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As expecting parents, we are not always properly prepared for the challenges that can present in the first year of a baby’s life.  One such challenge that most people don’t talk about is a category of disorders called Perinatal Mood and Anxiety Disorders.  These include Postpartum Depression, Anxiety, OCD, and even Psychosis.  These disorders are the most common complication of childbirth, affecting up to one in 5 women.

There is a “conspiracy of silence” surrounding these disorders due to the shame our culture associates with them.  Because of this, parents are not given education or empowered with information on what to do when such disorders strike.  These disorders are common, but not normal.  Not only are new moms not educated on these disorders, but are often told, “you should be happy” and “you can do it.” as opposed to really being listened to when depression is surfacing.  They are most often too afraid to tell anyone they are struggling for fear of judgement and deep feelings of shame.  Moms may need an outside person to lovingly bring a concern to them in order for them to recognize or share what they are going through.

I am a therapist trained to diagnose and treat anxiety and depression.  When I had my first child I had no idea I was suffering with postpartum anxiety.  With my second I had postpartum depression and anxiety, and it was not until an outside person pointed this out to me that I had any idea it was happening.  I took a training on perinatal mood and anxiety disorders when my second was 6 months old.  My new understanding of these issues changed everything for me.  It helped me understand what I was experiencing and gave me a passion for helping others going through the same thing.  Having this knowledge gave me the feeling of empowerment I needed to take control and start feeling better. 

Postpartum Depression and other disorders are very treatable and lots of times will resolve more quickly than other mental health disorders if detected early and treated.  Dads are the first line of defense for detecting a postpartum disorder and helping their partner get the help she needs.  If dads, friends, or family members know what to look for, moms can be helped sooner, improving outcomes for moms and entire families. 

It is normal for new parents to be overwhelmed, sleep deprived and emotional in the first weeks of life.  You can expect new moms to have a range of ups and downs the first weeks postpartum as hormones are adjusting and she is adjusting her life to taking care of a new baby.  Postpartum Mood and Anxiety Disorders are not diagnosed until after the 2 week mark.  Here are a few warning signs that the mom in your life could be struggling:

1. Mom isn’t sleeping.  If a new mom is sleep deprived from caring for the baby and is still struggling to fall asleep or stay asleep when the baby is sleeping this is a clear sign that something may be wrong.  If possible, a 4-5 hour stretch of uninterrupted sleep each night is the minimum required to support a mom being able to regulate her emotions.

2. Mom has feelings of guilt and failure.  Persistent feelings of guilt, failure, and low self-esteem could be a sign the mom in your life is struggling with postpartum depression.  Notice if she is consistently commenting on how she is failing or that she is not doing this or that good enough.  If Mom isn’t seeming to connect with, smile at, or get any enjoyment from baby there may be a problem.

Especially consider seeking help if she makes comments that you or the baby would be better off without her.  Suicidal thoughts in the postpartum period should be taken seriously.  If she expresses thoughts like this to you, stay calm and supportive and help her find a doctor or therapist trained in perinatal mood and anxiety disorders to see.  If you are concerned about her immediate safety you can call a local crisis line and they can help you assess next steps.

3. Mom is irritable.  Postpartum depression often does not present the same way as normal depression.  Moms that have postpartum depression often look very put together and are taking good care of their babies. If Mom seems constantly angry and irritable this is a sign she could have postpartum depression.  Moms with postpartum depression may not seem sad, they may just be short with you and other people, seem angry and be very irritable or impatient.  They are also less likely to stop doing all of their daily activities, like a person with severe depression would.

4. Mom is over or under worried about the baby.  If she is obsessing about the baby’s care, has a hard time handing off the baby to anyone else or is ruminating about the baby she could be experiencing Postpartum Anxiety.  Up to 20 percent of new moms experience Postpartum Anxiety.

Notice if Mom seems hyper vigilant about the baby.  She may just feel that she is being a good mom, but if she is worrying about a lot of things the average parent may not worry about, it is reason for concern.  Other signs of Postpartum Anxiety are racing thoughts, shortness of breath, panic attacks, or heart palpitations.

Some moms have extreme fear that they will hurt the baby and intrusive thoughts about hurting the baby.  This is called Postpartum Obsessive Compulsive Disorder.  This may cause her to want to avoid baby in fear of hurting the baby.  If she is having these thoughts it does not mean she will hurt the baby.  It does mean it is important to seek help only from professionals experienced with Postpartum OCD.

  5. Mom doesn’t seem like herself.  It is normal for a mom to go through some changes in regards to her identity when she becomes a mother.  It is not normal for her personality to completely change.  If Mom just doesn’t seem like herself it may be time to get extra help.  After baby is born the unique parts of her personality should be intact.

6. Mom is having flashbacks, nightmares or intrusive thoughts of the babies birth.  Up to 34 percent of new Moms report a traumatic birth.  9 percent of postpartum moms meet criteria for Post Traumatic Stress Disorder due to a traumatic birth. 

If you are worried that the new Mom in your life could be experiencing a Postpartum Mood or Anxiety Disorder, being a safe person to talk to is the most important first step.  Tell her that this is not her fault, she is not alone, and with treatment she will be well. 

It is important to seek help from qualified professionals with a specialization in Perinatal Mood and Anxiety Disorders.  Many well meaning therapists and doctors cause more harm than good when they are not educated specifically on these disorders and how to treat them.  Reach out for community support and use resources such as Postpartum Support International (http://www.postpartum.net/) in order to find a professional or support group.

Also note that up to 10 percent of new dads experience postpartum depression and anxiety.  If you see any of these signs in yourself it may be time for you to seek help. 

It is important during this time to lower your expectations of her and take things off of her plate.  If you are able to help with cooking, cleaning, childcare and whatever else, she will have a better chance of a fast recovery and returning to herself again.  Do not ask her to do anything extra and be very sensitive about any negative feedback, especially in regards to her parenting.   

Remember that hormones are a huge factor in causing this disorders and that this is not in her control. She can be well again with the correct support and help.  If you can support her in this period she will be much more effective as a partner, friend, and parent after she is well.