There is no shortage of advice on what to do and what to get after having a baby. There are an infinite number of guides about what to register for, books on everything from nursing to sleep schedules, and consultants to help you navigate just about any baby related challenge. And yet, there is no simple guide to taking care of your mental health after having a baby.
This astounds me as a mother, and as a clinical psychologist specializing in pregnancy and the postpartum period. And yet, I hear time and time again from friends and patients that they have received little to no guidance from their medical team about mental health during pregnancy and the postpartum period. They are not told what to look out for or how to care for themselves and are not given resources. I had the same experience with my OB. During both of my pregnancies I was screened using the Edinburgh Postnatal Depression Scale (EPDS) but because I “passed”, there was no conversation about mental health.
This is exceptionally concerning as perinatal mood and anxiety disorders are the number one most common complication of childbirth! Mental health concerns during pregnancy and postpartum can have a significant negative impact on mothers and birthing parents, and their families. These are serious health issues with significant consequences. The lack of attention to this issue is extremely consequential.
Mental Health After Baby
Please consider this a very basic guide to taking care of your mental health after having a baby. While the information presented is by no means exhaustive, my hope is that you can use this is a crib sheet to know what to expect, when to get concerned, and how to take care of yourself.
1. Know the facts about Perinatal Mood and Anxiety Disorder (PMADS):
PMADS represent a spectrum of mood and anxiety disorders that occur during the perinatal (during pregnancy/postpartum) period. These diagnoses include perinatal anxiety, perinatal depression, perinatal obsessive-compulsive disorder, perinatal panic disorder, perinatal bipolar disorder, perinatal psychosis, and postpartum posttraumatic stress disorder.
2. Know your Risk Factors:
There are a number of risk factors to look out for including: a personal or family history of depression, anxiety or other mental health concerns; medical problems including diabetes or thyroid disorders; having a “difficult” pregnancy or birth complications; financial stress; a lack of social support; a history of pregnancy loss; or a history of infertility. Additionally, women of color are at additional risk for developing a PMAD.
3. Know the symptoms:
Many women and birthing parents experience mood and anxiety symptoms in the first two weeks postpartum. This is called the “Baby Blues” and is a transient experience. Symptoms of PMADs persist beyond that period of time (or start during pregnancy) and can interfere with your ability to function. Symptoms vary but can include irritability, difficulty sleeping, lack of interest in pregnancy or baby, sadness, tearfulness, shame and guilt, feeling hopeless, worry or feeling like something bad is going to happen, racing thoughts, or restlessness. Many women experience “scary,” or intrusive thoughts which may include thoughts of hurting themselves or their babies. While these thoughts may feel distressing, they are not unusual.
4. Identify and Inform your Family and Friends:
Make sure your partner, family members, or support team know about your risk factors, know what signs/symptoms to look out for, and know who to call for help.
5. Plan ahead:
If you know you are at additional risk for developing a PMAD, it may be helpful to identify or engage in support before you experience symptoms. This could mean having a consult with a therapist or starting therapy preventatively. This could mean remaining on medications you use to manage pre-existing symptoms of anxiety or depression. This could mean putting together a resource list ready to go with names of therapists, support groups, and other community-based supports so that you are not struggling to get help when you need it most.
6. Be Proactive:
Prioritize your mental health! Engaging in basic acts of self-care such as getting outside every day, sleeping, talking to another adult, attending a mom’s group, and making sure you are eating and drinking enough can go a long way towards preserving your mental health. I often have my patients create a “Postpartum Coping List” which details a variety of coping strategies to use in different situations and that involve different amounts of effort. This could include things tasks that are easier to engage in like taking a few deep breaths or tasks that take more effort such as getting to a yoga class. I also suggest making a list of places to go or people you can see regularly to help combat isolation.
7. Prioritize Sleep:
As anyone who has ever been sleep deprived knows well, a bad night’s sleep can do a number on your mental health. Sometimes a good stretch of sleep can be the key to preventing or recovering from a PMAD. Getting prolonged sleep is really hard with a new baby but aim for at least one 4-hour stretch of uninterrupted sleep. This may not happen every night but if you are starting to feel anxious or depressed, this is a must for a few nights.
8. Know when to get help:
In my opinion, it is always worth a consultation with a well-trained therapist if you have any concerns about your mental health or wellbeing. You do not need to be experiencing a PMAD to benefit from support. I have yet to meet the person who does not struggle from time to time with the massive identity shits associated with becoming a parent. That is reason enough to get some extra help.
9. Know when it’s an emergency:
If you are feeling unsafe, have thoughts that are scaring you, or have been unable to sleep even when you are tired, do not wait to get help. Call 911 or contact one of the organizations listed below.
National Postpartum Depression Hotline: 1-800-PPD-MOMS
Thankfully, with proper screening, and quality treatment, perinatal mood disorders are treatable and even preventable. There is no need to suffer alone. Here in the DC area, we are lucky to have a number of amazing options for treatment and support. Please below for some ideas on where to get help.
Furthermore, please check out our Pregnancy and Infant Loss Resource for DC area moms if you are coping with the loss of a pregnancy or baby.