Defining Postnatal Mental Health
It is important to note that there are many defining labels to the wide spectrum of mental health disorders that present during the child birthing years, and that these labels or identifying names vary by region and country. The word ‘Perinatal’ refers to time within the span of pregnancy, birth, and postpartum. Most often, these mood disorders are categorized under one of these terms: Perinatal, prenatal, postnatal, postpartum, PMADS (perinatal mood and anxiety disorders) or PMH (perinatal mental health).
The most common PMH issue we hear about is postpartum depression (PPD, or postnatal depression- PND) but there are many more PMH categories that you may not have heard about including OCD, psychosis, bipolar disorders, PTSD, and anxiety. All of these can be given a label to indicate the period of time in which they are experienced (perinatal- anytime during pregnancy, birth, or postpartum. prenatal- during pregnancy. Postpartum/postnatal- after birth and up to 3 years later) These issues can all be experienced on different levels of severity, and vary individually. In both the UK and the USA more than 1 in 10 mothers will experience a PMH disorder. Fathers are also at risk. The risk number goes up when factoring in birth trauma, disparities, child loss, miscarriage, previous mental health histories, previous traumas, and more. More than half of the population who suffer from mental health struggles, in the UK and the USA are parents of young children.
Today, were going to explore one of these under discussed PMH issues- Perinatal Anxiety.
What is Perinatal Anxiety
Perinatal Anxiety can present itself anytime during pregnancy, birth, or postpartum. It can go hand in hand with other PMADS, most often- Perinatal depression, but it can also be experienced on its own. Anxiety is more than an increase in fear or worry, which can be a normal reaction to the changes we go through during this time; however, an increase in fear or worry can be a symptom when experienced severely or in combination with other symptoms. Anxiety can take on many faces, and present in many different ways.
Signs of Perinatal Anxiety
Here are some things to look out for, that may indicate someone is suffering from a form of anxiety, or possibly another PMH issue:
- Fear- this one is most commonly associated with anxiety. This can present as new fears, old fears that have grown in persistence, or an overwhelming amount of worry that you cannot seem to shake off despite reasoning. Fear is a normal emotion during the perinatal period, but should be reasonable and easy to dissuade with knowledge or comfort over time.
- Obsessive thoughts- Thoughts that won’t go away, like pop up adds, they keep coming and coming and coming to the mind no matter how often they shake them or push them away. They may be obsessive fears. They may be habitual related, obsessively wondering if they locked the door, or turned off a light, despite knowledge that they did complete this task. It can present as obsessively checking to make sure the task has been completed over and over- the thoughts or actions returning endlessly. They may also present as a high energy train of thought, an inner dialogue the person can’t seem to slow down or relax from, a high-strung frame of mind that won’t chill out. They may obsessive over small details.
- Rage- Being extremely or often irritable, or lashing out over small or non-existent issues. The person may lash out when sudden changes are presented to them that they were not expecting, or if they must adapt to a new situation quickly. This can also be a symptom of lack of sleep, which can increase the risk for developing a PMH.
- Panic attacks- These can look very different from person to person. A panic attack can look like a fight or flight response, it can include shaking, increased heart rate, sweating, nervousness, dizziness, hot flashes, stomach aches, sudden exhaustion, and more. You may notice the person displaying these symptoms, or you may notice them retreat inwardly and become visually unresponsive to the world around them as they attempt to process what they are experiencing. Stomach aches that are persistent or situational can also be a symptom.
- Avoidance- Avoiding certain people, locations, or topics.
- Energy issues- These can present in many different ways. They may experience high energy boosts that seem manic, obsessive, or concerning. They may feel restless, confused, unable to focus, often dizzy, or hyper focused. They may have trouble sleeping, staying asleep, or trouble staying awake during the day.
Finding Help for Perinatal Anxiety
There are many more symptoms and ways Anxiety can present itself, and if you are concerned that you or a loved one may be experiencing it, you should seek help as soon as possible. There are so many great resources for this. You can find online therapy, support groups, and help lines. Mothers who have experienced perinatal anxiety often find healing through a combination of talk therapy, peer support, and medication. While, it is important to remember that some things like birth trauma and situational events can increase a woman's risk for postpartum anxiety- it is not biased. Meaning- it can affect anybody no matter what type of birth or life they have. It is also important to remember that there is no one to blame in these situations. People who suffer from anxiety of any kind can not will it away, because it is not something they choose, it is not something in result of their thoughts or actions, it is not their fault in anyway but it is a medical diagnosis, and a mental illness, as real and treatable as any physical illness.
One of the most important things to do if you are struggling with anxiety, is to speak up and reach out. You do not have to brave this alone, and your chances of recovery are higher if you speak to multiple people about what you are going through. If the first person you speak to is not supportive, do not be afraid to reach out to someone else. Speak to your doctor or midwife, your friends, your family, anyone who can help you through this time. They can help you create a plan and help you start on a path to healing, to joy, and to reclaiming your mental health. The best thing you can do for yourself, your family, and your baby, is to take care of yourself. A healthy happy mum, that is the goal! Your mental health matters, your experiences and thoughts matter, you are not alone, you are not to blame, and there is great potential for help and healing in your future.
My Story with Perinatal Mental Illness
When I first became a mama, it took me 5 months to realize that what I was going through (PPA, PPD, and PTSD) was not routine or normal after birth, and another 2 months after that to admit my struggles and find the help I so desperately needed. I wish I had spoken up sooner, or been given the resources to understand what I was going through before it got that bad. I feel if I had, those moments of my baby's life that I will never be able to repeat, wouldn’t have been so lonely and heartbreaking. I wish I could get those moments back, but they are washed over with pain and blackness.
We had a very rough start. I fought many stigmas around mental health as a mum, I was overwhelmed by the fears of motherhood, fears that my anxiety increased to unbearable levels. I thought I had made a mistake in becoming a mom, and feared that my child was given a raw deal. It took a very long time for me to feel like I deserved to be his mum, and even longer to embrace the beautiful power in that role. When I started reaching out to ask for help, the first few people I talked to had no idea what to tell me, or where to direct me, and had never experienced anything like what I was going through. I felt isolated, and ashamed, and I hit many dead ends before I found the right path. I finally found people who recognized and understood my PMH struggles. They brought me education, and priceless perspective, they took my hand in theirs and walked with me on the journey towards healing.
On that path, I found so many lessons and wisdoms that I will cherish in my heart forever. I found ways to love myself and my child that changed our lives. I found joy in motherhood again. I found passion, and life, and peace. On the good days, I felt like the bad ones were an exaggeration of imagination. On the bad days, I felt like the good ones were a lie. There were so many ups and downs, and those PMH struggles are still a part of my history and story, and will be forever. I will never forget the first time someone reached out to me, and instead of having to shrug my shoulders and give them pity as so many did for me- I was educated enough to give them real resources and comfort. There is no better feeling then being equipped to help someone through something you had to suffer through yourself. I had so little support in the beginning, it brings me great joy to be that support now to other mamas, to fill that gap in even just one story.
The more we talk about these issues and realities, the more that people know and speak and share- the less future mums will have to suffer. I am honored to connect with Super Mumma and their partnership with PANDAS, to be a part of this future that all birth workers and supporters aim to create. A future of empowerment, and educated unconditional support. May no mother suffer needlessly, when there is healing and help ready for her.
-Written by Leann Allen, Birth Keeper, Birth Photographer, Postpartum worker
Trained in PMADS and maternal mental health by Postpartum Support International
Wife, mother, and survivor of PPD, PPA, and birth PTSDhttps://wildwoodbirthkeeper.com/
Sources and Resources: