Having a new baby should be the happiest time in a family’s life.

But it doesn’t always work out that way.

During pregnancy or the first year following pregnancy, 1 in 5 women or childbearing people will experience anxiety or depression. In fact, mental health issues are the most common complication of pregnancy and childbirth, turning joy into sadness, loneliness, confusion, regret, and guilt.

I experienced postpartum depression and anxiety after my son was born 20 years ago. We had a very scary emergency C-section. He refused to take a bottle, and I was exhausted and overwhelmed as I struggled to care for a newborn and a toddler. I told my husband I wanted a divorce and ran away from home, truly believing my family would be better off without me. It took almost six months to find the help I needed.

Broad Range of Mental Health Conditions, Symptoms, and Risk Factors

Maternal mental health (MMH) conditions can occur any time during pregnancy or the first year following pregnancy. These conditions include anxiety, depression, panic attacks, obsessive-compulsive disorder, and post-traumatic stress disorder. MMH conditions are bio-psycho-social illnesses. This means the root of the illness is often multi-factorial. It is crucial that pregnant and postpartum people experiencing these illnesses understand that they are not at fault.

Symptoms of MMH conditions include those commonly associated with depression (feeling sad, hopeless, alone) and anxiety (feeling overwhelmed, worried, fearful). In addition, those experiencing MMH conditions often say they are exhausted but can’t sleep, even when their baby is sleeping. They feel like they are drowning. They experience significant rage, often focused on their partner. They may feel like they are the worst parent in the world, and they often feel guilty for having these feelings. Some individuals have scary intrusive thoughts of hurting themselves or their babies. Please note that having these thoughts does not mean that the person is going to act on them.

Some of the well-known risk factors for MMH conditions include a personal or family history of anxiety or depression; sensitivity to hormone changes; lack of social support, especially from a partner; and major life stressors such as a new job, financial stress, or the illness or death of a loved one. Certain individuals are at increased risk for experiencing MMH conditions, including those who face racial or economic inequities, have a baby in the neonatal intensive care unit, or experienced a traumatic birth or previous sexual trauma. The COVID-19 pandemic has fueled a three-fold increase in MMH conditions as parents worry about how the coronavirus will impact them, their pregnancies, and their babies.

Path to Wellness 

Fortunately, MMH conditions are often temporary and treatable. The path to wellness includes a combination of self-care, social support, therapy, and sometimes medication.

1. Self-care. New parents need to recover from the physical and emotional challenges of pregnancy and childbirth. Being a new parent, caring for a newborn, and maintaining home and family are challenging, especially if you are feeling anxious or depressed. New parents should focus on:

Nutrition. Breastfeeding / chestfeeding parents should eat every time baby eats. Water and a high-protein snack (yogurt, cheese stick, nuts) are good mini-meals. Family and friends can stock a feeding station for parent and baby.

Exercise. Gentle exercise—such as a walk around the block—can have terrific benefits. The combined effect of a change of scenery, fresh air, Vitamin D from the sun, and endorphins released in the body can have a positive impact on mood.

Time off. No other job is so demanding, being on duty 24 hours/day, 7 days/week. New parents need time off to recharge and rejuvenate, especially if feeling overwhelmed. Even 15 minutes of peace and quiet in the shower can be restorative.     

2. Social support. Being at home with a newborn or young children can be socially isolating, compounding feelings of sadness. Peer support groups offer non-judgmental listening, support, and encouragement from others experiencing similar issues. Leaders of these support groups are caring, empathic, and have survived these illnesses.

3. Talk therapy / counseling. New parents may need to address topics such as their new role as parent, changes in relationships, and communications with partner. Talking with an objective third party—a social worker, psychologist, or professional counselor—can help put things in perspective.

4. Medication. Sometimes medication is needed to lessen symptoms of anxiety or depression. Several medications commonly used to treat anxiety or depression are widely considered safe to use during pregnancy or while breastfeeding. Primary care physicians, obstetrician/gynecologists, or psychiatrists can prescribe these medications.

How can you help someone struggling with an MMH condition?  Here are a few ideas:

• ASK a new parent how s/he is doing. Look the person in the eye and ask about them, not about the baby.
• NORMALIZE challenges. Let pregnant and postpartum people know that they are not alone, that many people have a tough time in the transition to parenthood, and that help is available. They are not alone. And they are not to blame.
• HELP by offering to care for the baby so new parents can take a nap, a shower, or a walk. Do a chore: cook dinner, fold the laundry, do the dishes, walk the dog.

With the right mix of support, self-care, and help, those struggling with MMH should be able to reduce or completely eliminate their symptoms.