Navigating the baby blues and more
- Perinatal mood, anxiety and depression describes mental health issues in moms from conception to one year after delivery.
- Hormone changes, lack of sleep and stress can lead to symptoms like brain fog, weeping and even suicidal thoughts.
- Providers will screen moms for PMAD and recommend treatment like support groups, counseling and medication.
When talking about the good and bad of pregnancy, you might have heard terms like postpartum depression or, more casually, baby blues.
It’s critical new mothers get help in this area, says Tiffany Waters, a birthing center charge nurse at OSF HealthCare. She says up to 80% of moms experience the so-called baby blues. But when talking about maternal mental health, experts prefer the umbrella term: perinatal mood, anxiety and depression (PMAD). Perinatal refers to the time between conception and one year after delivery.
Waters says for two to three weeks after delivery, most women experience hormone changes, a lack of sleep and general stress related to the “new normal.” Having a traumatic birth, like an emergency caesarean section, can compound mental health impacts. Waters says around one-third of women fall into this category.
All these factors can lead to a variety of longer-lasting PMAD symptoms, including brain fog, weeping, sleep changes, anxiety, depression, obsessive or compulsive behavior and even suicidal thoughts.
“There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors,” Waters says. “There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.”
There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors. There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.
Screening and treatment
Waters says health care providers should screen a woman for depression and other mental health issues during and after pregnancy.
“There are commonly used tools,” Waters says. “The woman answers 10 questions. It gives us a rating on how their emotional and mental well-being is.”
She’s referring to the Edinburgh Postnatal Depression Scale (EPDS). Each question is scored 0 to 3, with 3 being the response that most signals a possible mental health issue. That’s 30 total points, and a final tally of 10 or higher would warrant further evaluation.
Waters also says research is ongoing into whether certain biological markers in a woman are a sign of mental health issues to come.
“It can be difficult to admit or even recognize that a person is having depression or anxiety symptoms,” Waters says. “There are lots of reasons for that. There’s societal pressure to be a great mom. Moms might feel like if they admit how they’re feeling, their children might be taken away.”
Waters says journaling or talking to a trusted adult can help a mom document the issues she’s facing, opening the door for her to get help.
If a mom is diagnosed with PMAD, a provider will talk with her about resources like support groups, counseling, spiritual care and medication. Daily things like improved diet and exercise and exploring new hobbies can also help. And Waters says mothers should not be afraid to prioritize themselves. It’s OK to ask for a break from daily housework, for example.
Why it’s important
Waters says untreated PMAD can have consequences for the whole family and the people around the family. Substance abuse and domestic violence can increase. But if treated, it means a better life for everyone.
“It will improve the whole family dynamic,” Waters says. “It will lessen stress for everybody and lead to a happier unit.”