There are a lot of misconceptions and myths surrounding the mental health of pregnant women and new mothers. This is unfortunate, because misinformation can lead to a delay in or avoidance of treatment, which can be detrimental to both parents, the baby, and the entire family itself. In this article, I will attempt to clarify a few of the myths surrounding the arrival of a new baby.
1) PPD vs. PMAD:
We are most familiar with the term “Postpartum Depression,” and it is used most commonly, from casual
conversation to media presentation. But the reality is more complex. First, many women begin to experience difficulty with mood issues while still pregnant. To address that, the term “Perinatal” is more accurate. Additionally, Depression is only one of several issues many people face at this time of life. Anxiety, Panic, OCD, Bipolar, and PTSD are also commonly experienced problems surrounding the addition of a new family member. That is why “Perinatal Mood and Anxiety Disorders, or PMAD, is a more accurate term when discussing the spectrum of issues faced by new parents. Postpartum Depression is only one type of Perinatal Mood and Anxiety Disorder. The problem with using PPD as a more generic describer is that, many times, people who are suffering a great deal assume they don’t have “Postpartum Depression” because they don’t have the classic Depression symptoms, when in fact they are suffering with another mood or anxiety disorder. They may go untreated simply because of this misunderstanding.
2) “It’s Just The Baby Blues” or “It’s Been Too Long For This To Be Postpartum”
While 60-80% of parents report having a brief, difficult period adjusting to the demands of being a new parent, as well as adjusting to the swing of hormone levels after a birth, typical “Baby Blues” should last no more than two weeks. Baby Blues can include mild levels of crying, feeling overwhelmed, and being uncertain, as well as acute sleep deprivation and fatigue but you still have a predominant mood of happiness. If the symptoms are very severe, and/or if the distress continues after two weeks, it may be time to seek help. And you don’t need a “checklist” of symptoms before being distressed “enough” to get help. Often, we see people wait months before asking for help because they felt they didn’t fit a certain category of need. If you’re distressed, that’s enough. Additionally, many parents who begin to experience symptoms months after arrival of their child think it’s too late for it to be a postpartum issue, and therefore avoid seeking help. This is also a myth. Postpartum symptoms can appear almost a year after arrival of the baby.
3) “I Can’t Be Depressed, I’m Not Crying All The Time.”
We all have an image in our minds of what Depression or Postpartum Depression “should” look like, and if we don’t look like that, or if we don’t think we look like that, we assume we’re “fine.” First, take what you assume Depression looks like, and toss that away. As mentioned above, there are many faces to PMAD, which is why it’s no longer just called PPD, so I won’t repeat myself here. Additionally, even if you have Depression, your symptoms may not be the weepiness that we typically associate with Depression. Many people experience intense irritability instead of tears. Or big changes in sleep patterns such as not being able to sleep when the opportunity arises, or sleeping all the time. Changes in appetite, difficulty controlling thoughts, feelings of inadequacy, feeling numb; Depression can look very different from person to person and even from episode to episode. Some are unable to feel joy while holding their baby. Some are able to, and yet still have other symptoms of mood or anxiety disorder. Don’t be fooled by your mind’s picture of what a postpartum issue “should” look like. If you are distressed, unhappy, not functioning as well as you’d like or as well as you feel you could, perhaps it is time to seek help.
4) “Only Crazy People Get PPD” or “They’ll Take My Baby Away If They Know”
Let me first clarify: One in seven mothers experience a Postpartum Mood or Anxiety Disorder. While the symptoms are not a “normal” part of motherhood, they aren’t completely uncommon, weird, or “crazy,” as that 1 in 7 statistic shows.
One symptom that can occur with Postpartum OCD is something called “intrusive thoughts.” These are unwanted, frightening thoughts about something bad happening the baby. These thoughts seem uncontrollable, they’ll seem to “pop” into the person’s head, are viewed as awful and horrifying, and are often about harming the baby in some way. Mom (or even Dad) will often avoid certain situations because of these thoughts, in an effort to protect the baby. Parents who have these thoughts often avoid help for fear of their child being taken away because of the nature of their thoughts. And it doesn’t help that news stories about mothers who have Postpartum Psychosis, which is a different illness, but which is often mistakenly reported as “Postpartum Depression,” put even more fear into our hearts. But the reality is that there is a difference between Postpartum Psychosis and the intrusive thoughts related to Postpartum OCD, and that intrusive thoughts alone do not mean that you are a danger to your child. Postpartum Psychosis is when there is a break with reality such as delusions or hallucinations, and the thoughts about harming the baby seem reasonable to the parent. With the intrusive thoughts related to Postpartum OCD, there is low risk of harm. As noted above, the parent does not actually wish to harm the child, the thoughts are repulsive, and the parent often takes steps to protect the child by avoiding situations related to the thoughts.
With either situation, professional help can bring you relief. And even with Postpartum Psychosis, so much more is understood about this disorder than historically, so temporary hospitalization and recovery can mean reuniting with your family, whole and healthy. Early intervention is best, but get help as soon as you can.
You may have noticed this article uses the term “parents” often instead of “mother.” Studies are increasingly showing that Depression and other mood and anxiety disorders are increased among fathers and partners of mothers as well as adoptive parents after bringing a new baby home.
Among men, the symptoms may often be more irritability, aggressiveness, and hostility, as well as distancing by “checking out” and using distractions such as work or hobbies.
6) “It’s a Sign of Weakness” or “It’s All About Hormones”
As you can read in my next article, there are many risk factors that can contribute to PMADs. Yes, hormones play a role. And there are other biological/physiological risk factors. Family history of mood disorders gives a person higher susceptibility. Diabetes and a history of fertility treatment can also be risk factors.
There are psychological risk factors as well, such as a history of mood disorders, personally or within one’s family.
Additionally, there are environmental risk factors, including inadequate social support, financial worries, stress-related factors, big life changes, and more.
Lastly, there are exacerbating factors such as birth complications, a perfectionistic personality, sleep deprivation, and others. I will discuss the risk factors for PMAD more fully in my next article. Stay tuned.
If you feel it is time to seek help for your symptoms, please don’t hesitate. Untreated Perinatal Mood and Anxiety Disorder can have long term and adverse implications for parent, child, and family. You can contact a therapist, counselor, or social worker. We offer PMAD counseling services at the Adult Therapy and Cohesive Families Institute. You can also contact your OB/GYN for screening. You can contact a psychiatrist. You can contact Postpartum Support International through their helpline at 800-944-4773 or postpartum.net for support in your area.
“You are not alone. You are not to blame. With help, you will be well.”