Cathy Kreisel, LCSW, PMH-C
Psychotherapist serving California and Illinois
Adjustment to Parenthood
Are you or your partner feeling sad or depressed?
Do you or your partner feel more irritable or angry with those around you?
Are you or your partner having difficulty bonding with your baby?
Do you or your partner feel anxious or panicky?
Are you or your partner having problems with eating or sleeping?
Are you or your partner having upsetting thoughts that you can't get out of your mind?
Do you or your partner feel like you never should have become a parent?
You're pregnant or just gave birth and you're wondering why you're feeling sad, anxious or depressed when it's supposed to be the happiest time of your life. The reality of becoming a parent can look dramatically different from what you may have expected. During pregnancy and after delivery of your child, you and your partner go through a huge adjustment and may experience a range of emotions. This can be a challenging time for you both. Perinatal Mental Health Disorders are the most common complication of child birth yet it's rarely talked about.
Perinatal Mood and Anxiety Disorders
Perinatal Mood and Anxiety Disorders (PMADs) is common and effects 15-20% or 1 in 7 women during pregnancy or within a year after giving birth. PMADs is not just Postpartum Depression. It includes Postpartum Anxiety, Postpartum Obsessive Compulsive Disorder, Postpartum Traumatic Stress Disorder and Postpartum Psychosis. PMADs can be easily missed because many of the symptoms overlap with the expected changes during the postpartum period. PMADs are highly treatable, however, if left untreated can have lasting effects on the fetus, newborn, developing child and family.
Many women experience what is referred to as the "Baby Blues" or feelings of exhaustion, irritation and sadness shortly after given birth. Some mood changes are normal and to be expected. This happens after delivery because your hormones are rapidly changing and you're getting less sleep than you're used to. These symptoms surface one to three days after giving birth and subside within two weeks after birth. While these changes are a normal part of the hormonal, physical and emotional adjustments after pregnancy and childbirth, if it is lasting more than a couple of weeks, or these feelings come back anytime in the first year after delivery for more than two weeks, you should seek consultation.
Depression During Pregnancy &
Depression during pregnancy or after giving birth occurs more often than you think. Approximately 10% of women experience depression during pregnancy and 20% of women experience significant depression after child birth. Symptoms can start any time during pregnancy and up to one year following birth. Typically, if the symptoms listed below are present for two weeks or more, it may be more than just the "baby blues".
Irritability and anger
Lack of interest in your baby
Appetite or sleep disturbance
Crying and sadness
Feelings of shame, guilt or hopelessness
Loss of interest in previously enjoyable activities
Possible thoughts of harming yourself or your baby
The Edinburgh Postnatal Depression Scale (EPDS) was developed to assist health care professionals in detecting mothers suffering from PPD. This is a screening test and not a medical diagnosis. A careful clinical evaluation by a health care professional is needed to confirm a diagnosis and establish a treatment plan.
Anxiety During Pregnancy & Postpartum Anxiety
While some women may feel depressed after having a baby, the most common symptoms women feel are anxiety and overwhelm. Approximately 1 in 6 women develop anxiety during pregnancy and 1 in 10 develop anxiety the first year after giving birth. Symptoms often include:
Worrying over the health or safety of your baby
Feeling something bad is going to happen
Disturbances in sleep and appetite
Physical symptoms like nausea, sweating and dizziness
Postpartum Obsessive Compulsive Disorder
You don't need to be diagnosed with OCD to experience these symptoms of Perinatal Anxiety. Mothers who experience Postpartum Obsessive Compulsive Disorder (OCD) may never have had a diagnosis of anxiety or OCD before pregnancy or childbirth but are suddenly having intrusive, irrational, unwanted thoughts or images (obsessions) and sometimes need to do things over and over (compulsions) to reduce the anxiety caused by those thoughts. Postpartum OCD is temporary and treatable. Common compulsions may include:
The need to clean constantly
Check things many times
Fearful of being left alone with infant
Hypervigilant about protecting baby
Most mothers find these thoughts scary and unusual and are very unlikely to act on them
Postpartum Psychosis is rare, 1 in 2000, but it is a serious condition that is temporary and treatable but it is an emergency and requires immediate professional help. You should call 911 if you or someone you know is experiencing Postpartum Psychosis.
Women suffering from Postpartum Psychosis may do things they would otherwise not do given their altered state. Symptoms may include:
Hear or see things that others do not
Feel like others are out to get you or hurt your baby
Feelings of distrust, paranoia, suspicion of others
Experience memory loss
Have unusual, strange or delusional thoughts that seem real to you
How Therapy Can Help
It is very important during this delicate time to take good care of yourself. This can seem difficult considering how tired you may be feeling from physical and mental exhaustion. Few new parents have accurate expectations of how different their lives will become after welcoming a baby. You may not feel as supported by your partner as you hoped. While you might feel connected to your baby, you might feel disconnected from everyone else. It's very common for new mothers to feel isolated and lonely. Talking to a trusted therapist where you have a safe and supportive space to process your feelings can help you through the challenges of motherhood. If you take care of yourself, you're better able to care for your baby.
Taking care of a newborn around the clock is tiring, very tiring. It may seem like you can never leave the house, especially if you're nursing and the thought of finding childcare can be an obstacle to getting the support many new mothers need. As a mother myself, I understand this hardship and for this reason, I offer video/online therapy so new mothers can receive the support they otherwise might not receive.