If your mental health is negatively impacted during pregnancy or after giving birth, you’re not alone. Mental health issues are one of the most common complications connected to pregnancy and childbirth, according to the American College of Obstetricians & Gynecologists. However, perinatal mental health conditions often go undetected and undiagnosed.
“After giving birth, you don’t really know what’s normal or not normal,” says Dr. Alyson Gorun, assistant professor of clinical psychiatry at Weill Cornell Medicine, Acting Director of the Aaron Stern MD, PhD Program in Psychodynamic Psychiatry, and co-author of Postpartum Problem-Focused Psychodynamic Psychotherapy. “You may not recognize symptoms of depression or anxiety.”
Keep reading to learn more about common maternal mental health issues during and after pregnancy, symptoms to look out for and available treatment options.
What Is Perinatal Mental Health and Why Does It Matter?
Perinatal wellness includes the following time periods:
Perinatal mental health covers any mental health issues that arise during pregnancy and up to two years postpartum. It also includes pre-existing mental health issues that become exacerbated or re-emerge during the peripartum time period. Recognizing the signs and seeking appropriate mental health care early can help prevent symptoms before they worsen.
Risk Factors for Perinatal Mental Health Issues
Though any pregnancy can be associated with perinatal mental health problems, certain factors increase your risk. These include:
- Childhood trauma
- Intimate partner violence
- Early maternal age
- Limited social support
- Personal or family history of a mental health issue
- Unplanned or unwanted pregnancy
If you have any of these risk factors, it’s important to discuss them with your health care provider. You may benefit from more frequent monitoring or referral to a mental health professional.
Mental Health Issues Experienced in the Perinatal Period
Many mental health conditions can arise during pregnancy or in the months and years afterward. Common mental health disorders in the perinatal period include:
- Anxiety. This can cause you to develop excessive worry, difficulty sleeping due to anxiety, fear of harm coming to your baby or other fears. You may also experience panic attacks or intrusive thoughts about hurting yourself or your baby.
- Depression. You may feel frequently tearful, irritable, guilty, hopeless or even worthless. These thoughts can sometimes be associated with thoughts of not wanting to be alive.
- Obsessive-compulsive disorder (OCD). These are intrusive, distressing thoughts. You may also feel compelled to perform specific behaviors in response to those thoughts, such as washing your hands repeatedly due to fears of contamination or checking if your baby is breathing when it’s not needed.
- Post-traumatic stress disorder (PTSD). You have experienced a traumatic event in the past or during your pregnancy, childbirth or postpartum period. Because of this, you may experience recurrent and intrusive distressing memories, nightmares, flashbacks, avoidance of reminders of your trauma, negative beliefs about yourself, numbness or alternatively increased reactivity and irritability.
- Psychosis. Postpartum psychosis is rare but important to recognize due to the associated risks of harm to yourself and harm to your baby. You can develop insomnia or bizarre or disorganized behavior, confusion or disorientation. You may experience hallucinations of things that you can see or hear that aren’t there or become paranoid about people you trust. It is important to immediately go to a hospital for evaluation if you develop any of these symptoms.
Symptoms of Mental Health Issues
There is a wide range of symptoms that may indicate a mental health issue during pregnancy or after giving birth. Here are some to look out for.
- Difficulty bonding with your newborn
- Extreme, persistent worrying
- Feelings of sadness
- Inability to concentrate
- Loss of interest in activities you previously enjoyed
- Racing heart
- Restlessness
- Irritability
- Sleep problems
- Thoughts of hurting yourself or your baby
Any of these can indicate a mental health issue that may require expert care.
Detecting and Treating Perinatal Mental Health Conditions
Managing perinatal health starts with a conversation. At your first prenatal visit, discuss the topic with your OBGYN. Regular perinatal mental health screenings can help detect issues early.
If you experience symptoms, bring these up. Your health care provider can then work to diagnose your condition. If appropriate, you may get referred to a psychiatrist for further care.
Perinatal mental health treatment options include:
- Healthy lifestyle. Exercise, good sleep habits, a well-rounded diet and an overall healthy lifestyle are essential parts of good perinatal care. For example, Dr. Gorun has had patients find relief from depression and anxiety after a single night of good sleep.
- Medication. The right medication can help with moderate to severe depression and many other mental health issues. It is often paired with psychotherapy and can help manage impaired functioning or suicidal thoughts.
- Psychotherapy. This is often the first-line treatment for mild cases of depression during the postpartum period. Cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT) and psychodynamic psychotherapy may all be helpful for peripartum mental health difficulties. A mental health professional can help you determine which therapy is appropriate for you based on your symptoms.
Key Takeaways About Perinatal Mental Health
The miracle of birthing a child can be both rewarding and, at times, challenging and emotionally difficult. If you experience any of these feelings, you may be experiencing perinatal mental health issues.
- Perinatal mental health encompasses any mental health issues arising during pregnancy and up to two years postpartum. These issues potentially affect both the mother's wellbeing and the health of the pregnancy and infant.
- Risk factors include pre-existing mental health issues, childhood trauma and a lack of support, among others.
- Screening can help detect these issues, so that you can begin treatment as early as possible. Treatment options include a healthy lifestyle, medication and psychotherapy.
Want to protect your mental health before, during and after pregnancy? Learn more through our On the Mind podcast and find a doctor at Weill Cornell Medicine today.
