Depression before and after birth: You are not alone

July 26, 2021 Swedish Health Team

Key takeaways:

  • Mental health is often affected during pregnancy and after childbirth, but many women are still hesitant to get help.
  • Ups and downs are normal. If they don’t go away with rest and support, you may be experiencing a more serious mood disorder, like postpartum depression.
  • Depression before and after birth can be treated with counseling, medication and other therapies.

[5 MIN READ]

Picking your baby’s name.

Feeling for little kicks.

Constant snuggles and bonding.

It’s often these experiences that pregnant women look forward to while they are expecting their bundles of joy or after delivering their little ones. But that’s not always the case. In fact, 1 in 10 women will experience mental health issues during their pregnancy and 1 in 7 will experience some type of postpartum depression. One in 5 will experience depression, anxiety or both. In fact, the postpartum period is a time when mental health issues can be amplified, even including OCD or mania.

Giving birth and becoming a mother is a wonderful and transformative experience. It’s also a time of tremendous adjustment.

“Giving birth and becoming a mother is a wonderful and transformative experience. It’s also a time of tremendous adjustment, including changes in sleep, responsibilities, relationships, identity and self-image,” says Veronika Zantop, M.D., a psychiatrist and medical director for the Center for Perinatal Bonding and Support and reproductive mental health at Swedish.

“It’s no wonder, then, that so many women do develop symptoms of anxiety, depression or mood disorders during pregnancy and after giving birth. And it’s absolutely nothing to feel ashamed about,” Dr. Zantop continues.

There can be a stigma associated with postpartum depression and emotional distress during and after pregnancy because of societal pressure to have a perfect and blissful pregnancy and birth.

However, many women are nervous to reach out because they don’t know what treatment will look like or they may be worried that they will be seen as incompetent and someone will take their baby away. In the depths of postpartum depression, feelings and emotions are heightened and linear thinking isn’t always present. A woman may feel paranoid or even too paralyzed with shame to think about getting help. There can also be a stigma associated with postpartum depression and emotional distress during and after pregnancy because of societal pressure to have a perfect and blissful pregnancy and birth.

Fortunately, there is help available. Dr. Zantop shares her insight and advice on how you can improve your mental health, watch for warning signs and get support when you need it.

Understanding perinatal and postpartum depression

“Postpartum depression is an umbrella term for a range of mood and anxiety symptoms that start during your pregnancy and last for up to one year postpartum,” explains Dr. Zantop.

Emotions can ride high (or low) during pregnancy and after giving birth, but the key difference with perinatal or postpartum depression is that those unwanted feelings don’t go away on their own.

Emotions can ride high (or low) during pregnancy and after giving birth, but the key difference with perinatal or postpartum depression is that those anxious, depressed or unwanted feelings don’t go away on their own.

Dr. Zantop puts it into perspective:

“Pregnancy, childbirth and around-the-clock demands of caring for a newborn put a huge strain on a woman’s nervous and hormonal system. Most – if not nearly all – women experience some range of mood or anxiety symptoms. Some women need more than sleep and general support to help ease fears and feel in control again.”

The first two weeks postpartum are frequently characterized by “the baby blues,” which can include mood swings, exhaustion, more frequent crying, irritability and feeling overwhelmed. These emotions can be caused by sudden changes in hormones and decreased sleep.

If your symptoms become more severe or don’t improve after a few weeks or with rest, talk to your women’s health provider.

If your symptoms become more severe or don’t improve after a few weeks or with rest, talk to your women’s health provider. You should also be on the lookout for these signs and symptoms of a perinatal mental health issue or postpartum depression, especially if they continue past the initial “baby blues” time frame of four to six weeks after birth:

  • Loss of interest in favorite activities
  • Changes in appetite (including eating much more or less than normal)
  • Feeling anxious all or most of the time
  • Panic attacks
  • Racing or scary thoughts
  • Feelings of worthlessness
  • Irritability or rage
  • Mood swings
  • Uncontrollable sadness or crying
  • Fear of not being a good mother
  • Fear of being left alone with the baby
  • Changes in sleeping patterns
  • Difficulty concentrating
  • Thoughts of hurting yourself or the baby

Get help, gain control

Racing thoughts. Unwanted feelings. Feeling like you’re just not yourself.

These are unpleasant experiences – ones that no one should have to go through alone. That’s why Dr. Zantop encourages women to reach out for help if they are struggling with their mental health at any time during pregnancy or after giving birth. Many women are surprised to find that their women’s health provider can be extremely helpful in getting them the resources they need to deal with symptoms.

Many women are surprised to find that their women’s health provider can be extremely helpful in getting them the resources they need to deal with symptoms.

“Depression and anxiety are treatable conditions. We can help you find the tools and strategies you need to feel confident in yourself and your ability to take care of your child,” she reassures.

“Getting help isn’t just for you. It helps benefit your entire family by encouraging bonding, building support and nurturing yourself and your baby,” Dr. Zantop finishes.

The most effective treatments for postpartum mood and anxiety symptoms use an integrated approach. That may include medicine or non-medical interventions, like support groups and individual or group talk therapy.

Counseling can teach you how to recognize and change disturbing thoughts, manage your feelings and develop positive coping skills.

“Counseling can teach you how to recognize and change disturbing thoughts, manage your feelings and develop positive coping skills that will build your self-esteem,” says Dr. Zantop.

Dr. Zantop also encourages women to seek treatments that lay outside a psychiatrist’s office.

“Massage, yoga, meditation and acupuncture can also be very effective in helping manage your symptoms. Be sure to talk to your therapist or provider about what might be a good approach for you,” she says.

Make your mental health a priority

Even if you don’t have a history of mental health issues and are enjoying a comfortable, glowing pregnancy, it’s still good to take care of your mental health and prepare for your little one’s arrival.

“Get your support system in place – even before you need it. Knowing that you can pick up the phone and call a friend, family member or neighbor to watch the baby while you take a shower or just walk around the block for fresh air can go a long way in helping you feel less overwhelmed,” explains Dr. Zantop.

She also encourages pregnant women (and women who are trying to become pregnant) to prepare for the stress pregnancy and a newborn can bring:

  • Find go-to-stress relievers. Maybe it’s reading a book, doing a quick guided meditation or making daily yoga a priority (after healing, of course).
  • Develop coping skills. Late night feeding sessions or calming a colicky baby are not times to try out new skills. Instead, figure out what helps you calm down – whether that’s a breathing technique, a quick body scan or just counting backwards from 10.
  • Talk to someone. Sometimes, you just need a shoulder to cry on. Know who you can reach out to for a judgment-free crying or vent session. And don’t hesitate to get professional help if you need it.
  • Stay connected. Pregnancy and parenting a newborn can be isolating. Find ways to stay in touch with the important people in your life. FaceTime friends. Go on walks with a neighbor.
  • Set boundaries. It’s also important to let people know what you need – and don’t need. Let them know how to best support you by providing clear boundaries on when you’re up for visitors and any rules you have for visiting baby – like no sick visitors and proper hand hygiene. Your focus is good health (mental, physical and emotional) for you and your baby.

Support is available

At Swedish, we believe that pregnancy and parenting aren’t meant to be solo journeys. We’ve developed resources and support for you to lean on when you need us most. The Swedish Center for Perinatal Bonding and Support was created to help women be comfortable and confident in their roles as a mother – and to help manage anxiety, depression and mood disorders during pregnancy and in postpartum.

At Swedish, we believe that pregnancy and parenting aren’t meant to be solo journeys.

Our services include our day program where we help new moms bond with their babies and connect them with women experiencing similar emotions. We also offer counseling to help treat perinatal and postpartum mood and anxiety disorders and strengthen attachment.

--

Find a doctor

If you’re struggling with your mental health, connect with one of our experienced providers. Whether you require an in-person visit or want to consult with a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow-up as needed. If you need to find a doctor, you can use our provider directory.

Related resources

Watch Amy’s story

Learn how you can help women create a lasting connection with their baby

Reducing prematurity rates with equal access for all

Midwives fill a special role before, during and after birth

Just had a baby and need support at home? Swedish doulas to the rescue.

Swedish launches first-ever hospital-based postpartum doula services

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

Previous Article
Celebrating, supporting all mothers’ breastfeeding journeys
Celebrating, supporting all mothers’ breastfeeding journeys

Breast/chest feeding is a beautiful, natural experience but it’s not always easy. Women – especially Women ...

Next Article
Mango Almond Smoothie
Mango Almond Smoothie