Dr. Kartiki Churi, M.D.
Pregnancy is commonly referred to as an exciting and joyous time in a woman’s life, albeit with significant physical, hormonal, and psychological changes. Tremendous shifts occur in the mothers social, familial, professional, and interpersonal world. It is not uncommon for pregnant or postpartum women to experience mood changes, tearfulness and feel easily overwhelmed, commonly known as baby blues. While baby blues resolve on their own and quickly, perinatal mental illness tends to persist and severely impact the mother’s ability to return to normal function. “Perinatal” refers to the period while one is pregnant and after the baby is born.
Perinatal mental illness, also referred to as maternal mental health conditions, commonly include:
- Anxiety and anxiety spectrum illnesses like obsessive compulsive disorder, post traumatic disorder, panic disorder
- Psychotic symptoms which commonly present with bipolar disorder
- Substance use disorders
- Complicated grief after perinatal loss
Perinatal mental illness is one of the most common complications of pregnancy and post-partum impacts 1 out of 5 women in the United States. It has a substantial negative impact on maternal and infant health. Women with untreated or undertreated perinatal illness are unlikely to take care of themselves, may struggle with substance use, have poor nutrition, have none to very few positive interactions with the baby, experience nursing challenges, and question their competence as a parent. Suicide and overdose are the leading causes of death in the first year postpartum, with close to 100% of these deaths deemed as preventable. Children born to mothers with untreated perinatal mental illness are likely to have low birth weight, preterm birth, excessive fussiness, difficulty latching, and behavioral, emotional, and cognitive delays.
There are several reasons women hesitate to seek treatment during or after pregnancy, and most revolve around stigma and lack of awareness of the various treatment options available. Oftentimes, depressed and anxious postpartum women feel like a failure in their role as a parent and confront a great deal of shame, which can be a barrier in expressing their struggles. Some women keep expecting the symptoms to resolve and others fear that they will be labeled as an incompetent parent. Another common concern that several pregnant or nursing women have is the impact of medication on the embryo or infant. These and other barriers prevent the early detection and treatment of inherently treatable illness, and many women continue to suffer the short- and long-term consequences of perinatal mental illness. It does not have to be this way! With proper and timely treatment, most women experience symptom improvement and meaningful quality of life.
There are several medication and non-medication options available that are commonly and successfully used to treat maternal mental health conditions. Psychotherapy, including Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT) and several other therapy methods can be very effective for certain perinatal symptoms and illnesses. There are times when the nature of illness and intensity of the symptoms require medication consideration. There are several different ways in which perinatal mental illness could present. For instance, it might be the first onset of symptoms, with no prior mental health history. In other cases, a woman with prior mental health treatment history, might need to restart medication due to relapse of symptoms. Others might need adjustment in medication doses due to change in symptoms or switch to an alternate treatment option that is safely prescribed through pregnancy and after. In any of these scenarios, it is important to talk with your doctor and know what treatment options and venues are available to address your specific symptoms.
At FCC, we screen, evaluate, and treat perinatal mental health disorders with strong focus on the bio-psycho-social model of care. We collaborate with your primary care physician, obstetrician, and your social support system to empower you to make an informed treatment decision. Woman's mental health during pregnancy and the phase after comes with its unique challenges and can impact various aspects of her life. You are not alone on this journey.