May is Maternal Mental Health month and there has been a concerted effort by various organizations, such as Postpartum Support International (PSI), the Blue Dot Project, and Pregnancy and Postpartum Support MN (PPSM), to raise awareness about perinatal mood and anxiety disorders (PMADs). The Center for Family Wellness joins in these efforts to help families in Northeastern Minnesota gain access to needed services for perinatal and maternal mental health, and to hopefully reduce the prevalence of PMADs.
Perinatal mood and anxiety disorders are mental health conditions that parents can experience during pregnancy and/or postpartum. Commonly referred to as “postpartum depression,” this group of disorders actually includes a variety of diagnoses: Pregnancy or Postpartum Anxiety; Pregnancy or Postpartum Depression; Pregnancy and Postpartum Obsessive-Compulsive Disorder; Bipolar Disorder (often first diagnosed during pregnancy and postpartum); Postpartum Post-Traumatic Stress Disorder; and Postpartum Psychosis.
Recognizing the symptoms of PMADs in pregnant and postpartum people is vital to the entire family system. PMADs are the #1 medical complication related to childbearing and is a detectable illness. However, it is important to note that these conditions do not simply impact the pregnant or postpartum person; they impact relationships, physical health and wellness, functional abilities, children, and society at large. Relational problems and divorce, disability, loss of employment, child neglect and abuse, developmental delays, behavioral problems, problems with bonding and attachment, increased safety concerns, pediatric mental health challenges, infanticide, homicide, and suicide are significant reasons that everyone should care, and be aware of, perinatal mood and anxiety disorders. (P. Bryce, University of Sydney, Nepean Hospital, Penright NSW Australia; Postpartum Support International). Suicide is one of the three leading causes of maternal death (PSI) and at least 1 in 7 mothers experience clinically significant depression or anxiety during pregnancy and postpartum (American College of Obstetrics and Gynecology). 1-2 mothers out of 1000 experience postpartum psychosis (PSI). 1 in 10 fathers experience postpartum depression (PSI).
So what can a person do if their partner or loved one is pregnant or in the postpartum phase, and there are mounting concerns for either the parent or the baby? We recommend that both parents start learning about the risks, common symptoms, and warning signs for PMADs during pregnancy. PPSM created the following cheat sheet of risk factors that increase the chance that a person may experience a PMAD during or after pregnancy. The more factors a person has, the greater the risk (PPSM).
PPSM also created a handy postpartum planning kit that contains useful information for a pregnancy person and their partner throughout the entire pregnancy and after. You can access this free resource here: https://ppsupportmn.org/wp-content/uploads/2020/07/postpartum-planning-tool.pdf. Inside you’ll find helpful information about what to expect during pregnancy, ways to care for yourself and your partner, and common PMAD symptoms to monitor for throughout pregnancy and the postpartum phase (aka the fourth trimester). The following symptoms should be monitored in both parents, especially the pregnancy person:
You feel hopeless, sad, worthless, or alone all the time, and you cry often.
You don’t feel like you’re doing a good job as a new parent. You’re not bonding with your baby.
You can’t eat, sleep, or take care of your baby because of your overwhelming despair.
You can't sleep even if baby is sleeping. You have excessive worry.
You have panic attacks.
You have experienced a pregnancy loss and are grieving.
You have intrusive thoughts about something happening to yourself, your baby or someone you care about. (Sometimes these fears and thoughts are about you doing something to cause that harm and are very uncomfortable.)
You have thoughts that seem irrational or that other people tell you are irrational.
You are having “weird” thoughts, hallucinations, or delusions.
You are experiencing intrusive thoughts or flashbacks about the traumatic labor and delivery of your baby.
You have excessive energy and decreased need for sleep for several days.
You feel paranoid and suspicious of others.
You have rapid mood swings.
You become catatonic and cannot communicate with others.
You are feeling like seriously hurting or killing yourself, your baby, or someone else.
Go to https://www.postpartum.net/learn-more/ and https://www.thebluedotproject.org/whataremmhdisorders to read more information about the “baby blues”.
If these symptoms begin to occur during the pregnancy and/or postpartum phrase, it is important to seek help. Pregnancy or postpartum people can talk with their OB/GYN, primary care provider, contact PPSM’s Helpline at 612-787-7776 or email helpline@ppsupportmn.org, or connect with some of the excellent support groups focused on a variety of needs. Find the link here. You can reach out to a mental health provider who specializes in perinatal/maternal mental health (like Celleste and Brittany!). Plan to discuss how you’re feeling and to complete screening assessments to further evaluate symptoms and discuss options for treatment. Common assessments used by medical and mental health professionals that can be accessed for free online for PMAD screening include the Edinburg Postnatal Depression Scale and PHQ-9. Additional assessments may be warranted. Treatment options include psychotherapy, medication, and other evidence-based approaches. You and your provider(s) can discuss what works best based on your personal experience, wants, and needs.
Partners, friends, and family can gently approach their loved one with their concerns and communicate how much they care, love, and support their loved one in getting the help that is necessary. We like to use PSI’s Discussion Tool to help facilitate these conversations (https://www.postpartum.net/wp-content/uploads/2021/05/2021_05_21-Discussion-Tool-ENGLISH.pdf). Mobilize the support network around the pregnancy or postpartum person, and/or their partner. Untreated PMADs can have lasting effects and can persist for years if not addressed right away. It is worth noting that symptoms of postpartum psychosis (mania, delusions and hallucinations) are dangerous and require immediate response. Similarly suicidal or homicidal thoughts require immediate response.
Please call 911 if you or someone you love is feeling or acting unsafe. The National Suicide Prevention Hotline number is 1-800-273-8255 and the website can be found at www.suicidepreventionlifeline.org. Additional crisis resources:
Throughout Minnesota: call **CRISIS (**274747)
Crisis Text Line: is available for free, 24/7 by texting MN to 741741
The Trevor Project: 866-488-7386
Minnesota Farm & Rural Helpline: 833-600-2670
Crisis Nursery locations offer free, licensed childcare for up to 72 hours while parent(s) get needed support.
Crisis Nursery Duluth, Mankato, St. Cloud & Wright Co. (up to age 12).
Crisis Nursery Greater Minneapolis (up to age 6).
Olmsted County (up to age 12).
Sherburne County – located in Elk River (up to age 12).
Southern MN Crisis Nursery (New Ulm)
We hope that this information has shed some light on PMADs, provided direction on what to do if you or your loved one are experiencing symptoms, and connected various resources to reach out to for additional information or support.
Please know that there is help available, hope is possible, and that you and your loved one can recover.
Be well,
The Center for Family Wellness
Resources:
P. Bryce, University of Sydney, Nepean Hospital, Penright NSW Australia
Postpartum Support International
Pregnancy and Postpartum Support Minnesota
ACOG
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