Postpartum counseling & therapy in Atlanta, Georgia
Perinatal mood and anxiety disorders (PMADs) can occur during pregnancy and one year after the birth. **PMADs most commonly impact the birthing person, but partners and adoptive parents can also experience difficulties after the baby joins the family.
PMADs can take away the individual's ability to enjoy parenthood and it is important for individuals to get the support they need.
PMADs do not discriminate and can impact anyone regardless of age, income level, race, ethnicity and culture.** It is important to seek out support and help early on since PMADs can have risks if left untreated including negative impact on your physical health, relationship problems, and unemployment. Individuals who have had a previous episode of a perinatal mood or anxiety disorder are at increased risk for developing a PMAD.
Let's talkPerinatal mood and anxiety disorders (PMADs) make up 10-25% of postpartum cases, but only 0.5-10% of pregnant women receive treatment. No one knows exactly how many suffer from PMADs each year, but the National Alliance on Mental Illness estimates 1 in 5 mothers will experience some form of depression after having a baby.
There are many underlying reasons for the occurrence of PMADs. During pregnancy, a woman's body goes through many changes in order to provide for her unborn baby's growth and development. In addition to hormonal fluctuations early in pregnancy, many other factors play into a new parent's mental health such as lack of sleep, changes in your identify after becoming a parent, difficulties in feeding the baby, and feeling more isolated. There are assumptions that can negatively impact an individual's ability to transition into parenthood including breastfeeding will come easy, being a mother is instinctual or good mothers don't take time for themselves. These assumptions can leave parents feeling life a failure or alone when they encounter difficulties during the transition. All of these factors can impact an individual's mental health and it is important to get an accurate diagnosis and treatment.
Do I have a PMAD?
It can be overwhelming experiencing mood or anxiety symptoms and it can be hard to tell exactly what is going on. The best course of action is to meet with a psychologist and complete a first session where the psychologist will complete a diagnostic interview with you. Then it will be explained if you meet the criteria for a PMAD. While it can be easy to google symptoms, it is always best to get a diagnosis from a trained professional.
Does my partner have a PMAD?
If you have noticed your partner is withdrawing from you or the baby, it is important to seek help to see if your partner is suffering from a perinatal mood and anxiety disorder. While it can be easy to rationalize the symptoms away, it is crucial to have an evaluation done to evaluate for PMADs. During the first session, Dr. Jessica Bauer will do a comprehensive clinical interview to determine an accurate diagnosis and discuss treatment options. You can reference the resources page for additional resources.
Therapy for PMADs
Therapy can help moms struggling with perinatal mood and anxiety disorders because it provides the necessary support for moms to talk about what they're going through.
There's a sense of safety in being able to express their feelings from an objective third party without fear of judgement.
As a therapist, it is our job to listen, involve you in solutions, and provide additional resources. This helps make it possible for mom to see hope and gain some control over her life again.
Common therapy focuses for PMADs include:
- Perinatal mood disorders (Depression, Anxiety, OCD, PSTD, and Psychosis)
- Breastfeeding/formula support
- Weaning support
- Bonding and attachment after the birth
- Support and healing after a traumatic birth experience
- Co-parenting issues or parental conflict
- High-risk pregnancy/birth and NICU experiences
- Infertility
- Pregnancy loss
Therapy provides many benefits for patients. Some more common benefits include:
- Increased self-worth
- Developing healthy coping strategies
- Learning how to set healthy boundaries
- Decrease in depressive or anxiety symptoms
- Establishing more self-confidence in your role as mother
- Improved connectedness with others
Medication for PMADs
It is up to you whether or not you want to take medication. When Dr. Jessica Bauer meets with clients, she will explore the client’s feelings regarding medications and discuss the options based on several factors including severity of symptoms, access and openness to therapy, and support system. She will then refer to medical professionals for further evaluation. Therapy is the place where you explore your thoughts and feelings around medications. The medical professionals (PCP, psychiatrist) will help evaluate medications that will be appropriate given current symptoms and diagnoses. If you decide to take medication, that does not make you less of a parent. It is important to take care of your mental health.
Which PMADs are experienced postpartum?
Postpartum depression
Postpartum depression (PPD) is a form of depression that can occur for some parents after the birth. Postpartum depression may develop in the days or weeks after childbirth, but it usually begins within the first month. Individuals who have a history of PPD are at greater risk for developing this condition compared to individuals with no previous history of mental illness. Postpartum depression is treatable through various therapies such as psychotherapy, medication, or both.
The most common type of psychotherapy for postpartum depression is cognitive behavioral therapy (CBT). CBT focuses on the present and helps clients change negative thought patterns by examining their thoughts and testing out new ways of thinking about them. Clients learn to understand the distorted beliefs that often lead to self-destructive behaviors and then create a plan for healthy living and coping with whatever challenges they face.
In order to determine whether or not an individual has PPD as opposed to just postpartum blues, the person must have been experiencing the symptoms of PPD consistently for at least two weeks without any fluctuation.
Symptoms of postpartum depression
- Feelings of sadness and emptiness more days than not
- Difficulty bonding with baby
- Frequent crying
- Loss of energy nearly all day
- Disturbances in sleep
- Loss of appetite
- Increased irritability or anger
- Increase in negative thoughts of guilt or shame
- Loss of interest in activities you enjoy
- Isolation from others
- Thoughts of harming yourself or the baby
These symptoms can become worse if they go untreated; however, there is effective treatment available. Please reach out for support anytime you don't feel like yourself and you want to further understand the symptoms you are experiencing during the perinatal period.
Postpartum depression & the baby blues
The key difference between the baby blues and postpartum depression is the duration that a parent experiences depressive symptoms.
The symptoms of the baby blues typically last for a few days and can persist for a couple weeks after birth. Postpartum depression symptoms typically last more than a couple weeks.
Typical symptoms of the baby blues include:
- Sadness
- Irritability
- Feeling overwhelmed
- Crying
- Appetite changes
Postpartum anxiety
Postpartum anxiety is excessive fear, nervousness, or worry that occurs after the birth. This disorder is becoming more common in new parents. It is treatable and it can happen to anyone. Risks factors include personal or family history of anxiety, history of previous perinatal mood and anxiety disorders, previous pregnancy or infant loss or thyroid imbalance. It is important to reach out for support since it can consume your mind and take away your ability to be present in your life.
Common Symptoms:
- Excessive worrying
- Difficulty in controlling the worry
- Racing thoughts
- Changes in sleep
- Difficulty sitting still or feeling on edge
- Easily fatigued
- Irritability
Individuals with postpartum anxiety may also be experiencing postpartum depression. It is important to meet with a mental health provider to obtain an accurate diagnosis and see if you are experiencing comorbidity of depression and anxiety.
Postpartum OCD
Postpartum OCD is a condition that affects mothers, and sometimes fathers as well, who have recently had a child. It can be debilitating to those suffering from it due its persistent nature. Individuals suffering from postpartum OCD experience intrusive thoughts on most days of the week for at least 1 hour per day and engage in behaviors such as checking on the baby several times during the night or washing hands excessively after touching something potentially unsafe.
These compulsions can take up huge amounts of time and energy, leaving individuals exhausted and unable to carry out normal daily tasks. Individuals may feel ashamed about their condition and have trouble getting help because they think their behavior is over-the-top. The condition can be exacerbated by a lack of understanding from family members and friends.
Postpartum OCD impacts the lives of mothers in negative ways, increasing feelings of isolation, guilt, and self-blame. It has even been linked to symptoms of postpartum depression.
Individuals with postpartum OCD know their thoughts are bizarre and they are at a very low risk of harming their child.
Symptoms of Postpartum OCD
- Obsessions / Intrusive thoughts (repetitive thoughts or mental images related to the baby that are upsetting)
- Compulsions (doing things over and over again in order to reduce fears and obsessions such as checking on the baby repeatedly and removing items from your home that relate to the intrusive thoughts)
- Fear of being alone with baby
- Hypervigilance regarding the baby’s wellbeing
Postpartum PTSD
Postpartum post-traumatic stress disorder (PPTSD) can occur in an individual after witnessing perceived or real trauma.
Symptoms include intrusive and repetitive thoughts regarding the distressing memories of the event, recurrent distressing dreams, flashbacks, hypervigilance, avoidance of distressing memories, negative beliefs about oneself (“maybe I did something wrong”) and feelings of detachment
Exposure to any of, but not limited to, the following past traumatic experiences can lead to the development of postpartum PTSD:
- Unplanned C-sections
- High risk birth
- Baby going into the NICU
- Feelings of powerlessness during the birth
- Physical complications during delivery
Postpartum psychosis
Postpartum psychosis is a rare but serious psychiatric disorder that affects individuals after childbirth. In most cases, symptoms appear within one month after the birth and steadily worsen over a period of hours or days.
Postpartum psychosis can lead to the following symptoms:
- Hallucinations
- Delusions (strange beliefs)
- Hyperactivity
- Paranoia
- Rapid mood wings
- Disorganized speech (incoherence)
The difference between OCD and psychosis is the individual does not recognize that their thoughts are unhealthy or distorted and may have less anxiety when indulging in the thoughts or behaviors.
Any woman with these symptoms needs immediate medical attention. Please call your doctor or the emergency hotlines I have listed on my resources page.
Don't struggle alone
The idea that you, or your partner, are struggling emotionally during the transition to parenthood is something many people don't consider until they find themselves in the perinatal period.
But it's important to remember that struggling emotionally doesn't mean you aren't a good parent. It means the transition to parenthood is hard and it is okay to need additional support to work through any big emotions, fears or unseen past emotions that can come up during the transition into parenthood. You are not alone.
Therapy can help make sense of your feelings and thoughts and help improve your mood.
Don't struggle alone -- I'm here to help.