10 things you need to know about postpartum mental health
When I was pregnant, one of my biggest worries about postpartum was my mental health. From studying mental health for my BSc, I knew I met many of the risk factors for postpartum depression and anxiety. It was something I’d experienced periodically throughout my life, so I was prepared that it could be part of my postpartum journey. Despite this background, I still didn’t realize I had been experiencing postpartum anxiety and depression until almost a year after giving birth, when I was completing a course in perinatal mental health. There is just so much misunderstanding around postpartum mental health, which can make it challenging to address. So let’s try to understand it with these 10 things you need to know about postpartum mental health.
In this blog post:
Mental health problems can begin during pregnancy.
Mental health problems can look different for everyone.
Some emotional adjustment is normal after giving birth.
Postpartum mental health problems are not ‘just hormones’.
A mental health diagnosis is just a label, and does not have to define who you are.
Fathers can experience postpartum mental health problems.
Babies have mental health, too.
Breastfeeding protects mental health, sometimes.
Know what mental health support is available in your area.
All therapy is not created equal.
1. Mental health problems can begin during pregnancy.
The media gives a lot of attention to postpartum mental health problems. Yet almost half of perinatal mental health problems actually arise during pregnancy. Furthermore, experiencing mental health problems during pregnancy increases your risk of experiencing postpartum mental health problems. Promoting your mental health during pregnancy, and getting support if you do experience mental health problems during pregnancy, is one of the best things you can do for your postpartum mental health.
2. Mental health problems can look different for everyone.
There are many different symptoms can that be associated with mental health problems. Often we think of depression and anxiety as simply extreme sadness or worry. But did you know that anger can be a symptom? Have you heard of intrusive thoughts?
It is important to know about the symptoms of mental health problems to look out for, so you know when to seek help (caveat: it is always okay to seek help if you have any concerns, even if you don’t think your symptoms are at the level of a mental health problem). Postpartum Support International offers an excellent guide to postpartum mental health problems, including symptoms to look out for.
3. Some emotional adjustment is normal after giving birth.
It is normal to feel emotional during life changes and stressful situations. Having a baby is one of the biggest changes you can experience in life, and honestly, can be pretty stressful at times. There is also a certain amount of emotional fluctuation that can be associated with hormonal changes after giving birth, which is especially common around the time that your milk comes in. Not every tear or worry means you are experiencing a mental health problem, especially if short-lived.
However, it is important to recognize that there is a difference between feeling a bit emotional and feeling very distressed. With the ‘baby blues’, you might have heightened emotions, such as being more tearful or frustrated, but you can cope. If you are feeling overwhelmed or like you can’t cope, or your symptoms are lasting more than a few days, these would be signs that you should speak to your doctor, or seek help from a mental health professional.
But what about the grey area? When you are postpartum and everything is new, it can be hard to tell whether something is a ‘normal’ part of new parenthood. Let’s take the example of needing to feed a baby round the clock. It is exhausting, which can be emotionally challenging. It also can’t be helped that you need to constantly feed your baby… so perhaps this situation is normal and you just need to power through? Absolutely not - you never need to grin and bear a situation alone. In this example, seeking support from a therapist could give you the space to process the emotional challenge of frequent feeding, and teach you tools to cope with your difficult emotions. Even if the frequency of feeding stays the same, you could feel much better from supporting your mental health during the process.
4. Postpartum mental health problems are not ‘just hormones’.
Many people assume that mental health problems during the postpartum period are caused by the hormonal changes experienced after giving birth. This may be part of it, but not the whole picture. The ‘biopsychosocial’ model of mental health helps us to understand how a combination of factors can influence our mental health, whether we are postpartum or not.
Biological
Biological factors relate to things like nutrition, genetics, neurotransmitters, and yes, hormones.
Psychological
Psychological factors relate to things like our thought processes and behaviours.
Social
Social factors include things like our relationships, socioeconomic status, where we live, demographic factors, culture & society, external stressors.
5. A mental health diagnosis is just a label, and does not have to define who you are.
Whilst mental health is as serious as physical health, it is not the same. A doctor can locate and measure objective signs of physical illness in the body, but mental health problems are more subjective. Mental health problems are typically diagnosed based on a person meeting certain criteria of symptoms that they are experiencing in their thoughts, behaviours, feelings, or in the way they interact with the world. Mental health diagnoses can be thought of as a way of categorizing experiences that typically occur together. For example, if a person is experiencing low mood and excessive guilt, then these symptoms might be categorised as depression.
This system of categorising a person’s experiences can be helpful for many reasons. It enables people to access mental health services, is used for research, and can help practitioners understand what might help someone experiencing a certain set of symptoms. Some people find it validating to receive a mental health diagnosis. However, there are also drawbacks to speaking about mental health problems as diagnoses. For example, people who have received a mental health diagnosis often feel stigmatised, and like something is ‘wrong’ with them. It also allocates the source of a person’s distress within themselves, which decontextualizes their distress from their wider circumstances, which are often a very important part of the picture (the ‘social’ in the biopsychosocial model described above).
All this to say, a mental health diagnosis is not a diagnosis of who you are as a person, it is simply a way of describing your experiences. There is nothing shameful about having experiences that are distressing, but it certainly is a reason that you deserve support!
6. Fathers can experience postpartum mental health problems.
Did you know, if a mother is experiencing postpartum depression, there is a 50% chance that the father is too? Postpartum mental health does not apply only to mothers - mental health problems also increase among fathers in the first year after birth. Fathers are experiencing a huge life change too. Their brains are changing, they are adjusting to new roles, relationship dynamics, and pressures, and can have their own unique biological, psychological and social risk factors for mental health problems.
7. Babies have mental health, too.
I find the UNICEF framework really helpful for understanding what infant mental health really means. We don’t normally talk about infants as experiencing mental health problems. Rather, we talk about their current relationships, cognitive development, and emotional states. We also think about how their current experiences can shape their future mental health, which is particularly important when it comes to forming a secure attachment with a reliably responsive caregiver, and experiencing co-regulation so they can learn to regulate their own emotions. This does not mean that any challenge they experience as babies will negatively impact their future mental health! Experiencing stressors and then returning to a state of emotional regulation, through the support of a caregiver, is normal and can actually help them to develop their emotional resilience!
8. Breastfeeding protects mental health, sometimes.
In her book ‘Why Breastfeeding Grief and Trauma Matter’, Amy Brown explains that breastfeeding is generally protective of mental health - particularly in comparison to bottle-feeding. However, when breastfeeding does not go well, the risk of mental health problems increase. Brown notes the importance of breastfeeding support for helping people to overcome breastfeeding issues, or at least to gain a sense of understanding when breastfeeding does not go as hoped.
9. Know what mental health support is available in your area.
Common sources of postpartum mental health support include:
Psychotherapists or counsellors
Psychiatrists
Peer-support groups
Postpartum doulas
Support that isn’t directly related to mental health, but can be related to issues that impact mental health, are also helpful, including:
Breastfeeding support, to help you have a positive breastfeeding experience.
Mom and baby groups, to build relationships with others.
Physiotherapists, to support your physical postpartum recovery.
Trusted friends and family.
Hired help, such as a cleaner, who can lighten your load to reduce feelings of overwhelm.
10. All therapy is not created equal.
Different therapists take different approaches to therapy. Whilst there are many different types of therapy, some of the most common are:
Psychodynamic therapy, which explores how experiences in your early life may impact your present.
Cognitive Behavioural Therapy (CBT), which explores how our thoughts and behaviours contribute to our problems, and often involves teaching tools for emotional regulation.
Humanistic therapy, also known as person-centred therapy, which promotes the client’s innate process of self-growth through the relationship with a therapist who is empathetic, genuine and non-judgemental.
Therapists often combine approaches, which may be described as an ‘integrative’ approach.
Learn more about postpartum mental health
What else do you want to know about postpartum mental health? Send me a DM on Instagram so we can continue the conversation!
ABOUT THE AUTHOR
Ceridwen is a postpartum doula and lactation counsellor based in the Cayman Islands. She offers personalised, evidence-based information to help pregnant families prepare for their baby’s arrival. After birth, she helps postpartum families to feel calm, confident, and cared for, with a focus on lactation and mental health.
Learn more about Ceridwen here.
