“You were important before becoming a mom, and you are important after as well.”

The journey to motherhood is an exciting chapter of our lives filled with joy, love, and growth. 

It can also be a time of stress, anxiety, and emotional upheaval as the changes that come with pregnancy, childbirth, and caring for a newborn affect every aspect of our emotional, psychological, and environmental wellbeing. 

We may be surprised by how many emotions we’re capable of feeling throughout pregnancy. 

The internal shifts set off by pregnancy will likely rearrange other areas of our lives, such as how much time we spend with our partner, how often we go out with friends, how we like to dress ourselves, or the sheer exhaustion of navigating the world as a pregnant person. 

We’re not alone in experiencing perinatal (the period of time when you become pregnant and up to a year after giving birth), or postpartum (the period of time that begins after you give birth and lasts for six weeks) struggles, but it’s important to be proactive about our mental health and know when it’s time to seek help from trained mental health professionals.

We’ve asked two of our licensed clinicians, Cari Chapderlane-Cox, LICSW and Kelly Corrao-Fisher, LMHC to explain what perineal and postpartum depression involves, and how to improve our mental health through pregnancy, childbirth, and motherhood.

What are the warning signs of perinatal and postpartum mental health struggles?

If you’re experiencing depression while you’re pregnant, it’s called perinatal depression. If it’s in the year after you give birth, it’s called postnatal or postpartum depression.

“There’s a misconception that depression and anxiety only occurs “postpartum” or after giving birth,” says Cari. “Perinatal anxiety and depression are very common yet often ignored and overlooked.”

The changes that occur hormonally and physically, in conjunction with feelings of depression and anxiety, can have a real impact on expectant mothers’ health. For those of us who have a history of mental health conditions, perinatal depression can be even more challenging.

Signs and Symptoms of Perinatal Depression

If you have perinatal depression, you may be feeling:

• Down, depressed, or tearful
• Agitated, restless, or irritable
• Unfocused
• Overwhelmed with caring for self and completing daily tasks
• Guilty, worthless, or down on yourself 
• Isolated and unable to connect with others
• Foggy or a sense that things don’t feel right
• That you no longer find pleasure in life or things you usually enjoy
• Hostile or indifferent to your partner
• Hostile or indifferent to your baby
• Out of control with intrusive thought
• Suicidal feelings, delusion thoughts, hallucinations, or thoughts of hurting oneself or others

Signs and Symptoms of Postpartum Depression

Postpartum Depression (PPD), is a medical condition that many women experience after giving birth. It’s strong feelings of sadness, anxiety, and tiredness that last for a long time after having your baby. You may have PPD if you have five or more of the following symptoms that last longer than 2 weeks, 

• Feeling depressed most of the day every day
• Feeling shame, guilt, or like a failure
• Feeling panicked or scared a lot of the time  
• Severe mood swings
• Having little or no interest in things you used to enjoy
• Feeling tired all the time
• Eating a lot more or a lot less than usual
• Gaining or losing weight
• Having trouble sleeping or sleeping too much
• Having difficulty concentrating or making decisions
• Having trouble bonding with your baby
• Thinking about hurting yourself or your baby
• Thinking about suicide 

Feelings of postpartum and perinatal depression are valid and they are not your fault. If you’re thinking about suicide or have thoughts of harming yourself, you can call the 988 Suicide and Crisis Lifeline. 

The 24/7 hotline offers free and confidential emotional support to people who are in crisis, distressed, depressed, or suicidal.

What To Do When Experiencing Symptoms of Postpartum or Perinatal Depression

1. Treatment

If you’re experiencing symptoms of perinatal and postpartum depression, talk with your doctor about all of your treatment options. You and your provider will work together to create a treatment plan that best fits your needs and your baby. 

2. Medications 

Many of us may be concerned about continuing to use prescribed medications during pregnancy and postpartum. 

If you’re taking psychiatric medications, you may benefit from speaking with a reproductive psychiatrist who can help you make informed decisions about medication use and management. Ideally, this happens when you’re planning for pregnancy, although this isn’t always possible. It’s never too late to meet with your doctor. 

3. Talk Therapy 

Evidence-based therapeutic interventions, such as Cognitive-Behavioral Therapy (CBT) and interpersonal therapy, are proven to be effective for perinatal and postpartum depression.  

“CBT will assist new or expecting moms in identifying counterproductive and potentially harmful thoughts and behaviors: providing her with ways to target, challenge, and change these behaviors to decrease depressive symptoms and increase overall functioning,” says Cari. 

Cari explains that interpersonal therapy will help new or expecting moms gain a better understanding of how the life changes she experiences impacts her mood and interpersonal relationships. Moms will learn how to improve their communication skills, strengthen existing relationships, as well as build support networks. 

Mental Health Tips For New and Expecting Moms

1. Try to implement a routine

A simple and flexible routine can help new and expectant mothers sustain or improve their mood. It can feel grounding to write down your daily routine, putting it somewhere that you can easily refer to. 

Cari says that it’s important to take time for yourself everyday to connect with the “you” that isn’t a new mom or partner. It could be taking a walk around the block, getting coffee with a friend, enjoying a cup of tea early in the morning, or curling up with a good book.

2. Eat nourishing foods

Eating nutritious foods can do more than just nourish your body, it can improve your mental health and wellbeing. Some foods that contribute to positive mental health before, during, and after pregnancy include, vitamins B2, B6, selenium, DHA, and zinc. 

3. Go for a walk in the sun 

Getting out of the house and moving your body in the fresh air can drastically improve your mood and offer a change in perspective. A walk in the sun can increase your serotonin levels which is key in helping combat depressive thoughts and feelings.

4. Ask for help and support 

There are times in our lives when we need the help and support of others, especially trained mental health professionals. If you don’t already have an established relationship with a therapist, try to find one during the process of your pregnancy, instead of waiting until you’re busy taking care of your newborn. Of course, it’s never too late to start working with a therapist. Look to your loved one’s and friends for help finding and scheduling appointments with a provider.

5. Lean on your social network

Ensure that you’re staying connected to your network of friends and family. Loved one’s can help take the pressure off your busy schedule, and provide comfort and care when you’re feeling overwhelmed and need an outlet. If you need help with your mental health, don’t be afraid to ask for support. Talk to your partner, family member, or close friend about how you’re feeling to engage with their support.

6. Prioritize your rest and sleep

Sleep can be challenging to come by once your baby arrives, but Kelly stresses that rest is one of the most important factors in your mental and physical recovery after birth. If you’re struggling to sleep when your baby sleeps, consider asking a loved one to babysit for a few hours so you can catch up on rest.

7. Show yourself compassion

Life as a parent is full of challenges but acknowledging this truth and being kind to yourself through the process is not only vital to your mental health, but sets the tone for your whole family. 

Remind yourself that there’s no such thing as a perfect parent or partner. Adapting to your new role as a mother will take time, and no one is expecting you to know everything.

Remember, when your baby is born, so is a new mother.

Find Pregnancy and Postpartum Therapy in Massachusetts

At Handel Behavioral Health, we understand the stress that comes with motherhood, and want you to know that you are not alone in how you’re feeling. 

If you’re feeling a significant amount of stress or uncertain if what you’re experiencing is typical of pregnancy, call us today at (413) 343-4357 to schedule an in-take appointment with one of our providers. 

Our trained therapists and counselors are here to start working with you online or in our offices in Amherst, West Springfield, Franklin, Natick, or Wilbraham.

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