About Perinatal Mental Health
Perinatal Mental Health conditions are the number one complication of childbearing.
There are several types of Perinatal Mental Health conditions that can occur during the perinatal period (including pregnancy, postpartum, and post-loss) and affect not only the pregnant person but also other family members, including dads and partners. Some of these may occur individually, but you may experience a combination of PMH conditions during the perinatal period.
of perinatal mental health complications occur from pregnancy to two years postpartum.
of parents are still experiencing mental health conditions at 4 years postpartum.
Perinatal Mental Health Conditions
Learn more about Perinatal Mental Health conditions, including prevalence, symptoms, risk factors, and potential treatment options.
Perinatal Depression
(Pregnancy, Post-loss and Postpartum)
Perinatal depression, including postpartum depression, occurs more often than most people realize – in fact, it is the most common complication of childbearing. Studies show that 1 in 5 women or 1 in 10 men may experience depression during the perinatal period. However, the numbers are likely higher and increase for high-stress parenting groups.
It is important to know the signs and symptoms of Perinatal Depression. Perinatal Depression is treatable, and help is available. You do not need a diagnosis to reach out for help.
Symptoms
Symptoms can start anytime during the perinatal period and they differ for each person. They might include the following:
- Feelings of anger or irritability & rage
- Lack of interest in the baby
- Appetite and sleep disturbance
- Crying and sadness
- Feelings of guilt, shame or hopelessness
- Loss of interest, joy or pleasure in things you used to enjoy
- Possible thoughts of harming the baby or yourself
Risk Factors
Research shows that all of the things listed below put you at a higher risk for perinatal depression. If you have any of these factors, you should discuss them with your medical provider so that you can plan ahead for the care you may need.
- A personal or family history of depression, anxiety, or perinatal depression
- Premenstrual dysphoric disorder (PMDD or PMS)
- Inadequate support in caring for the baby
- Financial stress
- Marital stress
- Complications in pregnancy, birth or lactation.
- A major recent life event: loss, house move, job loss
- Birth of multiples
- Infants/Children who visit the Neonatal Intensive Care (NICU)
- Infertility treatments
- Thyroid imbalance
- Any form of diabetes (type 1, type 2 or gestational)
In addition, belonging to a high-stress parenting group may also be a risk factor. High risk parenting groups might include:
- Queer and Trans Families
- Military Families
- Teen Parents
- Multiples
- Single Parents
- Parents of Color
- Near Miss Survivor
- Loss
Treatment Options
Perinatal depression is treatable, and there are many options to consider when looking for the correct treatment option. You should consult your doctor or therapist, to find the right plan for you. Some may include:
- Social Support & Practical Help: including activities like prioritizing sleep, time for self, reading, podcasts, meditation, asking for help & support groups.
- Mental Health Counseling: Evidence-based therapy types may include CBT (Cognitive Behavioral Therapy) & IPT (Interpersonal Psychotherapy), but others may be an option.
- Medical Evaluation and Treatment: Medication may be an option, and you must consult a doctor to see what will work for you. Antidepressants are the most commonly used to treat depression. Medication Resources for lactation and pregnancy are listed here.
- Intensive Treatment Facilities are available and are listed here.
You are not alone. PSI is here to help.
Perinatal Anxiety
(Pregnancy, Post-loss, and Postpartum)
Approximately 20% of people develop perinatal anxiety during the perinatal period. You may experience perinatal anxiety independently, but it is often combined with perinatal depression. High-stress parenting groups experience perinatal anxiety at a higher rate.
Perinatal anxiety is treatable, and help is available. You do not need a diagnosis to reach out for help.
Symptoms
The symptoms of anxiety during the perinatal period might include:
- Constant worry
- Feeling that something bad is going to happen
- Racing thoughts
- Disturbances of sleep and appetite
- Inability to sit still
- Physical symptoms like dizziness, hot flashes, and nausea
Other Perinatal Anxiety You do not need a diagnosis to reach out for help.
In addition to generalized anxiety, there are some specific forms of anxiety that you should know about.
- Perinatal Panic Disorder- This is a form of anxiety with which the sufferer feels very nervous and has recurring panic attacks. During a panic attack, they may experience shortness of breath, chest pain, claustrophobia, dizziness, heart palpitations, and numbness and tingling in the extremities. Panic attacks seem to go in waves, but it is important to know that they will pass and will not hurt you.
- Perinatal Obsessive Compulsive Disorder: Learn more about OCD below.
Risk Factors
Risk factors for perinatal anxiety and panic include a personal or family history of anxiety, previous is perinatal depression or anxiety, or thyroid imbalance.
In addition, belonging to a high-stress parenting group may also be a risk factor. High-stress parenting groups include:
- Queer and Trans Families
- Military Families
- Teen Parents
- Multiples
- Single Parents
- Parents of Color
- Near Miss Survivor
- Loss
Treatment Options
Perinatal anxiety is treatable, and there are many options to consider when looking for the correct treatment option. You should consult your doctor or therapist, to find the right plan for you. Some may include:
- Social Support & Practical Help: including activities like prioritizing sleep, time for self, reading, podcasts, mindfulness, relaxation, asking for help & support groups.
- Mental Health Counseling: Evidence-based therapy types may include CBT (Cognitive Behavioral Therapy) & IPT, but others may be an option.
- Medical Evaluation and Treatment: Medication may be an option, and you need to consult a doctor to see what will work for you. Antidepressants, and possibly anti-anxiety medications, are the most commonly used to treat anxiety. Medication Resources for lactation and pregnancy are listed here.
- Intensive Treatment Facilities are available and are listed here.
You are not alone. PSI is here to help.
Perinatal Obsessive Compulsive Disorder (OCD)
(Pregnancy, Post-loss and Postpartum)
Perinatal OCD is a mental health condition characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). It is estimated that 7.8% of pregnant individuals and 16.9 % of postpartum individuals, and some partners, will experience Perinatal OCD.
Repetitive, intrusive images and thoughts are very frightening and can feel like they come “out of the blue.” Research has shown that these images are anxious in nature, not delusional, and have a very low risk of being acted upon. It is far more likely that the parent experiencing symptoms may take steps to avoid triggers and what they fear is potential harm to the baby.
Perinatal OCD is treatable, and help is available. You do not need a diagnosis to reach out for help.
Symptoms
Symptoms of Perinatal Obsessive-Compulsive symptoms can include:
- Obsessions, also called intrusive thoughts, which are persistent, repetitive thoughts or mental images related to the baby. These thoughts are very upsetting and not something that you have ever experienced before. People with Perinatal OCD know that their thoughts are bizarre and are very unlikely to ever act on them.
- Compulsions, where you may do certain things over and over again to reduce her fears and obsessions. This may include things like needing to clean constantly, check things many times, count or reorder things.
- A sense of horror about the obsessions
- Fear of being left alone with the infant
- Hypervigilance in protecting the infant
Risk Factors
Risk factors for perinatal OCD include a personal or family history of anxiety or OCD. Rates of perinatal OCD are higher among people who had an OCD diagnosis prior to giving birth.
Treatment Options
Perinatal OCD is treatable, and there are many options to consider when looking for the correct treatment option. You should consult your doctor or therapist, to find the right plan for you. Some treatment options may include:
- Social Support & Practical Help: including activities like prioritizing sleep, time for self, reading, podcasts, mindfulness, relaxation, asking for help & support groups.
- Mental Health Counseling: Evidence-based therapy CBT (Cognitive Behavioral Therapy), ERP (Exposure & Response Prevention), and DBT (Dialectical Behavioral Therapy).
- Medical Evaluation and Treatment: Medication may be an option, and you need to consult a doctor to see what will work for you. Anti-depressant medications are the most commonly used to treat OCD. Medication Resources for lactation and pregnancy are listed here.
- Intensive Treatment Facilities are available and are listed here.
You are not alone. PSI is here to help.
Postpartum Post-Traumatic Stress Disorder (PTSD)
Postpartum PTSD is caused by a perceived or real trauma during delivery or postpartum. These traumas could include prolapsed cord, unplanned C-sections, use of vacuum extractor or forceps to deliver the baby, baby going to NICU, feelings of powerlessness and/or lack of support and reassurance during the delivery, severe physical complication or injury related to pregnancy or childbirth.
Approximately 3% of people who give birth experience postpartum post-traumatic stress disorder (PTSD) following childbirth, while this increases to 15% for at-risk populations.
Postpartum PTSD is treatable, and help is available. You do not need a diagnosis to reach out for help.
Symptoms
Symptoms of postpartum PTSD might include:
- Intrusive re-experiencing of a past traumatic event (which in this case may have been the childbirth itself)
- Flashbacks or nightmares
- Avoidance of stimuli associated with the event, including thoughts, feelings, people, places and details of the event
- Persistent increased arousal (irritability, difficulty sleeping, hypervigilance, exaggerated startle response)
- Anxiety and panic attacks
- Feeling a sense of unreality and detachment
Risk Factors
People who have experienced previous trauma, such as rape or sexual abuse, are also at a higher risk for experiencing postpartum PTSD.
Treatment Options
Postpartum PTSD is treatable, and there are many options to consider when looking for the correct treatment option. You should consult your doctor or therapist, to find the right plan for you. Some treatment options, or combination of options, may include:
- Social Support & Practical Help: including activities like prioritizing sleep, time for self, reading, podcasts, mindfulness, relaxation, asking for help & support groups.
- Mental Health Counseling: Evidence-based therapy types may include CBT (Cognitive Behavioral Therapy) & EMDR (Eye Movement Desensitization and Reprocessing), IPT (Interpersonal Psychotherapy). A possible emerging therapy may include Brainspotting.
- Medical Evaluation and Treatment: Medication may be an option, and you need to consult a doctor to see what will work for you. Antidepressants, and possibly anti-anxiety and sleeping medications are the most commonly used to treat PTSD. Medication Resources for lactation and pregnancy are listed here.
- Intensive Treatment Facilities are available and are listed here.
You are not alone. PSI is here to help.
Bipolar Mood Disorders
Bipolar Mood Disorders include Bipolar I and Bipolar 2
Research shows that 50% of women with bipolar disorder are first diagnosed in the postpartum period.
There are two phases of a bipolar mood disorder: the lows and the highs. The low time is clinically called depression, and the high is called mania or hypomania.
Perinatal Bipolar is treatable, and help is available. You do not need a diagnosis to reach out for help.
Symptoms
Bipolar disorder can look like a severe depression or anxiety.
- Periods of severely depressed mood and irritability
- Mood much better than normal
- Rapid speech
- Little need for sleep
- Racing thoughts, trouble concentrating
- Continuous high energy
- Overconfidence
- Delusions (often grandiose, but including paranoid)
- Impulsiveness, poor judgment, distractability
- Grandiose thoughts, inflated sense of self-importance
- In the most severe cases, delusions and hallucinations
Risk Factors
Risk Factors for Bipolar Mood Disorder are family or personal history of bipolar mood disorder (also called manic-depression).
Treatment Options
Postpartum Bipolar is treatable, and there are many options to consider when looking for the correct treatment option. You should consult your doctor or therapist, to find the right plan for you. Some treatment options, or combination of options, may include:
- Social Support & Practical Help: including activities like prioritizing sleep, time for self, reading, podcasts, mindfulness, relaxation, asking for help & support groups.
- Mental Health Counseling: Evidence-based therapy types may include DBT (Dialectical Behavioral Therapy) & CBT (Cognitive Behavioral Therapy)
- Medical Evaluation and Treatment: Medication may be an option, and you need to consult a doctor to see what will work for you. Medication Resources for lactation and pregnancy are listed here.
- Intensive Treatment Facilities are available and are listed here.
You are not alone. PSI is here to help.
Perinatal Psychosis (PP)
(Pregnancy, Post-loss, and Postpartum)
Perinatal psychosis is a serious PMH disorder that usually has an onset in the first 2-weeks (but up to a year). Perinatal Psychosis occurs in approximately 1 to 2 out of every 1,000 deliveries, or approximately .1 -.2% of births. Review the information below to learn more about PP.
An active case of Perinatal Psychosis is considered an emergency, and you should reach out to one of the numbers below. It is important to stay with the perinatal individual and the child to ensure everyone’s safety.
Perinatal Psychosis is treatable, and help is available. You do not need a diagnosis to reach out for help.
If you suspect Perinatal Psychosis
Call or text the National Maternal Mental Health Hotline 833-852-6262. Hotline Counselors are available to discuss and explore next steps for you and your loved one. Available 24/7, in the United States only.
In an Emergency
Call or text the Suicide and Crisis Lifeline at 988 (in the United States and Canada only). Emergency Hotlines are available all the time. It is very important that you reach out right now and find the support and information you need to be safe. Call for yourself or someone you care about; available 24/7.
Symptoms
Symptoms of perinatal psychosis can include:
- Delusions or strange beliefs
- Hallucinations (seeing or hearing things that aren’t there)
- Feeling very irritated
- Hyperactivity
- Severe depression or flat affect
- Decreased need for or inability to sleep
- Paranoia and suspiciousness
- Rapid mood swings
- Difficulty communicating at times
The most significant risk factor for perinatal psychosis is a personal or family history of bipolar disorder, or a previous psychotic episode.
Of the individuals who develop a perinatal psychosis, research has suggested that there is approximately a 5% suicide rate and a 4% infanticide rate associated with the illness. This is because the individual experiencing psychosis is experiencing a break from reality. In their psychotic state, the delusions and beliefs make sense to them; delusions feel very real and are often religious. Immediate treatment for someone going through psychosis is imperative.
It is also important to know that many survivors of perinatal psychosis never experienced delusions containing violent commands. Delusions take many forms, and not all of them are destructive. The majority of individuals who experience perinatal psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and this is why this illness must be quickly assessed, treated, and carefully monitored by a trained healthcare or perinatal mental health professional.
Perinatal psychosis is temporary and treatable with professional help, but it is an emergency, and it is essential that you receive immediate help. If you feel you or someone you know may be suffering from this illness, know that it is not your fault and you are not to blame. It is important to stay with the perinatal individual and the child to ensure everyone’s safety. Call your doctor or an emergency crisis hotline right away so that you can get the help you need.
Treatment Options
Perinatal Psychosis is treatable but is also considered an emergency. Contact your doctor or an emergency crisis line immediately.
- If you suspect Perinatal Psychosis – Call or text the National Maternal Mental Health Hotline 833-852–6262. Hotline Counselors are available to discuss and explore next steps for you and your loved one. Available 24/7, in the United States only.
- Call or text the Suicide and Crisis Lifeline at 988 (in the United States and Canada only). Emergency Hotlines are available all the time. It is very important that you reach out right now and find the support and information you need to be safe. Call for yourself or someone you care about; available 24/7.
- Intensive Treatment Facilities are available and are listed here.
After the emergency treatment:
After emergency treatment, those individuals who have experienced Perinatal Psychosis should be followed by a doctor and therapist to continue treatment, including medication and ongoing therapy.
You are not alone. PSI is here to help.
