What Is Unique About Perinatal Depression?
I often have people ask me what the difference is between perinatal (pregnancy or postpartum) depression and any other form of depression. Perinatal depression is considered depression that occurs during pregnancy or the first year after having a baby. While many of the symptoms may be the same, and treatment for any form of depression is very important, there are a few distinct features of perinatal depression that someone may experience.
Anxiety
This is probably the most common differentiation. Women (or men) who are experiencing perinatal depression often have higher levels of anxiety. In fact, the Edinburg Postnatal Depression Scale (EPDS), which is the most frequently used screening tool for perinatal mood concerns, has specifically included more questions that assess for anxiousness and nervousness.
There are some common and frequent worries that come along with having a baby. You are sent home with a tiny human and supposed to know all the right things to do and exactly how to take care of him/her. I can’t think of many things that are potentially more stressful. It can be important, relieving, and helpful to talk with a professional who can assess if what you are experiencing may warrant additional support.
Scary Thoughts
Unwanted or unwelcome thoughts can happen at any period, but during the perinatal period these thoughts can be particularly concerning or scary for parents. I believe that many women don’t talk about the scary thoughts they may be having out of fear that they will be perceived as a bad parent or unable to care for their child. Sometimes the thoughts can be so morbid or seemingly bizarre that there is a concern that telling someone may make the parent seem “crazy.” As a mental health clinician, I talk to people about scary or concerning thoughts all the time. Research shows-- and I have experienced this myself-- that speaking thoughts to a trusted person can decrease their impact. I will write a whole other blog on scary thoughts in the perinatal period, but please know this: It is very important to talk to someone you trust l if you are having thoughts that concern or scare you.
Talking through scary thoughts with a trusted professional can help you better understand what is happening, allow you to feel more comfortable in knowing if the thoughts are just thoughts, and create opportunity for additional assessment and support if indicated.
*If you are having thoughts of wanting to hurt yourself, your baby, or anyone else you need to seek emergency mental health or medical care immediately.
Quick Onset
For some people, mood can change quickly in the perinatal period. One week (or day) you may feel great and the next you are feeling down, anxious, hopeless, and tearful. In the perinatal period it is recommended that parents assess for mood changes regularly. This is one of the many reasons I recommend having a mental health professional on your pregnancy care team. Just like you check in with your OBGYN, midwife, or doula, I recommend having semi-consistent check-ins on mood with a mental health professional.
Insomnia
Poor sleep is a common symptom of depression—either sleeping more or sleeping less than normal for you. With perinatal depression, parents can experience increased insomnia. In the postpartum period, insomnia is described as inability to sleep even when baby and others are sleeping. Frequent nighttime waking for baby can be the name of the game during the first several months, and these definitely impact parental mood and wellbeing. However, if your baby is sleeping and you are unable to, you may be experiencing postpartum insomnia.
I believe it is vitally important for pregnant and postpartum couples to be familiar with symptoms of perinatal mood concerns. You can view the EPDS scale HERE, which will allow you to self-screen anytime you’d like. Please know that this tool is not a diagnostic tool, so a positive score (defined as greater than 10 OR a positive score on the last question) does not mean that you have a mood disorder. But it does mean that you should check in with your doctor or mental health professional. Also know that if the score is less than ten that does not mean that you won’t benefit from additional support. The most frequent thing I hear moms say is that they wish they would have sought out support sooner. Anytime is a good time.
You can also learn more about the specific symptoms of postpartum depression, anxiety, insomnia, or psychosis HERE.
If you are pregnant or postpartum and wanting to add mental health support to your care team, I provide individual and couples counseling for Colorado residents. Various options available to meet your needs.
