Perinatal Mood Disorders

Perinatal Mood Disorders by Diane Wall MA LP CC

PERINATAL MOOD DISORDERS

Perinatal Mood Disorders have been identified in women of every culture, age, income level and race. The term “perinatal” generally refers to the period of pregnancy and the first year after a baby is born. Perinatal Mood Disorders were recognized as far back as 700 BC when Hippocrates wrote about the emotional problems of postpartum women and in 1858, Louis Victor Marce published a study linking negative emotional reactions with childbirth.

Most people are familiar with the “Baby Blues” and Postpartum Depression, but there is a wide spectrum of disorders that can affect mothers during pregnancy and postpartum.

BABY BLUES – Usually occurs within days of the birth and last for a few days to a few weeks. If symptoms continue for more than a few weeks, the problem may be more than the baby blues. Symptoms include: crying, anxiety, worrying, irritability, anger, impatient, quick mood changes, and problems sleeping.

POSTPARTUM DEPRESSION & ANXIETY – Onset can occur anytime within the first year and can last up to a year or longer. Symptoms can be the same as the baby blues, but also include: problems concentrating, lack of energy, feelings of guilt and worthlessness, changes in appetite, unwanted thoughts, excessive concern for the baby, feeling disconnected from the baby, not having any emotions, feeling overwhelmed, and thoughts of harming yourself or the baby, panic attacks, impaired memory, nightmares, feeling out of control, phobias, and feeling like you are going “crazy.”

POSTPARTUM OBSESSIVE-COMPULSIVE DISORDER – Symptoms include intrusive and persistent thoughts or mental images and a sense of horror about the thoughts or images. Thoughts are typically accompanied by behaviors to reduce the anxiety. These behaviors often include checking baby frequently and obsessively searching for information (books, internet, etc.) related to their fearful thoughts.

BIRTH-RELATED POSTTRAUMATIC STRESS DISORDER (PTSD) – The onset of PTSD can be immediate, or in some cases where the woman feels numb and just relieved it’s over, the onset may not be for several months or even after the baby’s first birthday. The baby’s first birthday may be the trigger that causes the woman to experience PTSD symptoms. Symptoms typically include dreams, thoughts of the birth, avoidance of anything associated with the event, persistent increased arousal such as irritability, hypervigilance, difficulty sleeping and exaggerated startle response.

POSTPARTUM PSYCHOSIS – Usually occurs within the first 3 weeks after the birth. Symptoms include a break from reality, hallucinations, delusions, severe insomnia, agitation, bizarre behavior, irrational statements, frantic energy, memory loss, confusion, and paranoia. Infanticide and suicide are associated with psychosis and immediate treatment is necessary.

Treatment of postpartum depression should, ideally, begin during pregnancy, so that the effects can be minimized. Sometimes when women are depressed while they are pregnant, they don’t tell anyone because they feel guilty or ashamed. This is a time when they are supposed to be happy. Maybe they ARE happy to be pregnant and everything in their life is fine, so then the depression leaves them feeling guilty.

Some researchers have found that depression during pregnancy can raise the risk of pre-term delivery or the baby being underweight. Depression may lead to drug and alcohol abuse or unhealthy habits such as not eating properly and smoking. Depression will affect important relationships and intensify negative thoughts. Postpartum depression will cause the mother to doubt her abilities to properly care for her baby. Her feelings of being inadequate will be supported by her physical symptoms, such as, being exhausted, irritable, anxious, uncontrollable crying, and problems breastfeeding. An infant’s normal cry will be perceived as “I can’t do anything right”. Sometimes the mother will become overly concerned with the baby’s health and safety. Thoughts about something happening to the baby can become consuming. On the opposite end, the mother may lack any interest in the baby. We know that postpartum depression can have an affect on the infant’s development. Problems can occur with sleep, activity levels, soothing abilities, language development, behavioral problems, and attachment insecurities.

Factors, besides hormones, that put a mother at risk for Perinatal Mood Disorders include:

• Stress in their life
• Lack of social support
• History of depression
• Unplanned or unwanted pregnancy
• Relationship problems
• Anxiety
• Childcare stress
• Low self-esteem
• An infant born with health issues or pre-term
• Infant temperament
• Traumatic childbirth experience, negative interaction with the staff, feeling out of control
• Emergency Cesarean, high level of medical intervention
• Difficult labor or induced labor
• Previous trauma such as abuse or rape

Preventative strategies for mothers at risk for Perinatal Mood Disorders include:

• Educate the parents about what to expect
• Have social support in place
• Associate with other new parents
• Don’t take on new responsibilities or make major changes
• Don’t feel like everything has to be perfect
• Make arrangements to have time to yourself
• Talk to your doctor about any history of depression
• Join a support group specific to your issue
• Don’t be ashamed to ask for help
• Prioritize the most important things in your life and let go of the least important.

Treatment for Perinatal Mood Disorders include:

• Psychotherapy
• Support groups
• Relaxation techniques
• Exercise
• Getting enough sleep. Arranging the time for you to sleep.
• Asking for help
• Proper nutrition
• Taking time for yourself without the baby
• Hormone replacement or antidepressant