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Warning signs and symptoms

Stressed Woman

What are the risk factors and warning signs?

Mental health conditions during pregnancy and early parenthood can affect anyone, regardless of your background. Perinatal Mood Disorders do not have a single cause, but likely results from a combination of physical and emotional factors. After childbirth, the levels of hormones (estrogen and progesterone) in a woman’s body quickly drop. This leads to chemical changes in her brain that may trigger mood swings. In addition, many 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, which can contribute to the symptoms of postpartum depression and anxiety.

Stresses during pregnancy and early parenthood

Getting used to being a parent can be hard work – and that’s if everything goes smoothly. If you add to it a colicky baby, difficulty sleeping, or recovering from a complicated birth, you could find yourself feeling pretty stressed out. If you’re dealing with a number of issues over a period of time, keep an eye on your moods and seek support if you need it. 

Factors that can increase stress

  • obstetric complications in the past, including fertility problems

  • a history of miscarriage

  • a stressful or unplanned pregnancy

  • a very long labor and/or complicated birth

  • severe baby blues after the birth

  • an anxious, perfectionist personality or being a 'worrier'

  • low self-esteem and being self-critical

  • difficulty with breastfeeding

  • a premature baby or problems with your or your baby's health, including separation issues

  • continuing lack of sleep or rest

  • an unsettled baby (e.g. problems with feeding and sleeping)

  • being a single parent

  • being a teenage parent

  • being the parent of more than one baby (e.g. twins or triplets).

This doesn’t mean that every new parent who faces challenges will develop a mental health condition – different combinations of risk factors affect us in different ways, and protective factors can strengthen our mental health and improve our resilience.

Protective factors

If we think about risk factors as the negative things that can chip away at our mental health, protective factors are the positive things that build us up and give us the skills and support to deal with challenges. These include:

  • strong support networks – family, friends, community, other new parents

  • a positive sense of identity and cultural heritage

  • being physically healthy and taking care of yourself – exercising, eating well, reducing stress where you can

  • good coping and problem-solving skills

  • optimism – a belief that life has meaning and hope

  • a positive attitude to support seeking

  • access to support services

Because of the wide scope of PMADs, it is important for all of us to understand and identify their signs and symptoms, and to know how and where to turn for help. ​

What does a PMAD look like?

PMADs can present in a variety of ways and must be diagnosed by health care professionals. Each illness has its own symptoms, but some common symptoms include:

  • Feeling sad, hopeless, empty, or overwhelmed

  • Crying more often than usual or for no apparent reason

  • Worrying or feeling overly anxious

  • Feeling moody, irritable

  • Feeling keyed up, on edge, or restless

  • Oversleeping, or being unable to sleep even when the baby is asleep

  • Having trouble concentrating, remembering details, or making decisions

  • Experiencing anger or rage for no apparent reason

  • Having frequent conflicts with a partner

  • Losing interest in activities that are usually enjoyable

  • Suffering from physical aches and pains, including frequent headaches, stomach problems, or muscle pain

  • Unexplained weight gain/loss or appetite increase/decrease

  • Withdrawing from or avoiding friends and family

  • Having trouble bonding or forming an emotional attachment with the baby

  • Persistently doubting the ability to care for the baby

  • Thinking about harming oneself or the baby.

While many women experience some mild mood changes during or after the birth of a child, 20% of women experience more significant symptoms of depression or anxiety. Please know that with informed care you can prevent a worsening of these symptoms and can fully recover. There is no reason to continue to suffer.

Where To Get Help

Don’t be afraid to reach out if you or someone you know needs help. Learning all you can about mental health is an important first step.

Reach out to your health insurance, primary care doctor, or state/country mental health authority for more resources.

Contact the PPSC SupportLine to find out what services and supports are available in your community. 

If you or someone you know needs help now, you should immediately call the National Suicide Prevention Lifeline at 1-800-273-8255 or call 911.

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