Maternal mental health has come into greater light the past few years as many celebrities have openly shared their experiences with Postpartum Depression (PPD). Some of the most recent to share their experiences include actresses Hayden Panetierre and Tamera Mowry-Housley. As the #1 medical complication related to childbearing, Perinatal Mood and Anxiety Disorders (PMADS) are temporary and treatable with the appropriate combination of care. If you or someone you know has or is currently experiencing some form of PMAD, this blog series is for you.
I begin with a brief write up on a great introductory webinar, Maternal Mental Health 101, presented by Birdie Gunyan, MD, RN, MA, CLC from Postpartum Support International in conjunction with Joy Burkhard, Executive Director and Founder of 2020Mom. As a mom, friend and counselor, I found this to be a very useful introductory resource into the world of perinatal mood disorders. Below is a summary of some key highlights. (This is not intended to serve as medical care. If you or someone you know shows symptoms, contact your medical provider right away.)
What does PMADS Stand For?
PMADS stands for perinatal mood and anxiety disorders. “Perinatal” represents the time of pregnancy up through the first year postpartum (after delivery). PMADS include the following disorders:
- Postpartum Panic Disorder
- Postpartum Depression
- Obsessive Compulsive Disorder
- Post-Traumatic Stress Disorder
- Bipolar Disorder
- Postpartum Psychosis
Postpartum covers the time span of the baby’s birth to their first birthday.
Some General Misconceptions
There are some general misconceptions we have as a culture regarding maternal mental health. Here are a few:
- PPD or PMADS are easy to identify. Between the sleepless nights, being a first time mom or having others one is caring for, it’s not always obvious to identify PPD or anxiety. Mom may feel something is off or not right, but she may need a loved one to help her see that she needs to see her doctor for her fatigue, elevated anxiety, irritability, crying or sadness.
- The “Baby Blues” are the same as Postpartum Depression (PPD). The Baby Blues are not the same as PPD. The baby blues generally last for two-three weeks and may include tearfulness and mood swings due to hormone fluctuation and sleep deprivation postpartum. Symptoms resolve without the need of medical intervention. About 80% of new moms will experience the “baby blues.”
- PPD only includes depression. PPD includes other symptoms such as anger (screaming or yelling at other children or partner), irritability (everything makes mom angry), appetite and sleep disturbance, feelings of guilt, shame or hopelessness, feeling disconnected to the baby (feeling more like the nanny than the mother), as well as thoughts of harming baby or oneself. PPD also includes anxiety. Symptoms may include insomnia, low appetite, fears and worries, restlessness, physical symptoms such as dizziness, rapid heartbeat, aches and pains.
- PPD means psychosis. Postpartum depression and psychosis are two different things. Psychosis can occur up to 6 months postpartum. Women experiencing psychosis are not horrified by their thoughts of harming their baby, rather they are comforted by them. Psychosis may include delusions (thinking the baby is possessed by a demon), or hallucinations (seeing the face or presence of a deceased family member), insomnia, rapid mood swings, hearing voices to hurt oneself, confusion and disorientation.
There are numerous factors that can contribute to PMADS. Women who did not experience any type of PMADS with previous pregnancies may experience them with preceding ones. There is often a combination of psychological, social, and biological stressors. Here is a list of some possible contributing factors:
- Traumatic delivery (pre-eclampsia, unplanned c-section)
- Previous PMADS
- Family history of mental health disorders
- Symptoms during pregnancy
- Personal history of mood disorders
- Significant mood reactions to hormonal changes
- Endocrine dysfunction (thyroid imbalance, diabetes)
- Social factors (inadequate social support, recent move)
- Complications in pregnancy, birth or breastfeeding
- Age-related factors (adolescence or premenopausal)
- History of sexual abuse
- Returning to work
Various Treatment Options
Just as symptoms vary from person to person, treatment options will also differ depending on the individual and severity of symptoms. One of the biggest keys to treatment is education on the differing treatment options. Options may include one or more of the following:
- A support group
- Family/friend support network
- Increased self-care
- Hospitalization for severe cases
- Placenta encapsulation (Note that there is currently no formal research to support this although many women have benefitted postpartum)
These illnesses are detectable and women should not feel ashamed, embarrassed or “crazy” for having PPD or other perinatal disorders. Compared to other countries, the experience of childbirth in the United States typically involves much less care and support for mothers during the critical first year. This care includes pampering and help with caring for other children and home. Women do not return to work right away and are supported as they begin this journey with their new little one whether their first or their fourth.
In my next post I will focus on how the Christian woman can understand and process their journey. Ongoing posts will include the testimonies of women who’ve survived PMADS as well as a husband’s testimony of going through this experience with his wife and how he learned to support and encourage her along the way. Stay tuned…