The process of planning a family and/or preparing for pregnancy can be daunting and stressful. Maybe you don’t even know where to start, or maybe you’re already trying to conceive naturally or are doing IUI or IVF. Or you are interested in adoption or surrogacy. Many people going through this stage may struggle with anxiety over uncertainty, stress about the success of family planning, and feelings of grief and loss when encountering fertility difficulties or experiencing a miscarriage. Having a safe space to analyze your choices, cope with uncertainty and anxiety, and process your emotions can be extremely helpful.

Perinatal Mental Health Disorders (PMHDs), otherwise known as Perinatal Mood and Anxiety Disorders (PMADs), are mental health disorders that can arise anytime within pregnancy through the first year postpartum. This includes Postpartum Depression (PPD), Postpartum Anxiety (PPA), Perinatal Panic Disorder, Perinatal OCD, Postpartum PTSD, Postpartum Bipolar Disorders, and Postpartum Psychosis. There are identifiable risk factors for developing these disorders, and steps that can be taken to prevent their onset or prevent them from getting worse. Screening for PMHDs can be a valuable step for parents-to-be or parents in managing their mental health. I use the Edinburgh Postnatal Depression Scale (EPDS) along with other assessment measures to help screen for PMHDs or symptoms that may indicate the need for more mental health support. You may have received screening for these from your OB/GYN, but it can be helpful to have a mental health professional screen for PMHDs as well.

It is completely normal to experience anxiety during pregnancy and postpartum. You’re preparing to become a new parent - a role that you may never have experienced before and/or that brings uncertainty, self-doubt, sleeplessness, and stress! Some new parents may even develop an anxiety disorder during the perinatal period. This sometimes manifests as generalized anxiety symptoms, physical symptoms of anxiety, or intense worry about your baby and its health or wellbeing. It’s important to manage the anxiety that arises using positive coping strategies. I help my clients manage anxiety using evidence-based coping techniques, cognitive reframing, and compassion-focused interventions. I encourage you to develop positive self-talk to support yourself through these changes, develop more positive cycles of thinking and behaviors, and identify sources of support.

If you are experiencing more intense anxiety about your pregnancy or new baby, you may be experiencing symptoms of perinatal Obsessive-Compulsive Disorder (OCD). Those who experience this have more intense, intrusive, and repetitive thoughts which can sometimes be very disturbing or distressing. Some people experience thoughts of harm coming to their baby or “flashes” of catastrophes that might happen to their baby. These often are accompanied by intense guilt or shame for having these thoughts, or concern that they are not good parents as a result. Some parents who experience these intrusive thoughts also take steps to make sure no harm comes to their baby, avoid situations that prompt anxiety, or are in a constant state of being on edge and hypervigilant to prevent bad things from happening. If you are experiencing this, know that you are not alone and you are not a “bad parent.” This can be one of the most isolating and distressing perinatal mental health struggles and you deserve support to alleviate this distress you’re feeling.

Have you been feeling sad, hopeless, or especially tearful? Or have you been experiencing mood swings, are quick to become irritable, or feeling a general sense of apathy or emptiness? You may be experiencing symptoms of depression, which can arise in the prenatal and postpartum period. Although 80% of new mothers experience the “baby blues” postpartum, 1 in 7 mothers develop postpartum depression (as well as 10% of non-birthing partners). This is characterized by general depression symptoms (feeling down, insomnia, loss of interest in activities, anger or irritability, reduced appetite, self-blame or negativity, suicidal thoughts, and difficulty concentrating) as well as additional symptoms of agitation or anxiety, stress reactions like anger or rage, significant insomnia, manic symptoms, intrusive thoughts or images, hypervigilance, and substance dependence. If you are experiencing any of these symptoms, you may be feeling hopeless, worried, and like you’re at your “breaking point.” Postpartum depression is temporary, treatable, and NOT your fault. Therapy can be so valuable in helping you develop positive coping mechanisms and feel stronger to tackle the stress of new parenthood.

If you have experienced a trauma during the perinatal period, such as a miscarriage, the loss of a child, birth complications, or another stressful event, you may be experiencing symptoms of perinatal or Postpartum PTSD. PTSD is an stress disorder that arises in the perinatal population in response to a traumatic event in which grave physical harm was threatened, perceived, or occurred. Although many people experience acute stress reactions to a traumatic event, if your nervous system does not return to baseline a couple months after the event, you may benefit from trauma-informed therapy. Already a highly stressful transition, those who experience trauma within the perinatal period often feel like their expectations for what should happen have been shattered. You imagine building a life for your future child and then something happens that drastically alters your view of the future. If you are experiencing a trauma response that is causing you distress, reach out to get therapeutic support.