Perinatal Mental Health is an umbrella term used to describe the variety of mental health issues that women and their partners can experience during pregnancy and the postpartum period. Mental health issues during this period are extremely common worldwide, with as many as 1 in 5 women experiencing depression and/or anxiety (e.g., O’Hara and Wisner, 2014). Although less research has been conducted on male and female partners of pregnant women and new mothers, partners also frequently experience similar mental health difficulties. For example, research suggests that during the first postpartum year, as many as 1 in 4 fathers may experience depression, with rates rising to as high as 1 in 2 among men whose partners are experiencing perinatal mental health issues (e.g., Goodman, 2004).
The exact nature and intensity of these difficulties vary from person-to-person, and can include any combination of the following: anxiety, depression, trauma, loss, and unexpected complications in mothers, infants, and children, psychosis, and a variety of other common stressors. These very real struggles are often not talked about, which can add an additional layer of stress to the shame, stigma, confusion, and isolation that you may face. It can be hard to make sense of these symptoms, and as a result, you may wonder whether you are “crazy,” “weak,” a “bad person,” or “not cut out to be a parent.” While these reactions are completely understandable, it’s important to remember that these are common symptoms in response to legitimate stressors, and do not define you.
At Opened Heart Therapy, we offer a variety of treatment approaches to address the broad range of difficulties and concerns you may experience during the perinatal period. Regardless of where you are in your parenting journey – trying to conceive, new to parenthood, parenting adult children, coping with grief and loss – we are here to help. Please read below to learn more about common difficulties during this period and reach out to us with any questions you may have. We’d love to hear from you!
Trauma, Loss, and Unexpected Complications in Mothers, Infants, and Children
In response to trauma, loss, and unexpected complications in birthing mothers, infants, and children, many families struggle with powerful and overwhelming shock, pain, grief, and devastation. In addition to how intense and consuming these experiences may be, many families may feel quite alone and isolated, as though no one quite understands exactly what they are going through or how difficult it is. Well-intentioned loved ones may also exacerbate feelings of sadness, anger, self-blame, and guilt in their attempts to be supportive.
If you are experiencing any of the following, please know that help is available. Therapy can help you feel less alone and more understood, and make life more livable and these painful experiences more bearable.
- Difficulty with conceiving and infertility
- Pregnancy losses, including miscarriages, stillbirths, terminations, and neonatal deaths
- Unexpected medical complications in infants and children, including cancer and other illnesses, genetic and/or chromosomal abnormalities, and physical or mental disabilities
- Challenges related to premature births, “failure to thrive,”* feeding difficulties, and/or developmental delays
- Unexpected complications in birthing mothers (e.g., traumatic birth experiences, birth injuries, medical issues or complications during labor or the postpartum period)
- Activation or triggering of trauma history and trauma reminders in response to pregnancy, labor and delivery, nursing, and parenting
- Relationship tension and conflict in the context of any of the abovementioned stressors
*Although “failure to thrive” is a term commonly used in the medical world, we know that this term can be very painful for families and exacerbate the stigma and self-blame they may already experience. We don’t endorse the use of this term for all families for this reason, but use it here to call attention to the negative impact it can have on families.*
Symptoms of perinatal anxiety may include intrusive and/or repetitive thoughts or images about harm coming to you or your family, worry that feels disproportionate or out of control, racing thoughts, physical restlessness, difficulty sleeping or concentrating, irritability or anger outbursts, and stress-related physical symptoms. Symptoms of panic (e.g., intense worry and physical symptoms such as racing heart, difficulty breathing, chest pains, headaches, heart palpitations, sweating, trembling, etc. that are so intense that you feel as though you might be having a heart attack or will pass out or die) are also common. Anxiety symptoms may also cause relationship conflict, negatively affect work performance, and interfere with your ability to stay present, experience joy, and make decisions that are not driven by anxiety.
Symptoms of perinatal depression may include intense sadness, frequent crying, difficulty bonding with children, feeling disconnected from your intimate partner and other loved ones, decreased interest in being a parent, feelings of self-blame, self-doubt, guilt, or worthlessness (especially related to parenting), loss of interest in activities that were previously enjoyed, sleep difficulties (e.g., not being able to sleep even when extremely tired, sleeping more than usual without feeling rested), cognitive difficulties (e.g., difficulty focusing even with intense effort, remembering, making decisions, completing tasks staying organized), irritability or anger outbursts, changes in weight or appetite, excessive worry about safety and health of you and/or your family, thoughts of killing yourself or wanting to be dead, scary thoughts that are repetitive, ruminative, and feel out of control, stress-related physical tension or problems, struggles with identity and the transition to parenthood, feeling emotionally numb or disconnected, social isolation, and lack of motivation. Depressive symptoms may also cause relationship conflict, negatively affect work performance, and interfere with your ability to stay present, experience joy, and make decisions that are not driven by your mood.
Symptoms of psychosis may include sudden and/or intense changes in mood, seeing or hearing things that are not observable to others, thoughts that are disorganized and/or not grounded in reality, difficulty functioning across a variety of domains, difficulty concentrating, and scary thoughts about harming oneself or others. Although these symptoms can be extremely frightening and can feel very out of character, they are responsive to treatment. However, evaluation and treatment should be sought immediately given perinatal psychosis can be quite severe and sometimes life-threatening.
Other Common Stressors
In addition to the above difficulties, other common stressors during the perinatal period that may benefit from therapy include the following:
- Clarifying your birth vision and plan
- Collaborating with birth partners regarding labor support, coping strategies and effective communication
- Reviewing and coming to terms with unexpected birth experiences
- Coping with your transition into parenthood
- Exploring your ambivalence, fears, anxieties, and disappointments about pregnancy, birth and parenting
- Negotiating different parenting styles and preferences
- Relationship conflict in the context of any of the above