Perinatal Mood and Mental Change in a Mother During Pregnancy

Welcoming a new baby into your life can be an exciting and special time — but it can also be stressful. In fact, most women will experience a bit of the “baby blues” in the first week after childbirth. Some individuals can be at an increased risk for developing mental health problems, particularly depression and anxiety. "Baby blues" affect up to 85% of new mothers. Additionally, a mental health illness known as "postpartum depression" (PPD) affects at least one in ten women.

The use of the term “perinatal” recognises that depression or mood change begins during pregnancy. “Postpartum depression’’, on the other hand, refers to depression experienced after childbirth.

Perinatal mood changes can include perinatal depression (depression occurring during or after pregnancy), anxiety, panic disorder, obsessive-compulsive disorder, and in rare cases, postpartum psychosis. This broad category captures the whole spectrum of emotional states a mother might experience, recognising that these can occur during pregnancy and after birth. Pregnancy and the period after delivery can be a particularly vulnerable time. Mothers often experience biological, emotional, financial, and social changes during this time.

Baby Blue: What is it?

After giving birth, mothers often experience a period of adjustment during which they may feel emotionally and physically overburdened. In the first two to three weeks after giving birth, between 50 and 80 per cent of new moms go through emotional fluctuations and cry a lot. It's common to refer to this as the postpartum "baby blues." A perinatal or postpartum mood and anxiety disorder is not the same as the baby blues. The symptoms will frequently fluctuate and go away a few days or weeks after birth with time, patience, appropriate self-care (eating, resting, hydrating, etc.), and the supportive presence of family and friends.

Signs of baby blues include:

• Crying often and not always for a reason
• Feeling very tired
• Having trouble falling and staying asleep
• Having trouble thinking clearly, or feeling out of touch
• Feeling very nervous around the baby
• Becoming easily annoyed and/or angry and not understanding why
• Feeling that nothing will ever be the same
• Not feeling like oneself

If these signs do not disappear, within the week, it may lead to postpartum mood and anxiety disorder.

What is Postpartum Mood and Anxiety Disorder?

PMAD occurs when baby blues symptoms last beyond a two to three-week period and become worse or begin to interfere with everyday living. There are a number of reasons why parents may become depressed or anxious. Mothers will experience many changes in their bodies during and after pregnancy, along with mood swings. A new baby will change parents’ sleeping schedules and lifestyles. Perinatal or postpartum mood and anxiety disorders affect 1 in 7 women and can happen even before your baby is born. These feelings get in the way of doing activities of everyday living, particularly caring for yourself and your baby. 

Types of PMAD

• Perinatal or postpartum mood disorder 
• Perinatal or postpartum anxiety disorder
• Perinatal or postpartum psychosis
• Perinatal or postpartum obsessive-compulsive disorder.

Some of the most common PMAD symptoms include:

• Feeling depressed most of the day
• Having severe mood swings
• Feelings of intense anger or irritability
• Frequent crying spells
• Loss of interest in basic self-care (like bathing or dressing)
• Having trouble sleeping or sleeping too much
• Having trouble bonding with your baby
• Persistent doubt about the ability to care for the baby.
• Thinking about hurting yourself or your baby
• Showing not enough concern for your baby

Symptoms of PMAD can change over time, so repeated screening is important during pregnancy and throughout the early months of parenthood.

What is Postpartum Depression?

Postpartum depression (PPD) is a type of mood disorder which has depression that begins in the months or weeks after a new baby is born. Although it usually appears in the first four weeks following delivery, it can appear at any point in the first year. Inappropriate treatment may cause symptoms to persist for weeks, months, or even longer. A postpartum anxiety disorder or other mental condition may also coexist in certain individuals. Major depressive disorder symptoms, such as feeling down, hopeless, or empty for more than two weeks, can be present in some or all PPD patients. 

Way to Overcome Postpartum Depression 

Depending on your symptoms' nature and intensity, postpartum depression is treated differently. Psychotherapy, antidepressants, anxiety medications, and support group involvement are available as forms of treatment. Remember that taking medication for depression, anxiety, or even psychosis is not impossible if you are nursing a baby. Discuss your options with your healthcare provider.

Here are some things you can do to help cope with postpartum depression:

• Find someone to talk to — a therapist, friend, family member or someone who will listen to you and help you.
• Examine your breast-feeding
• Resist isolation
• Get involved in a new parent support group.
• Make a conscious effort to eat well and schedule exercise.
• Put your well-being first.
• Have a phone conversation or go out with pals
• Find time for self-care and doing things you enjoy, like reading or other hobbies.
• Get help with household chores or errands.

Reference 

1. https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-depression.
2. https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression#management-and-treatment
3. https://www.healthline.com/health/depression/how-to-deal-with-postpartum-depression#your-doctor
4. https://www.chop.edu/conditions-diseases/perinatal-or-postpartum-mood-and-anxiety-disorders
5. https://www.forbes.com/health/family/postpartum-mood-and-anxiety-disorder/#:~:text=Signs%20and%20Symptoms%20of%20PMAD&text=Feelings%20of%20intense%20anger%20or,Loss%20of%20appetite%20or%20overeating
6. https://www.sabp.nhs.uk/our-services/mental-health/perinatal/what-does-perinatal-mean#:~:text=Perinatal%20is%20the%20period%20of,or%20postpartum%20meaning%20'after%20birth’