Information & Frequently Asked Questions

Adjustment to Life’s Changing Landscape

A developmental crisis occurs when one’s skill sets and coping mechanisms are inadequate for the demands of a new life situation. Some transitions are all consuming and require that new skills and means of coping be fast tracked in order to respond to the need. During these times there is emotional and psychological vulnerability to symptoms of emotional distress, anxiety and depression - as one’s self confidence, sense of self and sense of the world is re-established.

In addition to psychological and emotional vulnerability during times of challenge and transition, women are also physically and biologically vulnerable to depression and anxiety, especially during pregnancy and after and during the hormonal transition toward menopause.

Emotional Adjustment During Pregnancy & After … It’s Confusing!

Because so much changes during pregnancy and after, it can be difficult to determine if what you’re experiencing is “normal.” Up to 85% of of birth parents experience Baby Blues, which is considered a “normal” reaction to such a multi-faceted life change (hormonal-psycho-social-emotional).

While the Blues are considered typical, the intensity of thoughts and emotions often catch new parents off guard. Symptoms can include mood swings, crying, irritability, inability to sleep, loss of appetite and scary thoughts - often along side feelings of overwhelm, self-doubt and regret.

It’s important to pursue a further evaluation if you feel uncertain about what you are experiencing, have been experiencing symptoms for more than 14 days, or feel unable to care for yourself or your baby.

What Are Perinatal Mood and Anxiety Disorders?

Although the term “postpartum depression” is universally recognized, it doesn’t accurately describe other emotional experiences that parents are vulnerable to during pregnancy and after. Toward better understanding and awareness, the term Perinatal Mood and Anxiety Disorders includes the onset, re-occurrence or exacerbation of: depression (or other mood disorder) an anxiety disorder, or a thought disorder. It’s important to note that symptoms of depression and anxiety are different for everyone but can include:

• feeling sad, crying often

• having difficulty eating or eating too much

• having a difficult time sleeping (can’t sleep even when your baby is asleep), or sleeping too much

• feeling unable enjoy the things you used to

• feeling hopeless about the future

• having thoughts about hurting yourself, or not caring about your own wellbeing and safety

• having a difficult time feeling connected to your baby

• feeling panicky or worried

• feeling overwhelmed or unable to make decisions

• feeling irritability, anger or rage

• having intrusive, scary, or repetitive thoughts

• repeating the same actions over and over such as counting, checking, or cleaning

• feeling excessive guilt or self blame

• having nightmares or living past traumatic events

• shortness of breath, fast heartbeat, feeling dizzy, having chest or stomach pain

If you are experiencing these symptoms it is important to pursue a further evaluation by your physician or mental health provider.

How Often Do Mood and Anxiety Disorders Occur During Pregnancy and After?

• Mood and Anxiety Disorders are the single largest complication of pregnancy and childbirth. About 1:7 pregnant and/ or postpartum women will experience emotional complications that meet diagnostic criteria for a mood or anxiety disorder.

• Approximately NICU Mothers of high risk infants, such as those hospitalized after birth, experience

• Emerging evidence suggests that 1:10 non-birth parents experience symptoms of depression or anxiety as well.

• It is not uncommon for bi-polar disorder to be recognized and diagnosed for the first time after giving birth. Women with bi-polar disorder are at a significantly greater risk to experience symptoms of psychosis after giving birth. ADD LINK HERE

• Obsessive Compulsive Disorder (OCD) is a specific kind of anxiety disorder that affects 3-5% of women during pregnancy and after. This disorder is characterized by intrusive and scary thoughts, often about harm coming to your child - or fear that you, yourself, have an unconscious desire to harm your child.

• Postpartum Psychosis is a rare thought disorder that requires emergent evaluation and care; it affects approximately 1 or 2 women out of every 1,000 and occurs most often between 2 days to 2 weeks after giving birth. Women with a personal or familial history of psychosis or bi-polar disorder are at a higher risk. Postpartum psychosis is an emergency that requires immediate help.

Are Some Women More Likely to Experience Emotional Complications?

The following are factors that may place a woman at greater risk:

• Having a prior mood complication (depression, anxiety, bipolar disorder)

• Having a family history of mood complications or perinatal mood complications

• Experiencing mood complications during or after a prior pregnancy

• An unplanned pregnancy

• Having a difficult time breastfeeding

• Medical complications during pregnancy or childbirth, including premature delivery or having a baby with medical or developmental needs

• Being under the age of 20

• A recent stressful life event such as job loss, death of a loved one or pet, personal illness, divorce, or domestic violence

• Not having social and emotional support from a partner, family, or friends

• Alcohol or other substance misuse

• A history of physical, emotional, or sexual abuse

What Causes Perinatal Mood and Anxiety Disorders?

Perinatal Mood and Anxiety Disorders do not occur because of something that a woman does or does not do, but is likely the result of a combination of factors including neuro-biological-psycho-social and emotional changes.

After delivery, levels of hormones (estrogen and progesterone) in a woman’s body quickly drop. This leads to chemical changes in the brain that may cause mood swings. Additionally, the chronic sleep loss that new parents experience leads to physical, mental and emotional exhaustion, which contribute significantly to mood complications. We are also just now beginning to uncover some of the neurological changes that occur in women during pregnancy and after, which likely create a propensity to experience anxiety. The impact of disrupted sleep, and specifically Circadian rhythm, is also a likely contributor for some women.

What Happens If Emotional Complications Are Left Untreated?

Untreated emotional complications rob a new mother of her sense of self, which interferes with her ability to connect with and care for herself and her baby. If left untreated symptoms can persist for months or years and can lead to relational, attachment and developmental complications in children.

New fathers and non-birth parents are also at an increased risk for depression and anxiety during pregnancy and after. Additionally, untreated mood and anxiety disorders in one partner, places the other at risk and dramatically increases the risk of relationship dissolution.

How Are Emotional and Psychological Complications Treated?

There is help and you can feel better! Common treatment interventions include creating a plan to ensure your basic needs are being met (sleep & nutrition), as well as counseling and medication therapy, which can be used alone or in conjunction with one another. “HelpGuide.org” provides evidence based information in regard to options for both counseling and medication interventions.

Therapists, or psychologists, do not prescribe medications, however they can collaborate with you and your medical provider in regard to planning treatment and monitoring symptoms to help determine therapeutic benefit.

Other Things You Can Do to Feel Better

Sleep, exercise, socialization, intellectual or creative engagement, mindfulness practices- which provide a space for you to attune to yourself, provide a space for your nervous system to rest