly, over half of new mothers report having them. These thoughts are NOT an indication of psychosis, and they DO NOT denote intention to carry these things out. They may make a new mother feel like she is “going crazy” but she is not. These thoughts will make you feel like you are a bad mother. They will make her feel guilty and ashamed. Please remind mothers that this is a common symptom and to try and not beat themselves up about this.
Perinatal Anxiety is slightly less common than baby blues or PPD, impacts a reported 10% of new parents. However, many parents report having symptoms of both PPD and PPA at the same time.
Symptoms include: Increasing and disruptive fears and worries (that make daily life much more difficult), difficulty concentrating and focusing, Restless sleep, panic attacks, Irritability, Muscle tension, upset stomach, increased heart rate, tightness in the chest
Supporting Moms with PPD
When a new mom has postpartum depression (PPD), postpartum anxiety (PPA), or another maternal mental health concern, it can be a hard time for the entire family. Older children suffer when they lose the attention and support of their mother. Other family members may be called upon to fill the gap. Because this affects the entire family, it is important that family members know the signs and help their loved one seek help. The more you know about maternal mental health, the better you will be able to care for yourself and the ones you love.
If you know a woman who has signs of PPD, here is how you can help:
- Babysit so they can have a day or night off.
- Help them with the baby. Feed/play/sing/read to the baby.
- Go to the store with them or for them.
- Don't criticize them; compliment them (on things like: being a good mother, looking good).
- Take the initiative without them having to ask for help - prepare dinner, help with the other children, do laundry, etc.
- Keep others away while they rest or help them at night.
- Take their wants and needs seriously.
- Don't be jealous of the baby.
- Help them find things my baby likes.
- Give them hugs and affection.
- Help them take care of myself - not just the baby. Help them eat healthy foods and work out with them.
- Be kind and supportive of them when I breastfeed.
- Don't ask them about my weight.
- Be emotionally supportive - understand that they may be depressed sometimes.
- Help them reduce their stress by allowing them some time to do things they enjoy (movies, dinner, nap, etc.)
- Ask her to seek help. This is the quickest path to getting better.
- Offer support and hope. Your positive actions and words can ease some of her suffering.
- Listen. Her feelings are real.
- Allow her to focus on her own needs. Physical and social activities can help her feel stronger, more hopeful and better about herself.
- Help her with the baby. Feed/play/sing/read to the baby.
- Go to the store with her, or for her.
- Pick up more of the household duties than you would otherwise without your partner having to ask for help - prepare dinner, help with the other children, do laundry, etc.
- Help your partner with snacks, appropriate nutrition and getting enough water. This can be especially important when breastfeeding.
- Support your partner when she is breastfeeding during the day or night. This can be especially helpful at night when you can be available to help assist with putting the baby back down to sleep after night feedings.
- Focus on complimenting your partner on things she is doing well (on things like: being a good mother, taking care of herself and her health).
- Take time for yourself. Spouses and partners should go on with their work, hobbies and friendships.
- Ask the new mom how you can help, such as house cleaning and baby-sitting.
- Let her know you are there for her, offer to set up a schedule of calls/visits from a support system (family, church, support group, friends, etc.) with her comfort level in mind (how often she would like, ideally no more or less)
- Offer to walk with me, getting small but important amounts of walking in the sun to increase vitamin D levels and the endorphins from physical activity can be very beneficial to mood
- Be aware that the father/partner may also be stressed from the changes that come with being a new father or by a partner who is experiencing postpartum depression, postpartum anxiety, or another perinatal mental health diagnosis.