Acknowledging Perinatal Mental Health

The perinatal period is a significant phase in parents’ lives that brings about a range of physical, emotional, and psychological changes. Although the arrival of a new life is a joyous event, it can also lead to various mental health symptoms and challenges that require recognition and support. It is important to understand that perinatal mental health problems can affect both parents and often involve more than just feeling sad. In this article, we will explain some common mental health conditions that can occur during the perinatal period and some common treatments used to treat them.

What is Perinatal Mental Health?

The perinatal period, encompassing the time around childbirth triggers significant physical, emotional, and psychological changes for parents. Alongside the joy of welcoming a new life, this phase can lead to various mental health challenges that demand attention and support. Understanding the complexities of perinatal mental health is crucial to ensuring effective care for both parents and their children.

Perinatal mental health primarily focuses on the emotional well-being of individuals during pregnancy and the first year after giving birth [3]. Conditions such as perinatal mood and anxiety disorders (PMAD) have become common, affecting about one in every five women [1]. If left untreated, PMAD can result in short- and long-term complications for both the mother and the baby, including preterm birth, low birth weight, difficulties in mother-baby bonding, exacerbated PMAD symptoms, and, in rare cases, maternal mortality [1]. Challenges in diagnosing and managing PMAD are further compounded by disparities in social, racial, and ethnic contexts within maternal healthcare [1].

During this critical period, the body undergoes significant changes. Hormonal fluctuations, adjustments in lifestyle routines, and adaptation to different emotional and social situations can profoundly impact mental health [3]. Perinatal mental health focuses on recognizing and addressing the array of mental health challenges that can arise during this phase.

Perinatal Mental Health Conditions

This spectrum of mental health challenges includes various conditions with distinct features and implications, highlighting the need for comprehensive awareness and support. Common perinatal mental health conditions include:

• Baby blues: Characterized by mood swings, tearfulness, and mild anxiety following childbirth. They usually fade within a few weeks.
• Perinatal depression: Involves depressive symptoms such as persistent sadness, hopelessness, and disinterest, significantly affecting daily functioning [6-7].
• Perinatal anxiety disorders Manifest as experiencing symptoms of anxiety that include excessive worry, restlessness, and intrusive thoughts, causing significant distress and impairment [3,7].
• Postpartum psychosis: A severe condition characterized by hallucinations, delusions, and disorganized behavior, requiring immediate medical attention [7].
• Perinatal bipolar disorder: Involves mood swings from depressive to manic episodes, requiring specialized management [3, 7, 9]. 
• Perinatal OCD: Involves intrusive, distressing thoughts and repetitive behaviors that can affect parenting and daily functioning [2-3, 7].
• Birth trauma and PTSD: Some mothers may develop post-traumatic stress disorder due to birth complications and other risk factors that may occur during labor.
• Paternal mental health: While maternal mental health typically receives more attention and discussion, paternal mental health during the perinatal period is equally significant. Paternal perinatal mental health conditions, including paternal depression and anxiety, can significantly impact family dynamics and child development, necessitating increased awareness and support [3]. Studies have revealed that approximately 8-10% of fathers go through postpartum depression during the first year after the birth of their child. However, this condition may persist for up to a year following the baby’s arrival. It is essential to raise awareness and provide adequate support to fathers who experience mental health problems [8].

Causes and Risk Factors

Perinatal mental health conditions are typically caused by a mix of biological, psychological, and environmental factors. For example, a history of prior depressive episodes can impact perinatal depression, leading to heightened emotional sensitivity, decreased self-confidence, and significant life difficulties [7]. Similarly, postpartum anxiety disorders are believed to be linked to a blend of genetic predispositions, changes in hormones, and heightened stress levels during pregnancy and after childbirth [7]. Recognizing these root causes is crucial for managing and dealing with perinatal mental health challenges.

Perinatal mental health disorders can pose a significant challenge for women during pregnancy and the postpartum phase, impacting their well-being and that of their infants. Early screening and targeted care are vital for timely intervention and support. Studies have indicated that women with a history of depression face a higher risk of experiencing perinatal depression [7]. During pregnancy and the postpartum period, significant life events can exacerbate perinatal depression, underscoring the importance of tailored support and interventions [7].

Likewise, postpartum psychosis is more prevalent in women with bipolar disorder and is influenced by genetic predispositions, hormonal changes, and the stress associated with childbirth and childcare. Identifying these risk factors can help recognize those at risk [7]. Recognizing these underlying causes and risk factors is essential for effective management and intervention for perinatal mental health challenges [7].

Treatment Options

Effectively managing perinatal mental health conditions requires a comprehensive approach that integrates psychotherapy, medication, and social support and may incorporate additional or alternative treatments. Here is an overview of key treatment options for addressing perinatal mental health disorders:

• Medications: Commonly used psychiatric medications include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and other mood stabilizers to manage and treat depression or related disorders [5].
• Psychotherapy: Various therapeutic interventions, including cognitive-behavioral therapy (CBT), interpersonal therapy, and peer support groups, have effectively addressed these conditions and promoted recovery [6-7].
• Cognitive-behavioral therapy (CBT): A psychotherapeutic approach to address and modify negative thought patterns and behaviors to treat various mental health conditions. CBT focuses on the interrelations between thoughts, emotions, behavior, physical reactions, and the environment, aiming to bring positive changes in each domain [4].
• Interpersonal therapy (IPT): Suitable for pregnant and postpartum women experiencing depression or anxiety related to significant role transitions [4.
• Group peer support: Involves support from peers in a group setting, providing a sense of community and shared experiences to alleviate symptoms of perinatal depression [5].
• Psychoeducation: Education and information provided to individuals and families about mental health conditions and their treatments to promote understanding and management of symptoms [5].
• Individual supportive therapy: One-on-one therapy focused on providing emotional support and guidance to individuals experiencing perinatal depression [5].
• Stepped collaborative care intervention: A comprehensive approach involving various healthcare professionals to provide coordinated and integrated care for women experiencing postpartum depression [5].

Non-Traditional and Adjunctive Therapies

Non-traditional and Adjunctive Therapies play a significant role in the holistic approach to managing perinatal mental health. In addition to these alternative treatments, various lifestyle modifications and supportive measures can also contribute to improving overall well-being during this critical phase. Here are some key practices and support strategies that can complement traditional treatment approaches:

• Transcranial magnetic stimulation (TMS): TMS therapy is a non-invasive procedure that uses magnetic fields to stimulate specific brain areas to alleviate depressive symptoms [5].
• Light Therapy: Studies have shown promising results in treating depression in pregnant women. Exposure to bright light for a specific duration has been associated with significant symptom improvements [4].
• Holistic Treatment Options: Refers to non-traditional treatments such as acupuncture, omega-3 fatty acids, and light therapy used alongside conventional medical approaches to manage perinatal depression [5].
• Exercise Therapy: Involves the use of physical exercise as a means to alleviate symptoms of postpartum depression and improve overall well-being [5].
• Yoga: Incorporates various physical postures, breathing techniques, and meditation practices to promote relaxation and alleviate depressive symptoms during the perinatal period [5].
• Prenatal Massage: A therapeutic massage administered during pregnancy to reduce stress, promote relaxation, and alleviate symptoms of perinatal depression [5]. Massage has demonstrated benefits for mother-child interaction and bonding.
• Other Adjunctive Therapies: Includes exercise, herbal remedies, and acupuncture. Exercise during pregnancy has been found to reduce depression and anxiety. St. John’s wort, an herbal treatment for depression, and acupuncture have also been explored in treating perinatal mood and anxiety disorders [4]. Make sure you consult with your doctor before taking any supplements to ensure they don’t counteract with any medication you’re currently taking or affect breastfeeding.

Help and Support

Taking care of your mental health during and after pregnancy is crucial. If you’re facing any challenges, know that you’re not alone. There are mental health professionals ready to support you through this journey. Don’t hesitate to reach out for help. You deserve to feel your best for yourself and your growing family.

If you or someone you love is experiencing symptoms of perinatal mental health conditions, contact Neuro Wellness Spa today for professional guidance and support. Our experienced team of mental health providers is dedicated to providing comprehensive care and tailored mental health treatments to help you navigate this challenging phase. Reach out to us to learn more about your treatment options. We provide in-person and online psychiatry for medication management to regulate levels of neurotransmitters in the brain and alleviate symptoms of mental health conditions. Our brief integrative psychotherapy program can help you identify and treat the underlying causes of perinatal mental health disorders and teach you effective coping skills. If traditional treatments haven’t been effective, TMS therapy targets and treats parts of the brain that are responsible for mood regulation. We’re here to help you find the support you need.

References      

1. Ayala, N. K., Lewkowitz, A. K., Whelan, A. R., & Miller, E. S. (2023). Perinatal Mental Health Disorders: A Review of Lessons Learned from Obstetric Care Settings. Neuropsychiatric disease and treatment, 19, 427–432. https://doi.org/10.2147/NDT.S292734
2.  Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C. M. (2016). Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of affective disorders, 191, 62–77. https://doi.org/10.1016/j.jad.2015.11.014
3.  Fisher S. D. (2016). Paternal Mental Health: Why Is It Relevant?. American journal of lifestyle medicine, 11(3), 200–211. https://doi.org/10.1177/1559827616629895
4. Misri, S., & Kendrick, K. (2007). Treatment of perinatal mood and anxiety disorders: a review. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 52(8), 489–498. https://doi.org/10.1177/070674370705200803
5.  Nillni, Y. I., Mehralizade, A., Mayer, L., & Milanovic, S. (2018). Treatment of depression, anxiety, and trauma-related disorders during the perinatal period: A systematic review. Clinical psychology review, 66, 136–148. https://doi.org/10.1016/j.cpr.2018.06.004
6.  O’Brien, A. P., McNeil, K. A., Fletcher, R., Conrad, A., Wilson, A. J., Jones, D., & Chan, S. W. (2017). New Fathers’ Perinatal Depression and Anxiety-Treatment Options: An Integrative Review. American journal of men’s health, 11(4), 863–876. https://doi.org/10.1177/1557988316669047
7.  O’Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: definition, description, and aetiology. Best practice & research. Clinical obstetrics & gynaecology, 28(1), 3–12. https://doi.org/10.1016/j.bpobgyn.2013.09.002
8.  Scarff J. R. (2019). Postpartum Depression in Men. Innovations in clinical neuroscience, 16(5-6), 11–14.
9.  Yang, K., Wu, J., & Chen, X. (2022). Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC psychiatry, 22(1), 63. https://doi.org/10.1186/s12888-021-03684-3