The transition to motherhood is marked by hormonal fluctuations, sleep deprivation, and adjustments to a new role, potentially impacting a woman's mental well being. The significance of this topic lies in the potential long term consequences of untreated postpartum mood disorders, affecting not only the mother but also her family unit. Unaddressed postpartum mood disorders can disrupt the formation of a secure mother child attachment and hinder the child's emotional regulation and overall mental health.
1 in 5 mothers are affected by mental health conditions during pregnancy and postpartum. Mental health conditions are one of the leading causes of maternal mortality, accounting for 22% of pregnancy related deaths. Additionally, 75% of cases go untreated, which can lead to lasting effects on mom, dad, and baby.
What Are PMADs?
When we talk about postpartum mental health we are talking about perinatal or postpartum mood and anxiety disorders (PMADs). You also might hear the term "perinatal" which refers to the time from pregnancy to the end of the first year postpartum. You might hear people talk about the "baby blues" but this is different from PMADs. Baby blues refer to the period of adjustment after having a baby when moms may feel physically and emotionally overwhelmed and have mood swings. These usually resolve as hormone levels normalize again after a few weeks. PMADs occur when baby blues symptoms last beyond a 2 to 3 week period and become worse or begin to interfere with everyday living. They start to interfere with your ability to care for your baby and yourself.
Types of PMADs
- Perinatal/postpartum depression
- Perinatal/postpartum anxiety
- Perinatal panic disorder
- Perinatal obsessive compulsive disorder
- Postpartum post traumatic stress disorder
- Postpartum psychosis
Early identification and recognizing symptoms is so important for getting proper treatment. See the Maternal Mental Health fact sheet for more information.
Guest Speaker
On this episode, we feature guest speaker Caitlin Sparks. Caitlin recently graduated from The University of St. Mary with her doctorate of occupational therapy. She did her capstone project within the postpartum care setting and developed a prevention and education resource for new mothers called "Functional as a mOTher". This curriculum was designed to support pregnant and postpartum mothers through educational modules.
"Functional as a mOTher" Curriculum
Caitlin created a community based group for perinatal mothers to help prevent and identify PMADs. It was shaped by the cognitive behavioral frame of reference and Jane Honikan's 7 steps of wellness. Her curriculum has 7 modules:
- Setting the stage: introduction, ice breakers, teach the first mindfulness strategy (controlled breathing)
- The postpartum brain: teaches about how the brain changes and the first coping strategy of restructuring negative thoughts
- Barriers in seeking help: recognizing PMADs, the impact of social media and culture. Teaches progressive muscle relaxation.
- Neuroscience behind PMADs: education on the body's fight or flight system
- Steps to wellness: focus on occupations (sleep, nutrition, movement). Teaches self talk and affirmations.
- Cognitive behavioral strategies: behavior activation and activity scheduling
- Support and resources: offers emotional and practical support, resources, and designs a plan of action
What Is the Cognitive Behavioral Frame of Reference?
The cognitive behavioral frame of reference involves rewriting the story of our brains. Our brain makes up a story and we can choose to believe or rewrite it with our strategies. This frame of reference teaches each of us to reframe our negative thoughts and feelings. It centers on changing dysfunctional thought patterns to improve daily performance.
Mindfulness Strategies to Practice
- Controlled breathing: Easy to do wherever you are (feeding, driving, showering). Box breathing means breath in for 4, hold for 4, breath out for 4, hold for 4. Hand breathing means inhale as you trace up your finger to the tip, exhale down.
- Progressive muscle relaxation: For example, clench and relax your fists.
- Self talk and affirmations: Scripts for yourself such as "I am a good mom" and "I am safe."
Practice these things before you are in crisis!
Activity Scheduling and the Impact of Routines on Mental Health
Activity scheduling is a behavioral treatment used for mental health disorders, especially depression. It focuses on increasing engagement in social activities and rewarding activities. It talks about the impact someone's behaviors and actions have on their emotions. Activities are scheduled to improve mood and lessen emotional distress. Routines and schedules provide new parents with a sense of grounding and stability. These predictable activities can help lessen mental health symptoms.
Where to Go for Help
- Postpartum Support International
- PSI Support Groups
- Mental health hotline: 1-833-852-6262
- Talk to your doctor
Social support is the number 1 preventative measure for PMADs.
Video Resources for Mindfulness
- How to do deep breathing
- Belly breathing demo
- Guided 5 min breathing exercise
- Progressive muscle relaxation exercise
- TED talk on psychological flexibility
This article is a companion to Episode 4 of the Functional Fourth Trimester podcast.