Mental health concerns during and after pregnancy

Many parents feel a range of emotions when welcoming their newborn into the world — from excitement and joy to nervousness and anxiety. However, women’s bodies rapidly change during and after childbirth. And with challenges such as sleep deprivation, a new routine and feelings of isolation, the beginnings of parenthood may not always feel as happy as imagined.

According to experts, mental illnesses are among the most common pregnancy complications, affecting nearly 1 in 5 women. And perinatal mood and anxiety disorders — conditions affecting pregnant people during pregnancy or the first year after delivery — include more than just postpartum depression.

“Most new moms experience ‘baby blues,’ which commonly include mood swings, crying spells and difficulty sleeping, usually beginning within the first two to three days after delivery and potentially lasting for up to two weeks,” says Dr. Elizabeth Hudler, a perinatal mental health certified psychiatrist affiliated with Sharp. “However, some new moms experience a more severe, long-lasting form of depression known as postpartum depression.”

Postpartum depression is a medical condition that can develop after having a baby and is different from ‘baby blues.’ Many people are familiar with this term; however, it is now known as perinatal depression because symptoms can develop during pregnancy or in the first year after giving birth.

Affecting about 15% of women, symptoms of perinatal depression are more intense and can last longer.

These symptoms include:

• Severe mood swings

• Difficulty bonding with the baby

• Withdrawal

• Intense irritability

• Overwhelming loss of energy

• Insomnia

• Hopelessness

• Panic attacks

Other pregnancy-related mental health concerns

“There are many disorders beyond the more well-known postpartum depression that can also affect moms during the perinatal period, including conditions ranging from anxiety to psychosis,” says Dr. Hudler. “Everyone’s bodies and responses are different, so I encourage families to be mindful of perinatal mental health and to know the signs and symptoms.”

Potential perinatal mental health disorders include:

• Postpartum anxiety
  Excessive worrying that occurs after childbirth can signify postpartum anxiety and can occur along with postpartum depression. Although postpartum depression and anxiety have many of the same symptoms, the two are different conditions.
  
  Anxiety is associated with being constantly nervous and with excessive worrying, not with sadness. Dr. Hudler adds that moms will know it's postpartum anxiety and not just typical worrying because it feels like a worry that never stops, often interfering with the ability to calm down or even leave the baby alone with a trusted adult.
  

• Perinatal obsessive-compulsive disorder (OCD)
  Perinatal OCD is characterized by obsessions, which are recurring thoughts or doubts, and compulsive rituals, which involves repeating an action to reduce anxiety. Examples may include cleaning or sterilizing excessively or repeatedly checking on the baby throughout the night to ensure they are still breathing. Alternatively, some new moms with perinatal OCD have a fear of being alone with the baby.
  

• Post-traumatic stress disorder (PTSD)
  Almost 10% of women experience postpartum PTSD after childbirth, usually caused by real or perceived trauma during delivery or after birth.
  
  “Examples of trauma include, but are not limited to, the baby going to the neonatal intensive care unit, an unplanned c-section or severe complications,” says Dr. Hudler. “Women with PTSD may experience flashbacks or nightmares, panic attacks, feeling a sense of detachment, or intrusive re-experiencing of the event.”
  

• Postpartum psychosis
  Most often developing within the first week of delivery, postpartum psychosis is a rare and serious condition that disrupts a person’s sense of reality after giving birth. Symptoms include obsessive thoughts about the baby, hallucinations, paranoia, making attempts to harm oneself or the baby, or confusion. It should be considered a mental health emergency with immediate medical attention.

How do I know if I — or someone I love — needs help?

If symptoms get worse and do not fade after two weeks, seeing a medical professional, such as an OBGYN, primary care physician or therapist, is recommended. They can help parents understand what they are going through and, if needed, can refer them to Sharp HealthCare’s Maternal Mental Health outpatient program.

“These conditions are treatable with professional help and should not be avoided due to a fear of stigma,” Dr. Hudler adds. “Early diagnosis and treatment are extremely important and are vital steps towards hope and healing.”

Learn more about Sharp HealthCare’s Maternal Mental Health Program; get the latest health and wellness news, trends and patient stories from Sharp Health News; and subscribe to our weekly newsletter by clicking the "Sign up" link below.