It's Maternal Mental Health Week and local Licensed Professional Counsellor, Jacintha Carson is here to answer your questions about difficult thoughts and feelings that can come up in pregnancy and postpartum, her own experience with postpartum anxiety, and how mind-body practices like yoga can support mental health and wellness.
Maternal mental health issues are the number 1 complication of pregnancy. As many as 1 in 7 women and 1 in 10 men suffer from mental health disorders related to pregnancy and postpartum but there are significant barriers to diagnosis and treatment.
Mothers are at an increased risk for mental health problems during the pregnancy and postpartum for a variety of reasons: drastic changes in hormones, redefining of roles and relationships, identity shifts that come from having more responsibilities, and those are just a few. Even when these changes are anticipated, the day-to-day reality of new parenthood often doesn’t match up to the expectations of that time. That is why it is so important to reduce the stigma of talking about and experiencing mental health issues in pregnancy and postpartum and to allow mothers to see and hear that they are not alone and help is available!
Most people have some awareness about postpartum depression (PPD) but there are other less expected ways that mental health issues show up. The terminology that is now used for mental health problems occurring in pregnancy and postpartum is Perinatal Mood and Anxiety Disorders (PMADs). This term is more inclusive of the range of issues that can affect both expectant and new moms.
Postpartum Anxiety and OCD
I want to focus here on Postpartum Anxiety and Obsessive Compulsive Disorder (OCD) because it tends to be that people know less about these problems than postpartum depression. (For more on Postpartum Depression, see here)
Everyone has anxiety
It’s important to know that everyone gets anxious sometimes. Anxiety is our body’s alarm system that alerts us to danger. Sometimes that alarm system malfunctions, especially if we are on high alert for a longer time, or we have a history of scary things that happened in the past that might cause our anxiety alarm systems to misfire.
Anxiety in the postpartum phase is common. New moms or pregnant women may have many worries, which can include:
· What if I’m a bad mom?
· What if my baby cries and I don’t know what to do?
· What if I can’t handle being a parent?
· What if everything changes and I don’t like it?
· What if something is wrong with my baby?
If you feel your anxiety is out of control and preventing you from doing or enjoying things you would normally do or enjoy, reach out for help to determine if you could be suffering from an anxiety disorder. Again, anxiety is a normal part of the perinatal period, but if you feel it is intense, lasting longer than 2-3 weeks, and affecting your daily life, reach out for support.
Scary thoughts and images
Postpartum OCD can come in the form of scary thoughts; unwanted, intrusive, repetitive scary thoughts or images. These thoughts can include general worries of something bad happening to you or your baby. They can also be more specific, such as images or thoughts of dropping the baby, or other specific things happening to you or your baby that scare you.
For me, this is how I knew I needed help. I had never experienced these scary, intrusive images and thoughts before, even though I knew I had anxiety throughout my life, so I was blindsided and scared. With the help of a therapist, and my own research on the subject, I learned that intrusive thoughts in the postpartum period are common and DO NOT equal intent. I’ll say that again for those that need to hear it. Scary thoughts or images DO NOT equal intention to do harm. If you are horrified by your scary thoughts, like I was, that is actually a good sign that you don’t have intentions to harm yourself or your baby. For many women, there is a fear of speaking up because they might be scared that someone will take their baby away or they will be labeled an “unfit” mother. Not true! It’s VERY treatable with therapy and/or medication and other supports! You don’t have to suffer through it alone! Reach out for support to a health provider you trust, or call the PSI hotline at 1-800-944-4773, you can also use the text line at 503-894-9453.
Creating your care plan
Support, Support, Support! As new moms, we need more support than we may have ever needed. It’s important to find a variety of supports that make up a system that works best for you. Especially in the current times, it can be incredibly isolating being home with a newborn and having all your attention on your baby. Luckily, there are lots of options for support.
Some examples include:
· Asking your immediate support networks for help with meals, chores, cleaning, laundry if you are able to. Think friends, family, coworkers, religious groups and community organizations. In the time of COVID-19 ask people to leave food or subscribe you to a meal preparation service. Allow yourself to receive any help that is offered, especially in the first few months.
· Connect with a local mom’s group: Local support organizations such as P.A.C.E, and INOVA offer new mom’s groups that can be normalizing and powerful - both of these groups are currently being offered in a virtual format. I participated in a P.A.C.E group and recommend it to everyone I know. Postpartum Support International and Postpartum Support Virginia websites have lots of helpful resources and directories of providers that specialize in maternal mental health.
· Work with your medical care team (PCP, therapist, psychiatrist) and anyone who can help you advocate for your health and have regular check ins to monitor how things are going. Tell your doctor if you don’t feel like yourself. It’s important to have that conversation and can prevent you from suffering unnecessarily on your own.
· Sleep - get as much as you can because sleep affects EVERYTHING. Ask for help with the baby if needed so you can take a nap whenever you can, especially in the first 3 months post birth.
· Seek ways to connect your body and mind through exercise, meditation, yoga, etc.
The Postpartum Stress Center was a key resource in my own journey for reading and learning about my symptoms and hearing stories from others. Sometimes it’s helpful to hear the words of others so you can figure out examples of how to describe, in your own words, what is happening for you. I highly recommend the book 'Good Moms Have Scary Thoughts: A Healing Guide to the Secret Fears of New Mothers' written by Karen Kleiman, the founder of The Postpartum Stress Center. The style of this book is more like a comic book with images and information in a visually friendly way that makes the topics relatable and accessible for anyone curious about PMADs. Postpartum OCD is one of the topics discussed in the book, with examples of thoughts that are common for new moms.
Mind-Body Connection in Pregnancy and Postpartum
Through pregnancy and postpartum, your body changes so much during the perinatal period. It’s important to find ways to love and accept these changes instead of putting unnecessary pressure on yourself to 'bounce back' in an unrealistic period of time. It can be common to feel like your body is not your own during this time due to feeling 'touched out' from always carrying a baby, breastfeeding, etc. It’s important to remind yourself that you birthed a human! Your body is amazing! Treat it that way.
Yoga has been such an essential way for me to create that connection for myself. Through Claire’s prenatal and postnatal yoga classes and the Yoga & Mindfulness for Labor & Birth workshop, I learned so much about being more in tune with my body and embracing the messiness that came after having a baby.
Yoga has so many known and researched benefits that have been shown to reduce anxiety and depression, in addition to the physical benefits of increased strength and flexibility. I highly recommend starting your own yoga practice or routine for an added way to reduce stress and connect with your body in a healthy way.
Stay well mamas!
Teletherapy appointments are available!