The ‘baby blues’

While pregnancy is widely considered to be a time of joy and hopeful anticipation, it can also be a time of stress, anxiety and even depression for many expecting women. In fact, it’s one of the most common complications of childbirth.

According to Jill Garrett, PsyD, PMH-C, the founding psychologist and program director of The Motherhood Space, a maternal mental health program at Baptist Health, seeking mental health support while pregnant is just as important as medical care.

But since the symptoms of anxiety or depression mimic common pregnancy symptoms, how do you know when to see a professional?

Signs and symptoms of PMADs

Symptoms of perinatal mood and anxiety disorders (PMADs) might include:

• Down, depressed or irritable mood
• Loss of pleasure in previously enjoyed activities
• Excessive worry or periods when your mind is racing
• Changes in sleep, appetite and energy levels

Dr. Garrett cautioned that this is not an exhaustive list of symptoms, and if you have concerns, talking to a health care provider who is trained in mental health during pregnancy is the next best step.

Who is at risk for PMADs?

PMADs are not uncommon. While people can experience mental health difficulties like depression and anxiety at any point, the perinatal period (pregnancy through around one year after childbirth) is a time when individuals might be at higher risk. PMADs can occur in up to 1 in 5 mothers.

In some populations – such as mothers of color, military families, and NICU parents – rates may be as high as 1 in 3. PMADs can also occur in 1 in 10 fathers, highlighting that perinatal mental health is a family-wide experience.

“I tend to describe how biological, psychological and social factors all converge and create a bit of a perfect storm to make us more prone to perinatal mood and anxiety disorders,” said Dr. Garrett.

Biological factors like hormonal fluctuations and lack of sleep, psychological vulnerabilities such as a history of depression or anxiety, and social vulnerabilities such as work, finance or relationship concerns combine to make women more susceptible to PMADs during pregnancy.

Practice the NURSE self-care method

There are lifestyle changes you can make to help manage your anxiety and depression, and according to Dr. Garrett, “it all starts with self-care and being your own NURSE.”

NURSE is a helpful acronym that outlines steps you can take to be your own health advocate during pregnancy:

• Nutrition/needs: Fueling your body with balanced meals, drinking plenty of water and making sure to take any prescribed medications.
• Understanding and awareness of PMADs: Educating yourself on the signs and symptoms.
• Rest/relaxation: Taking time to recharge in healthy ways that work for you.
• Support: Accessing resources by connecting with other moms via groups, reading self-care books and more.
• Exercise: Enjoying both physical and mental activities like taking a walk or downloading an app to follow relaxation or meditation techniques

“Just like you plan for baby’s arrival by organizing a registry and decorating the nursery, I encourage women to also add building a healthy self-care routine for during and after pregnancy to their to-do list,” said Dr. Garrett.

When to seek professional help

“A good rule of thumb is that if mood changes persist beyond a couple of weeks or interfere with your day-to-day life, you could benefit from professional support,” said Dr. Garrett.

Recognizing you're experiencing PMAD symptoms and seeking professional help is the first step in preventing issues down the road. Accessing support in the prenatal period can reduce the risk of challenges associated with untreated anxiety and depression, potentially including preterm delivery, low birth weight, low Apgar scores (a scoring system used to test a baby’s general condition at birth) and impaired bonding.

A behavioral health specialist trained in maternal mental health can help you talk through your emotions and come up with a plan to adjust and thrive in your new normal. He or she can also assess if medication or further treatment options are needed.