Watching for and Treating Depression or Anxiety in Pregnant Women and New Moms

May means a lot of focus on moms and the issues that affect them, but it’s also Maternal Mental Health Awareness Month worldwide.

Kim Myers, MSW, the behavioral health clinical program manager and social worker at Intermountain Healthcare, said “Being pregnant or being a new mom often means going through a lot of changes. Even with a planned pregnancy and birth, sought-after changes bring stress. By nature, moms have another person’s needs to care for and think about, besides managing their own personal needs.”

Factors that may contribute to being at risk for peripartum mood disorders

During pregnancy and after delivery, women’s hormone levels are changing. On top of that, many new mothers are unable to get the rest they need to fully recover from giving birth. Constant sleep deprivation can lead to physical discomfort and exhaustion.

“Pregnancy and the postpartum period are a time when women may experience a mood disorder like depression and anxiety. This can happen for the first time, or it can usher in a new episode of these disorders, or it can worsen an existing condition,” said Myers.

“In addition, the COVID-19 global pandemic has increased anxiety and social isolation, and has also led to life stressors like job changes, moving, childcare challenges and that’s a lot of things that can factor into a woman’s mental health. A happy time – where one may typically experience a lot of outside support – becomes an isolated one. And new parents may have fewer family and financial resources due to the pandemic,” she added.

Pregnancy complications, including contracting COVID-19 while pregnant, add a level of stress. Stress can put people over the edge, especially in vulnerable populations.

Postpartum depression is common

Like mental health conditions in general, postpartum depression is common.  Up to 1 in 8 women in Utah experience postpartum depression. A better term is actually peripartum mood disorders, because they can occur during pregnancy or after birth. Mood disorders can manifest not only as depression, but in other ways like anxiety or obsessive-compulsive disorder, even psychosis.

“The most recent reports from the Utah Department of Health indicate overdose and suicide are the leading causes of maternal death in Utah which of course are both associated with a behavioral health condition. We need to understand the why and take care of mothers and help them know where to get help,” added Myers.

Many women may wonder if their feelings are normal, or if they are just the baby blues, or if they may be experiencing true depression or anxiety.

How is postpartum depression different from the “baby blues”?

• The “baby blues” is used to describe feelings of worry, unhappiness, and fatigue many women experience after having a baby. This occurs in 80% of women.
• Babies require a lot of care, so it’s normal for mothers to be worried about or tired from providing that care.
• Baby blues includes feelings that are somewhat mild, last a week or two, and go away on their own. Doing things like taking a break or a nap and eating well usually help.

It’s ok to talk to a provider about mental health concerns

“Parenting is often romanticized and therefore struggling with parenthood and/or a new baby can make a parent reluctant to ask for help. This is a major life adjustment, and some struggle is normal,” said Myers. “Don’t be embarrassed to talk to a provider about anxiety or depression.”

“The nature of depression is it’s hard to reach out for help, so family and friends need to help watch for symptoms and reach in toward moms to understand what they’re experiencing and also help them feel comfortable enough to reach out for professional help.  Providing practical help like caring for the baby, cooking, or cleaning can be a big support as well” she said.

OB and primary care providers can help screen for mental health concerns and provide referrals for behavioral health.

“If a mom is experiencing mood changes that are interfering with her ability to care for herself or her child, it’s ok to talk about it. It’s never wrong to share concerns with a provider,” added Myers.

She emphasized that even under non-pandemic conditions, women are somewhat socially isolated when they have a baby. They’ve taken time off work or quit their job and are spending more time at home.

“While this is maternal mental health month, let’s not forget that adjustment can be hard for dads or partners, too,” said Myers.

Myers said moms and their partners, families and friends should be aware of the symptoms of  peripartum mood disorders that need urgent treatment such as:

• Having trouble bonding or forming an emotional attachment with her baby
• Persistently doubting her ability to care for her baby
• Never feeling good
• Thinking about harming herself or her baby.
• Experiencing anger or rage
• Fear of taking medications
• Psychosis – thoughts that are irrational

Symptoms can also manifest, as anxiety, obsessive compulsive disorder or lead to substance abuse.

Signs of postpartum anxiety 

• Worry more than normal about the newborn
• Terrified of hurting the baby
• Panic attacks

Signs of obsessive-compulsive disorder postpartum

• Obsessed with checking things over and over
• Irrationally concerned about baby’s safety or wellness
• Intrusive thoughts become prevalent and occur often
• Taking action to avoid intrusive thoughts.

Where to get help

1.  Talk to an OB or primary care physician about mental health concerns and ask for a referral. There are resources available for those who don’t have insurance.
2.  Call the Intermountain Behavioral Health Navigation Line at 1-833-442-2211.

It’s free and can be reached seven days a week from 7 am to 7 pm. It connects callers with a trained care coordinator who can provide appropriate self-care tools, peer support, treatment options, crisis resources, and more.

3.  If symptoms are severe, go to an Intermountain Behavioral Health Access Center

Intermountain LDS Hospital in Salt Lake, McKay-Dee Hospital in Ogden and St. George Regional Hospital offer walk in behavioral health access centers that are open extended hours. Check with the specific location for hours or other Intermountain behavioral health locations to see if they have urgent appointments available.

Visit the Postpartum Support International  or PSI-Utah for additional resources.

About Intermountain Healthcare

Headquartered in Utah with locations in eight states and additional operations across the western U.S., Intermountain Healthcare is a nonprofit system of 33 hospitals, 385 clinics, medical groups with some 3,900 employed physicians and advanced care providers, a health plans division called SelectHealth with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For more information and updates, click here