New mothers may be shocked when their tears of joy from holding their infant give way to tears of sadness or anger. Their feelings may not match their expectations or what they learned from other women about the first year of motherhood. Their mood may be worsened if they feel isolated—different from other women—when in fact they are not alone in this situation.
“Between 5 to 25 percent of women may experience some kind of postpartum blues,” says Barry Schlafstein, MD, an OB/GYN who is also the Chair of St. Joseph’s/Candler’s department of obstetrics and gynecology. “The symptoms are usually fairly mild and transient for most women, but a small number of new mothers can experience a more severe, long-lasting and potentially debilitating mood disorder.”
Perinatal mood disorders usually occur in the first four months after delivery, but can onset at anytime in the first year. The symptoms are similar to those in women who are not pregnant but are suffering from major depression or anxiety: changes in sleeping or eating patterns, irritability, mood swings, feelings of hopelessness and worthlessness, crying jags and difficulty concentrating. Women with a perinatal mood disorder may also find that they are uninterested in the new baby or have irrational fears of harming him or her, and may notice physical ailments such as headaches and heart palpitations.
“A perinatal mood disorders is often self-limiting,” says Schlafstein. “However, it can sometimes be a form of clinical depression or anxiety that requires treatment.”
Mothers who need help for their perinatal mood disorder may be feeling too overwhelmed and isolated to know where to start. First Steps, a St. Joseph’s/Candler program that provides community-based parenting support and education to families of newborns, is working to solve that problem by making help just a phone call away. First Steps has collaborated with Project Healthy Moms to create the Warmline.
“Warmline is a way for new mothers with a perinatal mood disorder to communicate with a mother who has been there and survived the experience,” says Stephanie Mobley, Community Outreach Coordinator for First Steps. “Not only have these moms survived, they are thriving.”
Warmline can be accessed through telephone or e-mail, and the process is fairly simple. Mothers call the number and leave a message or write an e-mail, and a peer support person calls or writes back as soon as possible. The return contact usually happens within twenty four to forty eight hours.
“Then, you just talk,” Mobley says. “It may sound simple, but sharing with someone who has been there, who truly understands, is often the best kind of help there is.”
The Warmline support person will also have a resource list of counselors to recommend if necessary.
“No one will think less of you if you ask for help with this, and there is no award for toughing it out,” Mobley says. “It does get better, and it can get better faster if you don’t try to go it alone.”
Dr. Schlafstein agrees. “In general, the earlier the initiation of treatment, the better the prognosis,” he says.
In rare cases, women can suffer from postpartum psychosis, which comes on quickly and strongly and can endanger both the infant and the mother. A history of bipolar disorder can indicate a woman at high risk for this uncommon condition.
Risk factors for the less severe perinatal mood disorders are also tied to a women’s personal or family history of other mood disorders.
“It is not always easy to predict who is at risk,” Schlafstein says. “Lack of sleep is a very important factor, as are hormonal changes. Social circumstances including marital, family, or financial difficulties can also play a role.”
Yet even a woman who has none of those risk factors is susceptible and should seek help if she experiences the symptoms of a perinatal mood disorder. Treatment can range from medication to support groups or counseling. Your physician will exclude any medical causes for the mood disorder and use the severity of the symptoms to guide treatment. But if you have questions right now, don’t hesistate to call the Warmline.
“I cannot emphasize enough how important it is to reach out for help, any kind of help, as soon as you begin to think something is not right,” Mobley says, noting that without treatment of the mom’s mood disorder, the infant’s social development may also be negatively affected.
“For your sake and your child’s, don’t suffer in silence.”
If you are pregnant or a new mother and you feel overwhelmed, angry, sad or alone, contact the confidential Project Healthy Moms Warmline at 1-800-933-9896 ext. 234, or e-mail PHMhelp@mhageorgia.org.
It does get better, and we are here when you are ready to talk. Please note that the Warmline is not for emergencies. If you are afraid that you are going to hurt yourself or your child, this is a postpartum emergency and you need to call 911.