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When it's more than just the "baby blues"

Let's talk about perinatal mental health

Though having a new baby is often a joyous occasion, it’s also a massive life transition that can bring about stress, uncertainty, and most of all, lack of sleep. It’s not surprising that new parents often feel like they’re experiencing the highest highs and the lowest lows after coming home from the hospital with their newborn.

While some of this is normal and expected as a result of hormone changes and an adjustment period — you may have heard this called the “baby blues” — it can sometimes point to a more serious mental health concern, like postpartum depression. When feelings of sadness, irritability, anxiety, and exhaustion continue for more than several weeks or months after birth (or if the feelings interfere with the parents’ normal abilities to cope, function, or parent their newborn), it’s likely developed into postpartum depression or a more general perinatal mood and anxiety disorder (PMAD).

What is a perinatal or postpartum mood and anxiety disorder?

You’ve probably heard of postpartum depression and anxiety, but the term has changed recently to acknowledge that these mental health struggles can develop at any point during pregnancy External Site and up to one year after having a baby. Types of PMADs include depression, anxiety, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and psychosis (a serious emergency).

PMADs affect at least 20 percent of all birthing people External Site, making it the top complication of pregnancy and childbirth. Non-birthing people (including fathers, partners and adoptive parents) aren’t immune either. According to a recent study in the American Journal of Men’s Health External Site, up to 9 percent of new fathers can experience postpartum depression. And, if one parent develops a PMAD, the other is more at-risk for developing one as well.  

Luckily, perinatal mood and anxiety disorders are very treatable with any combination of talk therapy, medication, self-help techniques, support groups, and, if necessary, temporary hospitalization.

As with any mental health condition, PMADs are not the fault of the individual and are a medical issue just like any other physical ailment. PMADs are caused by chemical changes in the brain brought on by a major life event. They are also associated with several different risk factors External Site — including a lack of social support, financial stress, personal history with mental health conditions, and other sudden life changes, to name a few.

What does a perinatal mood and anxiety disorder look like?

PMAD symptoms can vary and range from mild to severe. Symptoms can include External Site:

  • Feeling depressed
  • Severe mood swings
  • Excessive crying
  • Withdrawing from family and friends
  • Extreme fatigue or loss of energy
  • Insomnia
  • Intense irritability and anger
  • Severe anxiety and panic attacks
  • Intrusive thoughts that are highly disruptive
  • Feeling worthless or inadequate
  • Thoughts of self-harm or harming your baby

Though these symptoms are similar to the “baby blues” at first, they last much longer than a few weeks after childbirth and can interfere with bonding and caring for your newborn.

More about postpartum psychosis

Postpartum psychosis is a rare PMAD normally develops within a week of childbirth and is a life-threatening emergency that needs immediate treatment. According to the Mayo Clinic External Site, signs of postpartum psychosis include confusion and disorientation, hallucinations, delusions, paranoia, excessive energy and agitation, obsessive thoughts about your baby, severe sleep disturbances, and attempts to harm yourself or your baby.

Do you suffer from a perinatal mood and anxiety disorder?

If you have been struggling, you're not alone. Being diagnosed with a PMAD has zero reflection on you and your ability to parent; rather, it more accurately reflects the struggles most new parents face that aren't openly acknowledged or talked about. 

Just as you would seek care for any other disease, it is just as critical to seek care for mental health issues, as well. Getting and receiving this care will not only help you be able to be your best, but it will also help you care for your other family members.

If you recognize any of the symptoms above, reach out to your OB/GYN, midwife, other health care provider you saw during pregnancy, or even your personal doctor. They'll help you determine the next steps for treating your PMAD, whether that's medication, talk therapy, support groups, or a combination of those. 

Don't be afraid to tell your loved ones that you're experiencing PMAD symptoms, either. Oftentimes, extra support from friends and family members can help lessen the severity of what you're dealing with. Accepting help can make a difference — whether its someone offering to cook a hot meal or hold the baby while you sleep, shower, or do other self-care tasks.  

Caring for yourself during pregnancy and postpartum

trusted answers and helpful resources when pregnant and postpartum

If you’re a Wellmark Blue Cross and Blue Shield member, you have access to trusted answers and helpful resources during your pregnancy and beyond.

  • The free Pregnancy Support Program through myWellmark® Secure is available when you need it (day or night) and includes optional access to personalized support from a case management nurse. It also includes the WebMD® Pregnancy Assistant, Count the Kicks® app, and more.
  • myWellmark can help you manage Opens New Window all aspects of your health during pregnancy and after you’ve had the baby. It gives you a transparent look into your health care usage and easy-to-use tools, resources, and insights. You can check claims details, view health care spending, find an in-network doctor, use tools to understand your benefits and more. Plus, you have access to wellness tools and resources from WebMD®. If you aren’t signed up, you only need a few minutes and a valid email address.
  • BeWell 24/7SM  provides you with around-the-clock help from a real person. If you have health-related concerns, simply call Eight, Four, Four, Eight, Four, Be Well for answers around topics like treatment options, in-network providers and facilities, and the best place to go for care based on your symptoms.

Racial disparities among perinatal mood disorders

In addition to stark racial disparities in maternal and infant health, people of color are also more likely to experience External Site perinatal mood and anxiety disorders. Studies have shown that new mothers of color External Site experience PMADs at twice the rate of white mothers in the U.S., and up to half of them do not receive any support or treatment. However, those numbers may be even higher, with as some research suggesting s that as many as half External Site of people experiencing a PMAD do not report it.

Anecdotal evidence External Site shows that Black women may stay quiet about feelings of depression due to shame, embarrassment, and racial stigma. And, screening tools designed to catch perinatal mood disorders don't take into account symptoms that tend to present in nonwhite women External Site, like high blood pressure, unexplained body aches, and nausea.

Making maternal health a priority

The Blue Cross and Blue Shield Association (BCBSA) Opens PDF recently launched a national health equity strategy confronting racial disparities in several key areas of health care. The multi-year initiative focuses on four areas of health care — including maternal health External Site — that disproportionately affect communities of color in the United States. As a part of this strategy, the BCBSA has set a goal to reduce racial disparities in maternal health care by 50 percent over the next five years. To learn more, visit External Site.