Maternal Mental Health Disorders impact up to 1 in 5 families.
Moms are the anchors in their households. When a mom isn't well, everyone suffers. Maternal Mental Health disorders impact 15-20% of pregnant women and women in the postpartum period (year after birth), yet most are never diagnosed and treated.
By conservative estimates, this means more than 600,000 women in the U.S. suffer each year.
These experiences can have lasting consequences on a mother and her family including her infant's cognitive and behavioral development, the well being of other children and her relationship stability.
Facts
According to the American Academy of Pediatrics, depression and anxiety disorders are one of the most common, yet most under-diagnosed, obstetrical complications in the country. Research suggests that 15-20% of the approximately 4 million U.S. women who give birth each year will be affected by a maternal mental health disorder, which occur during pregnancy and up to one-year postpartum.
Despite the high prevalence, many doctors and other medical professionals remain unfamiliar with the signs of maternal mental health concerns and it is estimated that only about 15% of those women will get the help and treatment they need.
Maternal mental health disorders like depression and anxiety impact 15-20% of women during pregnancy and the postpartum period. That's up to 1 in 5 pregnancies and a lot of moms and families who have suffered and are suffering now.
Following is a summary of a large-scale research study on postpartum depression and anxiety (2013).
Moms are Not Routinely Screened
Pregnant women and mothers in the postpartum period are not routinely screened for maternal mental health disorders, though there are recommended screening questionnaires (referred to as tools). This is largely due to a shortage of and the inability of screening providers to find easily qualified healthcare providers who can provide necessary treatment, including psychiatrists -Medical Doctors (MDs) who can prescribe medication when necessary, and therapists like psychologists, social workers, counselors, and more.
Prevalence as Compared to Cancer or Gestational Diabetes
According to the U.S. Centers for Disease Control (CDC), there were 3,952,841 births in 2012. And women who have pregnancy loss can also suffer from a maternal mental health disorder. Source: FASTSTATS - Births and Natality
15-20% of women (592,926-790,568) will suffer from maternal mental health disorders surrounding pregnancy.
According to the American Cancer Society, the most recent estimate of new cases of invasive breast cancer was about 232,570 (2009). Source: How many women get breast cancer?
According to the American Diabetes Association, it is estimated that Gestational Diabetes impacts up to 18% of pregnancies. It's also important to note that women who have any form of diabetes, including gestational diabetes, are at great risk of suffering from maternal depression.
About Maternal Mental Health Disorders
Maternal mental health disorders are not the “baby blues,” which impact up to 80% of women and includes unexplained tearfulness resulting from sharp changes in hormones. The blues resolve naturally within two weeks.
While many women feel stigmatized by asking for help, disorders like postpartum depression are a legitimate medical concern with biological influences and generally require treatment. They may make it difficult for women to care for themselves or their family and put them at a significantly higher risk of suicide. In extreme cases of psychosis (which affects .1 to .2% of all new mothers), in which a woman may become delusional and paranoid, it can result in a mother taking her child’s life (infanticide).
However, there is effective treatment and women do not need to suffer in silence. The earlier a woman seeks professional help, the greater the likelihood of physical and emotional recovery.
What causes maternal mental health disorders?
These disorders do not have a single cause, but likely result from a combination of physical, psychiatric and environmental risk factors. Postpartum depression does not occur because of something a mother does or does not do.
Immediately after childbirth, the levels of hormones (estrogen and progesterone) in a woman’s body quickly drop. This leads to chemical changes in her brain that may trigger mood swings. In addition, many mothers are unable to get the rest they need to fully recover from giving birth. Constant sleep deprivation leads to physical discomfort and exhaustion, which can contribute to the symptoms of postpartum depression.
Maternal mental health disorders can affect any woman regardless of age, race, ethnicity or economic status. However, some women are at greater risk for developing postpartum depression because they have one or more identified risk factors, such as:
· Personal and/or family history of a mood or anxiety disorder.
· Symptoms of depression during or after a previous pregnancy.
· Fertility issues and/or previous pregnancy loss.
· Mixed feelings about the pregnancy, whether it was planned or unplanned.
· Relationship and/or financial stress.
· Recent big life changes such as moving, a new job or loss of a job, getting married, personal illness, death of a loved one or domestic violence.
· Medical complications during childbirth or traumatic childbirth.
· Having a baby in the NICU or a special needs baby.
• A lack of strong emotional support from spouse, partner, family or friends.
• Alcohol or other drug-abuse problems.
· Sudden discontinuation of psychotropic medication.
How can a woman tell if she has a maternal mental health disorder?
Only a healthcare professional (medical doctor or licensed therapist, psychologist or psychiatrist) can diagnose a woman. Because symptoms are broad and may vary among women, a healthcare provider can help a woman figure out whether the symptoms she is experiencing are a maternal mental health disorder or attributable to other issues.
Before diagnosing a mood or anxiety disorder, healthcare professionals should first rule out physical disorders, such as hypothyroidism or hyperthyroidism.
Symptoms of a maternal mental health disorder may include:
· Feeling sad, hopeless, empty or overwhelmed.
· Crying more often than usual or for no apparent reason.
· Excessive worry, anxiety or fear.
· Feeling moody, irritable or restless.
· Oversleeping or being unable to sleep, even when her baby is asleep.
· Having trouble concentrating, remembering details and making decisions.
· Experiencing anger or rage.
· Losing interest in activities that are usually enjoyable.
· Suffering from physical aches and pains, including frequent headaches, stomach problems and muscle pain.
· Eating too little or too much.
· Withdrawing from or avoiding friends and family.
· Having trouble bonding or forming an emotional attachment with her baby.
· Persistently doubting her ability to care for her baby.
· Experiencing
How are the “baby blues” different from postpartum depression?
The “baby blues” is a term used to describe the feelings of stress and fatigue that many women experience after having a child. Babies require a lot of care, so it’s normal for mothers to be worried or tired from providing that care. The baby blues, which affects up to 80% of mothers, includes fairly mild feelings that last a week or two and go away without intervention.
With postpartum depression and mood disorders, feelings of sadness and anxiety can be extreme, may interfere with a woman’s ability to care for herself or her family, and generally requires treatment. The condition may begin shortly before or any time following childbirth. It most commonly begins between a week and a month after delivery but can manifest up to a year postpartum.
How is postpartum depression treated?
There are a variety of effective treatments for postpartum depression, which may be recommended singularly or in combination. A woman’s healthcare provider can help her choose the best treatment for her, which may include:
Social Support Groups: There are hundreds of free, ongoing social support groups for pregnant and new moms throughout the country. These groups are run by women who have experienced maternal mental health disorders themselves and/or who are healthcare professionals. In the support group setting, women have an opportunity to experience normalization and validation of their experience while obtaining useful advice and making important interpersonal connections with other new mothers.
Counseling/Talk Therapy: Involves talking one-on-one with a mental health professional (counselor, therapist, psychologist, psychiatrist or social worker). The two types of counseling shown to be particularly effective in treating postpartum depression are:
· Cognitive behavioral therapy (CBT): Helps people recognize and change their negative thoughts and behaviors.
· Interpersonal therapy (IPT): Helps people understand and work through problematic personal relationships.
Adjunct and Complimentary Therapies: Omega-3s, lightbox therapy, acupuncture and massage have all been shown to assist in recovery from perinatal mood and anxiety disorders.
Medication: Antidepressant medications act on the brain chemicals that are involved in mood regulation. Many antidepressants take a few weeks to be most effective. While these medications are generally considered safe to use during breastfeeding, a woman should talk to her health-care provider about the risks and benefits to both herself and her baby.
What is postpartum psychosis?
A smaller number of women (1-2 out of every 1,000 births) suffer from a severe maternal mental health disorder called postpartum psychosis. Women who have a personal or family history of bipolar disorder or a history of a psychotic episodes are at higher risk for postpartum psychosis.
The onset of symptoms is usually sudden, within the first month following birth, and can include:
• Delusions or strange beliefs.
• Hallucinations (seeing or hearing things that others do not).
• Severe irritability.
• Hyperactivity or its opposite, physical retardation or catatonia.
• Significantly decreased need for sleep or inability to sleep.
• Paranoia.
• Rapid mood swings.
• Difficulty communicating.
If a pregnant woman or new mother is experiencing these symptoms, she requires immediate intervention. Postpartum psychosis is considered a medical emergency due to the potential for a mom to harm herself or her baby.
Find Help & Social Support
The National Maternal Mental Health Hotline is available to families and those in need. Call 1-833-TLC-MAMA (1-833-852-6262). TTY users can use a preferred relay service or dial 711 and then 1-833-852-6262.
Find trained treating mental health providers through the Postpartum Support International Online Directory.
Find connection and support through community-based non-profits through the Policy Center for Maternal Mental Health’s Community non-profit map.