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What to Expect When You're Not Expecting: An Overview of Three Perinatal Mood and Anxiety Disorders

Becoming a parent is a thrilling and life-changing experience, but it can also be overwhelming and stressful, even if you’re prepared. It's not uncommon for new parents to experience a whole spectrum of feelings in the postpartum period. For some people, this can include postpartum anxiety, postpartum depression, or postpartum obsessive-compulsive disorder (OCD). These conditions are often referred to as "postpartum mood and anxiety disorders," or PMADs, and if you’re experiencing them, you’re not alone, and there is support available.

Perinatal Anxiety (PPA)

Postpartum anxiety is characterized by excessive worry, fear, and stress. It can interfere with daily functioning and make it difficult to care for yourself or your baby. Common symptoms of postpartum anxiety include racing thoughts, difficulty concentrating, irritability, and sleep disturbance. As a new parent, it is normal to have new worries or concerns such as “When should my baby be able to roll over?”, or “What does typical infant sleep look like?”. Examples of excessive worrying can look like not being able to sleep due to frequent checking on your baby to see if they are breathing, worrying that you’re a “bad parent” for not breastfeeding, or being afraid to let your partner care for the baby because “something might go wrong.” These thoughts are often distressing and can impact your ability to sleep, take care of yourself, and engage with those around you.

Perinatal Depression (PPD)

Postpartum depression is a more severe form of depression that can occur after birth. It is marked by persistent feelings of sadness, hopelessness, and lack of interest in activities that were once enjoyable. Other symptoms of postpartum depression can include difficulty bonding with your baby, difficulty with breastfeeding, and difficulty with daily care for yourself or your baby. It’s important to note that the “baby blues,” which occur within the first two weeks of birth, are a normative physiological response to your hormones rapidly decreasing due to birth and, while challenging, will resolve on its own. If symptoms persist beyond those first few weeks, what you’re experiencing could be postpartum depression, so it’s important to seek support of someone who can provide appropriate assessment and guidance.

Postpartum Obsessive Compulsive Disorder (PPOCD)

Postpartum OCD is a type of anxiety disorder that involves obsessive thoughts and compulsive behaviors related to your baby. This may include excessive worry about your baby's safety, intrusive thoughts about harm coming to the baby (whether from yourself, someone else, or through accidents), and ritualistic behaviors such as repeatedly checking on the baby or cleaning excessively. These thoughts and behaviors can be very distressing, even debilitating. Parents often choose not to share these with others out of fear of judgment. Karen Kleiman, author of “Good Moms Have Scary Thoughts,” notes in her book that over 90% of new moms have frightening thoughts about their babies. Though not all of them have postpartum OCD, the reality is that there are so many parents out there who will be able to empathize with having this experience and therefore may be able to offer some level of support.

There Is Hope - Seeking Help

It's important to recognize that postpartum mood and anxiety disorders are common and treatable. Many new parents may feel ashamed or guilty about experiencing these conditions, but it's important to remember that they are not a sign of weakness or failure. It's completely normal to experience a range of emotions after having a baby, and seeking treatment is a brave and important step towards feeling better. At The Life Workshop, we believe that all parents deserve care, compassion, and informed treatment in order to take care of themselves and their families.

If you are experiencing symptoms of postpartum anxiety, depression, or OCD, it's important to seek help from a qualified mental health professional. Treatment options can include individual therapy, group therapy, support groups, medication, or a combination of any of these. Support from loved ones, such as a partner, friends, or family members, can also be very helpful. Here at The Life Workshop, we offer individual and group therapy, as well as a wealth of referrals and resources specific to the needs of the perinatal population.

Remember that you are not alone and that you don't have to suffer in silence. If you are struggling with postpartum mood and anxiety disorders, please reach out for support. By seeking treatment, you can take important steps towards feeling better. You deserve to experience all of the love and joy that new parenthood can offer. It is our hope to continue to open up conversations about the many hidden aspects of parenthood, and are so glad you’re joining us for these critical discussions.

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