There are many changes that come with motherhood – body changes, sleep changes, relationship changes, identity changes, emotional changes, routine changes, & psychological changes.  Having some challenges adjusting to the changes that come with pregnancy or with the arrival of a new baby is normal!  But struggling significantly is a lot more common than most people realize.

Here are 7 Important Things You Need to Know About Perinatal Psychological & Emotional Health:

1.  Perinatal mood and anxiety disorders (PMADS) are a common complication of pregnancy and postnatal care. Women of every culture, age, income level, and race can develop PMADs.  Symptoms can range from mild to severe. Fortunately, these symptoms often respond well to support and treatment.
2. “Postpartum Depression”is different than the baby blues: The baby blues can happen in the postpartum period, and may represent an adjustment to life with a new little one.  The most important factor to consider when deciding whether you are experiencing the baby blues, is how long the symptoms have been occurring,  and how severe the symptoms are. Symptoms that develop, or last longer than 2 weeks in the postpartum period, and are present nearly every day, nearly all day – are no longer considered to be the baby blues and may represent depression.
3. Some of the emotions of normal adjustment to having a baby may also overlap with PMADs.  For example, it is common for new mothers to cry. However, if you cry all day, for many days, and struggle to function because you are crying, that signals that something more may be happening. Although it may be normal to feel some extreme emotions during pregnancy and following delivery,  when the emotions impact your energy, concentration, appetite, sleep, or ability to function, this may indicate more than normal adjustment.  
4. Depression, anxiety, bipolar, OCD, PTSD/birth trauma & psychosis can all begin, or worsen, at any time during pregnancy or after childbirth.. 

Signs of anxiety and depression postpartum include:

*There are also many other symptoms not listed here. If you or someone close to you experiences any symptoms or feelings that worry you, please seek support. 

• Feeling sad, low, or crying for no obvious reason
• Persistent, generalised worry, often focused on fears for the health or wellbeing of your baby
• Being nervous, ‘on edge’, or panicky
• Being easily annoyed or irritated
• Withdrawing from friends and family
• Difficulties sleeping, even when your baby is sleeping
• Abrupt mood swings
• Feeling constantly tired and lacking energy
• Physical symptoms like nausea, vomiting, cold sweats, lack of appetite
• Having little or no interest in the things that normally bring you joy 
• Fear of being alone or with others
• Finding it difficult to focus, concentrate or remember
• Increased alcohol or drug use
• Panic attacks (racing heart, palpitations, shortness of breath, shaking or feeling physically ‘detached’ from your surroundings)
• Developing obsessive or compulsive behaviours
• Thoughts of death, suicide or harming your baby.

• A University of British Columbia study found two times as many women experience significant anxiety in the postpartum period, compared to depression.
• Men may also experience symptoms of anxiety and depression after having a baby – afterall, it is a big adjustment for you both! Symptoms in men typically develop more gradually over the course of the child’s first year.
• The wellbeing of the entire family can be impacted when a mother is struggling psychologically.  A University of Calgary study has also found that children of women with prenatal depression are more likely to suffer from mental health issues later in life as a result of altered brain development. Postpartum maternal anxiety is associated with impaired adaptability, and infant soothing difficulties. In some studies, mothers suffering from severe anxiety are found to interact less skilfully with their children.  As a result, children are more likely to have insecure attachments.
• Maternal prenatal anxiety is also associated with medical complications such as preterm delivery, miscarriage, preeclampsia, and low birth weight.  

Where to Seek Help for PMADs 

Everyone experiences PMADs differently. However, the sooner people seek support, the more quickly they can start feeling better.  Untreated PMADs can cause impairment in functioning and quality of life.  

It is very important for expecting and new parents who are worried about their emotional and mental wellbeing to seek support! You can speak with a trusted health professional such as a doctor or Registered Psychologist.  You can also call the Postpartum Support International (PSI) free Helpline at 1-800-944-4773(4PPD) to get basic information, support, and resources or send a text message to 1-503-894-9453

This post was authored by Mallory Becker, a Registered Psychologist in Edmonton, Alberta. She specializes in anxiety, mood, relationships & maternal mental health. Mallory co-founded Pine Integrated Health Center, which provides multidisciplinary health services for women & families throughout the lifespan. You can find her @yeg_psychologist and @pine_health_yeg.

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