New moms may feel down in the dumps, sad, listless, etc after the birth of their babies. If these feelings last from the birth up to two weeks then she may be experiencing baby blues. If these feelings persist beyond two weeks after the birth, this is NOT baby blues and could be a PMAD.
PMADs can be diagnosed in 15-20% of new mothers. New moms may experience symptoms of anxiety, depression, Obsessive-Compulsive Disorder (OCD), or a combination of disorders. Mothers with Bipolar Disorder or another mood disorder are at an increased risk of experiencing a PMAD.
PMADS are treated with talk therapy or medication. Severe symptoms respond best with both therapy and medication management. Medical professionals use assessment tools such as the Edinburgh Postnatal Depression Scale (EPDS) to screen for PMADs.
It’s normal to have thoughts around the safety of your baby. Many new moms report experiencing intrusive thoughts such as while bathing their baby, it would be so easy for her to slip under the water and drown. Some thoughts can have a sexual nature as well.
Perinatal psychiatrists view these thoughts as normal but acknowledge the distress they cause in new moms and dads. Perinatal psychosis occurs when a new mom doesn’t consider these thoughts disturbing and may have plans to act on them. Psychosis is a break with reality and a medical emergency.
New parents fear that if they share these thoughts with a therapist their babies will be taken away by Child Protective Services (CPS). Many new moms suffer in silence with these unwanted and disturbing thoughts. Talk therapy is a great place to share these thoughts without fear of your baby being taken from you.
Sleep is vital for physical and mental health. Many new parents suffer from disturbed sleep due to the nature of newborns/infants. Therapists and psychiatrists will start with addressing the family’s sleep needs as the first intervention in treating PMADs.
Families may need to consider hiring a postpartum doula, night nanny, taking shifts, or creating an arrangement where both parents are getting enough rest. Therapists can help brainstorm and connect new parents to sleep resources.
Some new mothers may have suicidal thoughts such as the baby would be better off without me. These thoughts are to be taken seriously and may be an expression of depression.
Therapists conduct a suicide assessment and determine the level of risk for self harm/death. If the parent is in danger of hurting herself or her baby she can voluntarily check herself in to the hospital for psychiatric treatment. If a mom is unable to ensure her safety or the safety of her baby she may be involuntarily held in a hospital (Commonly called initiating a 5150).
I work really hard with my clients to help them to volunteer for treatment rather than being involuntarily hospitalized because that in itself can be traumatizing.
Many new parents feel symptoms of burnout. These symptoms mirror depression and may be present in combination with a PMAD. Burnout is a sign parents need to take a break.
Burnout looks like passive-aggressive behavior around caretaking. For example, it’s dad’s night to give the baby a bath and he’s caught up in a video game. For mothers, it may be zoning out on social media or watching a show and ignoring the baby.
I recommend the book Burnout-The Secret to Unlocking the Stress Cycle by Amelia and Emily Nagoski to clients. Talk therapy helps with burnout because new parents feel seen and heard.