It doesn’t take a microscope to see that us moms are under a lot of stress. Just glance around at your next playdate and you’ll see the varieties. There’s the mom taking a precious second to sit back and relax, another catching up on her social media feed, another following her baby around like a hawk, and yet another barely checking in while her kid gallivants around and finally the mom who only cracks a smile when her baby looks at her. Needless to say, we are going through a lot, a lot more than we probably realize.
And certainly a lot more physically, emotionally and mentally than we experienced in our pre-motherhood days. I like to say we are managing life on a whole new playing field with new rules, new boundaries, new limits, and challenges.
This blog post is about assessing where we are at in managing the “newness.” Not to master this new role to fill, but to manage it because it can be overwhelming. After all, becoming a mother completely changed your life and, newsflash, you are not expected to glide through it effortlessly.
Maternal Mental Health
There will be ups and downs and bumpy roads, which is why you need to check in on the status of your maternal mental health.
Maternal mental health is a growing focus under the umbrella of mental health because it affects not only the mother but also the baby. If a mother is suffering from an untreated mood disorder, there can be dire consequences for both her and the baby. In contrast, “treating the depression of mothers leads to improved growth and development of the newborn and reduces the likelihood of diarrhea and malnutrition,” according to the World Health Organization.
Thankfully, the awareness continues to grow with conversations about mental health in the news, media and even the Gram. The more we talk about mental health, the less taboo it becomes, but we need to be more specific. What exactly is maternal mental health? How does it affect you personally? Are you just having a bad day or is it more serious? Is that even the right question? Mental health is complex and should not be downplayed, even if you are just feeling “the blues”
Maternal Mental Health Facts from WHO
Worldwide about 10% of pregnant women and 13% of women who have just given birth experience a mental disorder, primarily depression.
Maternal mental disorders are treatable.
Depression causes suffering, disability and reduced response to a child’s need.
Maternal mental health problems are considered a major public health challenge.
Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding, and infant care.
All women can develop mental disorders during pregnancy and in the first year after delivery.
Poverty, migration, extreme stress, exposure to violence (domestic, sexual and gender-based), emergency and conflict situations, natural disasters, and low social support can increase the risk for specific disorders.
Mental illness can negatively impact a woman’s ability to function and thrive which can directly affect her fetus or child with long-lasting physical, cognitive and emotional outcomes.
- 7 in 10 women hide or downplay their symptoms.
So what are these disorders and what can we do about them?
Postpartum Depression vs. PMADs
Since entering the momosphere, we have heard the term “postpartum depression” (PDD) countless times. For a while now, it has served as a catch-all term for feelings of loneliness, restlessness, worthlessness, sadness, anxiousness and more that last longer than a couple of weeks after giving birth. This term is an important step in being aware of the state of our mental health but it is one-dimensional.
A more encompassing and appropriate term is now PMADs which stands for Perinatal Mood and Anxiety Disorders. Perinatal means through pregnancy and postpartum; so to “qualify” for mental illness, negative feelings don’t have to surface just in the postpartum phase, they can start during pregnancy.
And it’s not just depression that moms are feeling, it’s anxiety and a number of other symptoms. According to Postpartum Support Virginia (PSV), these symptoms and feelings include “sadness, lack of energy, lethargy, feelings of hopelessness. Some [mothers] are anxious or have scary thoughts, perhaps of harm to baby. Others are highly irritable, angry, or feel out of control. Some women report physical changes, such as weight loss or inability to sleep. Some women have one symptom, some have all of the above.”
Do I have a PMAD?
According to PSV, “risk increases significantly for women who have a personal or family history of PMADs, anxiety or depression. Other risk factors are biological, such as changes in hormones and sleep, life stressors, such as lack of support from partner/family, and psychological factors, such as difficulty with transitions.”
PMADs are the number one complication of pregnancy and childbirth and 1 in 5 women experience some type of PMAD. Women of every culture, age, income level, and race can develop perinatal mood and anxiety disorders.
The following PMADs can all be treated with a combination of self-care, social support, talk therapy, and medication, if necessary:
Baby Blues — A wide range of feelings including sadness and irritability that last up to three weeks and usually resolve on their own.
Depression — Anger, sadness, irritability, guilt, lack of interest in the baby, changes in eating and sleeping habits, trouble concentrating, and thoughts of hopelessness and sometimes even thoughts of harming the baby or herself that arise during pregnancy and during the first year postpartum.
Anxiety — Extreme worry and fear, often over the safety of the baby, that can manifest itself physically as shortness of breath, panic attacks, chest pain, dizziness, numbness, tingling and a loss of self-control.
Obsessive-Compulsive Disorder — Having repetitive, unwanted and upsetting thoughts or mental images (obsessions) and then performing something over and over again (compulsions) to reduce the anxiety caused by those thoughts.
Panic Disorder — A form of anxiety but with recurring panic attacks and possibly experiencing claustrophobia, heart palpitations and dizziness.
Post-Traumatic Stress Disorder — Having flashbacks of a traumatic or frightening childbirth or other event associated with childbearing and feeling the need to avoid things related to that event.
Psychosis — Experiencing hallucinations, seeing or hearing voices or images that others cannot; believing things that are not true and distrusting others. Someone experiencing this may also have periods of confusion, memory loss and seem manic.
Postpartum Psychosis — A rare but serious form of psychosis that occurs after the baby is born and affects 1–2 out of 1,000 women. Women can experience hallucinations along with delusions and paranoia. The results can be “devastating . . . in which the safety and well-being of the affected mother and her offspring are jeopardized," according to Dr. Dorothy Sit and colleagues. This is very serious and requires immediate medical attention.
You can further assess your symptoms by answering the questions on the Edinburgh Postpartum Depression Scale. It takes less than five minutes and is a good tool in knowing when to reach out for further support and professional help.
If you find yourself on the path to healing from a PMAD, please join our supportive online community, Kyte KLUB. We are a band of moms with one goal in mind: to care for each other. Feel free to ask questions, offer support, lend a listening ear, have some mom time and more in our safe space.
Just as you would take a walk for your physical health, wash your hair for good hygiene, brush your teeth for oral health, go to your annual gyno appointment for preventative health, you can do small and simple things to address your mental health daily. Here are 5 ways to take care of your mental health:
This doesn’t mean writing a novel, let alone a paragraph. Once a week, just write down one thing you are grateful for. Not feeling too grateful, it can be just a word like “baby,” “coffee,” “Target,” “pedicures,” “quiet” . . . you get the picture. Studies show that expressing thankfulness can help you sleep better, lower the risk of heart disease and soften symptoms of depression. But if you’re not feeling it, don’t push yourself. It can also have backwards affects too.
- Do something you’re good at
Not great at laundry but pretty decent at sweeping? Forget the pile of clothes and pick up the broom. Performing tasks that you enjoy or have a knack for builds self-confidence and can even give you the momentum to tackle something a little more challenging. And your “something” doesn’t have to be a chore? If you’re great at singing or baking, by all means, take a moment to do it.
- Get creative
This one is daunting to me because I am such a perfectionist. When an arts and crafts project doesn’t turn out just so, I self loathe. So this suggestion is all about the process and not the outcome itself. Read this excellent article from Forbes on why creativity is so beneficial for your mood.
In short, when we create something, the act of accomplishment manifests itself as an increase in dopamine, the feel-good chemical in our brain. So even if we don’t feel good about what we created, our brain does and that drives our motivation to accomplish even more. Moreso, repetitive creativity like knitting helps us focus which can calm our emotions and even lower heart rate; writing is a productive form of processing intense thoughts and feelings; and painting or coloring helps us express trauma and other emotions that are difficult to communicate. The next time your toddler is coloring, pick up a crayon and join him.
- Take an omega-3 supplement
Populations that consume a diet rich in omega-3s tend to have lower rates of mood disorders. This finding has led scientists to study the effects of omega-3s on the brain. Studies show that two omega-3 fatty acids EPA and DHA play an important role in the makeup and function of neurons. An article from the US National Library of Medicine National Institutes of Health proposes a link between depression and low levels of omega-3. If you already take medicine for a current mood disorder, consult your physician first before taking an omega-3 supplement as it can interfere with pharmaceutical drugs. If not, try eating salmon a few times a week or find a high-quality supplement with both EPA and DHA.
- Limit screen time
Just as you limit screen time for your kiddo, do the same for yourself. Social media too often portrays an unattainable perfection when it comes to physical appearance i.e., makeup, fashion, hair, and even decor and lifestyle. It is also full of misinformation and cyberbullying. Ask yourself if it serves you or lifts you up? If it does not, separate yourself from the vapidness of it all by putting the phone away for a few minutes. Take this time to feel the sunshine on your skin — a dose of vitamin D will help your body absorb that omega-3 even more efficiently — breathe, meditate or have one-on-one time with your loved ones.
And of course, please talk to a friend and seek professional help.
While the conversation around mental health is becoming louder and more accessible, it is still quite narrow and suffers from tunnel vision. Many people don’t see mental illness as more than depression and even more have never heard the term “maternal mental illness.” The spectrum of maternal mental illness varies vastly and needs to be redefined so more women feel like they fit into the definition and can, therefore, feel qualified to reach out for help and treatment.
Mental health is not picky, it doesn’t target just a few. We can all be victims of mental illness, especially when we conceive and become mothers. With this knowledge, let’s spread the word that mental illness is common, unique and can affect everyone, even dads. Check in with your mom friends and ask how she is really feeling. Use the hashtag #maternalmhmatters to spread awareness of PMADs, perinatal mood and anxiety disorders, and remember that mental health is treatable! It takes small but intentional steps. Take action by seeking parental support, practicing self-care and talking with a professional.
Motherhood can feel lonely but we can’t let it be lonely. Our mental health depends on it, on each other and ourselves.
Click the links below to find more information on Perinatal Mood and Anxiety Disorders, Mental Health and to find support near you.
- Postpartum Support International
- Women’s Mental Wellness
- Postpartum Support Virginia
- The Motherhood Center of New York
- Maternal Wellness Clinic
- Motherfirst: Maternal Mental Health Strategy
- Reproductive Mental Health Programme
For international groups, visit this site.