Perinatal Mental Health—Baby Blues, Postpartum Depression, Anxiety & More

by Brood

Pregnancy might be your first experience of full-on managed healthcare, and when your body is being so closely monitored, it’s surprisingly easy to forget about your brain. Shifting perspectives and slightly more mental health support has given millennials and Gen Z an opportunity to discuss neurodivergence and general mental wellbeing more than their parent’s generation.

But still, especially for those of us with a uterus, research, tools, and focus lags behind (sigh, it is “women’s” healthcare after all!). Depending on your pregnancy care provider, you might go through nine months of appointments without so much as a conversation about your mental health—or what to do to support or preserve it. This can lead to feeling stigmatized, isolated, and overwhelmed when you have to address it in the moment, already in crisis.

Prevention is always the best cure because your hormones, experiences, and needs change at lightning speed during pregnancy and postpartum, so the best time to set up your mental health supports is when you’re feeling great! Do some research, understand what can happen during pregnancy, birth, and postpartum, and then consider your mental health before, during, and after. Your care provider, family doctor, or therapist is usually a good place to start if you’re experiencing any mental health challenges and if those places don’t feel safe, local mental health support groups or an anonymous crisis line might feel more accessible. 

Below, we will outline the differences between baby blues, postpartum depression, postpartum anxiety and postpartum psychosis. This is by no means a detailed list of all the perinatal mood disorders that may affect you. Having a better understanding and baseline knowledge of these is a great place to start and as doulas we understand that arming you with education and evidence based information can support you in feeling more confident during any challenges that arise. 

Baby Blues

Starting about three days after birth, you may notice mood swings, crying spells, generalized anxiety and/or difficulty sleeping (when you have the ability to). This tends to last about two to four weeks.

Resources

Your community of care may be able to support you by having a touch-person that can organize logistics, care, visits and more. Share as much as you can with your primary relationship(s), as this may bring catharsis and allow you to access care.

Booking a therapy session in your pregnancy for two weeks postpartum will allow you to get support and care that you did not need to plan post-birth.

Your care provider will be able to illuminate if your symptoms are out of the range of “normal,” and validate your experience.

If your low mood continues past a month postpartum, consider getting your blood drawn to check if you are deficient in iron or other nutrients. Make sure you are eating, hydrating and staying in bed as much as possible. The time to exercise, “get back to life” and move at a faster pace will come— it’s not now.

Prenatal preparations

These feelings are an expected part of your hormonal matrix, and are very typical. Knowing this can help you to understand why it’s occurring and remember that it will pass.

Build your community of care to uplift you and support you as you move through the many highs and lows of parenthood, including any baby blues. It is deeply important to build systems to support you when you won’t be able to support yourself.

Postpartum Depression

The signs and symptoms of postpartum depression (PPD) may begin in pregnancy and last up to a year afterwards. They are longer lasting and more severe than baby blues. PPD

usually interferes with your ability to care for your baby and yourself, often presenting as a difficulty bonding with the baby. You may withdraw from your family and friends, and have reduced interest in activities and things you used to find joy in. Feelings of hopelessness, worthlessness, restlessness and suicidal thoughts are also common.

Resources

Your care provider will have resources specific to your area and severity. Be sure to ask about medications so that you know your options early. That way there is more time to make a decision.

Prenatal preparations

Sharing your history and understanding your risk factors are helpful, so that you can line up the appropriate care for after birth (even if you don’t end up needing or using it). Your primary care provider can connect you with the proper resources within your community.

Prioritize these appointments in pregnancy, and book them for your first few weeks postpartum. If you are comfortable, share these experiences with your community of care, so they can anticipate your needs and provide appropriate levels of care.

Postpartum depression cont.

Below are common risk factors:

  • A history of depression (in previous pregnancies, postpartum or generally in life).
  • Stress or grief in the past year, caused by events such as illness, loss, or pregnancy complications.
  • Having difficulties in postpartum (such as, troubles nursing, unstable primary relationship(s), or health issues with yourself/your baby).
  • A smaller and/or not physically close community of care.
Postpartum Anxiety

The mental and physical signs of postpartum anxiety (PPA) can range greatly. For some, it can present as constant worry that can’t be eased, or fears and dread that dominates your

thoughts. For others, it can present as racing, constant and obsessive thoughts and/or recurring nightmares, and cinematic trains of thoughts. The physical symptoms can include heart palpitations, hyperventilating, shakiness, trembling, sweating, nausea, upset stomach and/or vomiting.

Resources

As with postpartum depression, setting up supports early on and discussing medication, resources and coping tools with your care provider is wise. Finding your way back to gentle movement, nervous system regulation, sleep and time in nature can all be deeply effective. 

Once you have these regularly in your life, you may be able to determine which symptoms need more attention and support.

Prenatal preparations

Understand your risk factors: a history of anxiety, depression, OCD or mood disorders (including intense PMS).

Folks who have a history of eating disorders, controlled eating habits, and/ or previous pregnancy or infant loss are at increased risk.

Set up any mental health support(s) that have been helpful in the past. Your care provider can support you in finding any in your local area. Attending a few meetings before your birth is a great idea.

Postpartum Psychosis

This is a rare condition. The signs for this are very specific, and typically develop within a week of delivery. They are:

  • Hallucinations and delusions
  • Excessive energy and agitation
  • Paranoia
  • Attempts (and thoughts) to harm yourself, others and/or your baby
  • Sleep disturbances, confusion and disorientation
Resources

Reach out to your care provider, this is not something you can heal from alone.

Prenatal preparations

Being aware of the signs and symptoms, while knowing this is a rare illness is incredibly helpful. Postpartum psychosis affects 1 to 2 people out of every 1,000 births. Risk factors include a previous psychotic episode and/or a family history of bipolar disorder, schizophrenia or other psychosis.

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