While many women experience the “baby blues” in the first two weeks after having a baby (worry, sadness and tiredness), these symptoms usually resolve on their own. However, Perinatal Mood and Anxiety Disorders (PMADs) can be more serious. According to the CDC, about 1 in 9 women experience symptoms of depression and 1 in 7 women experience symptoms of anxiety during or following pregnancy.
We spoke with Tiffany Willis, PsyD, licensed neonatal psychologist about the symptoms and treatment.Dr. Willis works in the Fetal Health Center, Neonatal Intensive Care Unit and the Neonatal Follow-Up Clinic to provide therapy and emotional support for families and their babies.
What are Perinatal Mood and Anxiety Disorders (PMADs)?
Dr. Willis: The shift from using the term “Postpartum Depression” to PMADs is two-fold: 1) to recognize that depression and anxiety can occur during pregnancy as well as in the postpartum period, and 2) to acknowledge that depression is not the only experience that could be initiated by pregnancy or in the postpartum period. Many people have heard of postpartum depression but not perinatal/postpartum anxiety or perinatal/postpartum psychosis. These are the three categories of PMADs. Additionally, moms can experience perinatal/postpartum obsessive-compulsive disorder or posttraumatic stress disorder under the umbrella of anxiety.
When are women most at-risk for developing a PMAD?
Dr. Willis: It varies. Most women experience the onset of depression within the first three months after delivery; however, it can occur up to one year following the birth of the baby. Studies show that for fathers, depression is most likely to occur between 3-6 months after delivery. Anxiety most commonly occurs within the first 6 months. Psychosis, where moms begin to experience disorientation, bizarre thinking, or thoughts of hurting or killing herself or the baby, occurs in less than 1% of women and usually presents itself in the first four weeks, but can happen anywhere between 2-12 weeks after delivery.
What should moms do if they think they may have a PMAD?
Dr. Willis: Systems are moving towards having moms screened for PMADs at OB/GYN offices, pediatric offices and during NICU stays; however, this is not yet universal. Moms should be sure to tell a medical professional if they are concerned their mood or behavior is unusual or different than pre-pregnancy. Partners and support people also play a major role in the identification of symptoms, as they are usually the first people to notice a shift in moms’ behaviors. If moms are unsure, there is a great website that has free, printable questionnaires (in multiple languages that are culturally specific) they can fill out about their symptoms and take with them to their doctor.
What are the treatment options for PMADs?
Dr. Willis: It depends on the individual and their symptoms. Therapy is always a great first line of treatment. For some, individual therapy works best, while others may prefer group therapy or even couple’s therapy if the diagnosis has affected their relationship. Some people require medication in addition to therapy to help them re-stabilize. There are several medications that are approved for moms to take while breast feeding, so that should not be a deterrent from seeking psychiatric help.
How can friends and family help new moms?
Dr. Willis: Friends and family can help in many ways, and new moms should let them! Our society puts a lot of pressure on moms to take on a lot, which sometimes causes moms to feel that they can’t ask for or accept help from others. My biggest suggestion is to accept help. Friends and family can offer to purchase or cook meals, watch the baby so that mom can nap, clean or do laundry, or simply be a listening ear. Friends and family should be sure they aren’t dismissing the mom’s feelings or being overly positive, which may make moms feel like their feelings are bad or wrong. Instead they should try to validate, listen, and provide reassurance when appropriate.
What is the biggest takeaway for moms?
Dr. Willis: Being a mom is hard work and there are many challenges and adjustments in the first year of a baby’s life. It is normal to have depression or anxiety and it is okay to receive help for these experiences. If motherhood is not turning out to be how you’d hoped, you are not alone. If parenting feels hard or unsatisfying, it does not mean you are a bad mom and you don’t have to just deal with your feelings. You can receive help to manage your emotions more effectively and improve your motherhood experience. Untreated depression or anxiety could become dangerous to you or your family. Do not wait if you are concerned, there are professionals who can and will help you.
Birthing Hope: Momma Support Group
Birthing Hope is a FREE program developed to increase access to care and designed to support pregnant and postpartum women who are struggling with difficult diagnoses, disconnection to their baby (born or in utero), anxiety, depression, past pregnancy or infant loss. If you are pregnant or have a child under one year and you have ever felt sad, lonely, uncertain, afraid or hopeless, let us help. The group is 10 weeks and includes free childcare, snacks, tools and resources for each family. Group: 6 - 7:30 p.m.
Click here to register or get more information about the group.
For more great content like this, subscribe to Parent-ish