Tips for Supporting Maternal Mental Health, with Anna C. Maling, LGPC
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We’re coming to you today to talk about all things related to maternal mental health. We’ve been part of so many discussions over the past couple of weeks with parents who have been affected by the family tragedy in Massachusetts, and we’ve recognized that there’s a lot of information that is unavailable to the people who really need it. So we’ve collected questions that we have observed other people asking, and we have also generated a list from the members of our own After Baby Club so that we can connect you with the answers that you need to best support yourselves and your loved ones.
The biggest question that’s looming in peoples’ minds is: “for postpartum mental health, is what I’m going through normal?”
Mood disorders during this time are common, but not normal. You are 100% not alone! One of the best things you can do is reach out for help. Reach out to your village, to your friends, to us. We can’t fix what’s going on with you, but we are here to help. You don’t have to go through it alone.
Getting yourself mental health support when you need it is imperative. And surrounding yourself with other adults who care about you and your baby can be a really valuable tool right now. And if you need help finding help, please reach out to us. Erica is our resident mental health professional and can help you get connected with the resources you need.
We also want to emphasize that hearing and talking about mental health, especially postpartum psychosis, can be really unsettling, and it’s totally valid to have big emotions about events that aren’t directly connected to you.
So, how can you differentiate between baby blues, postpartum depression, and postpartum psychosis? How can you advocate for yourself? How can you support a loved one that is struggling? We answer these questions and so much more on our recorded chat with Anna. For an abbreviated version, keep reading.
Meet our Guest, Anna Maling.
To help answer some questions, we’ve brought our professional colleague and friend Anna C. Maling, LGPC. She is a licensed therapist in Maryland, with a specialization in reproductive and perinatal mental health. She has completed training specifically around perinatal mood disorders, and she often works with individuals who are pregnant or postpartum. She is also the owner of Anna C. Maling Therapy. She is a mom of three, and has her own personal experience with perinatal anxiety. We’re linking more information at the bottom of this article about Anna and how you can connect with her.
What are the baby blues and how can you tell if it has evolved past the norm and turned into depression?
Baby blues are really common; up to 85% of new moms will experience it. This is due to the physiological change that happens right after the baby is born. Your hormones are completely in flux, you’ve just experienced a really significant event physically, and you’re just going through a lot. Baby blues may look like anxiety, crying, or restlessness.
The two key differences between baby blues and the mood disorders are that baby blues are mild, and temporary. The baby blues only occur in the first two weeks of postpartum.
What are some of the other mental health issues, in pregnancy or postpartum?
The one we hear the most about is Postpartum Depression (PPD). Postpartum Depression is pretty common, affecting 15% of women during postpartum and 10% during pregnancy. Some symptoms of Postpartum Depression are anger, irritability, difficulty eating or sleeping, loss of interest, and potentially thoughts of harming self or baby.
There are several other issues under the umbrella of Perinatal Mood and Anxiety Disorders (PMAD). This includes Perinatal Anxiety, Perinatal OCD, Postpartum Post-traumatic Stress Disorder, Perinatal Bipolar Mood Disorder, and Postpartum Psychosis (PPP).
There are different symptoms, and risk factors for each of these issues. There will be a link at the bottom of this article to Postpartum Support International’s website that breaks each of these disorders down by symptoms.
What are the symptoms of Postpartum Psychosis? Is it treatable? How common is PPP?
Postpartum Psychosis has been front and center in the news and peoples minds lately, and Postpartum Psychosis and Postpartum Depression are often being used interchangeably. But Postpartum Psychosis and Postpartum Depression are totally separate. Postpartum Psychosis is pretty rare, and only occurs in 1-2 out of every 1000 deliveries. When it does occur, it is considered an emergency. If someone you know is exhibiting the symptoms, you should get them to an emergency room and a crisis professional immediately.
Postpartum Psychosis typically starts within the first 2 weeks after delivery. Some risk factors that would indicate that someone is more likely to develop PPP would be a personal or family history of Bipolar Disorder prior to pregnancy or postpartum, or a previous psychotic episode. It’s important for those individuals to get connected to resources, ideally before getting pregnant to make sure they have a good support system in place.
Common symptoms of Postpartum Psychosis are delusions or strange beliefs, hallucinations (seeing or hearing things that aren’t there), feeling very irritable, hyperactivity, severe depression or flat affect, decreased need or inability to sleep, paranoia or suspiciousness, rapid mood swings, and difficulty communicating. It may be difficult for someone experiencing those symptoms to identify in themselves, so it’s definitely something for their support system to be looking out for.
PPP is definitely treatable with professional help. It is not a weakness or a failure on the parent’s part. It is a serious disorder.
What should I do if I think I need mental health support?
If you are in a non-crisis situation, there are a few options. You can call Postpartum Support International’s Warmline at 1-800-944-4773. There is also a National Maternal Mental Health Hotline at 1-833-943-5746.
PSI also has a directory of perinatal mental health trained professionals, so that is a really wonderful way to locate local resources.
You might also consider talking to your OBGYN/Midwife provider to ask about medication and see if they have any referrals for mental health providers.
What should I do if I’m in a mental health crisis, and what does that look like?
For a true mental health crisis where you feel like you are a danger to yourself or someone else, call 911 or go to your nearest emergency room. There is also a National Suicide and Crisis Line that you can call at 988.
The following questions were submitted to us by members of After Baby Club
Why is is difficult to recognize or admit that I’m dealing with depression, anxiety, or scary thoughts when I’m pregnant/postpartum? I feel bad but I’m so scared to tell someone in case they’re going to lock me up or take away my kids.
There is such a stigma around mental health, and particularly around mental health in motherhood/parenthood. Not only does that make it hard to admit to yourself and your loved ones, but there is real fear in seeking help because of not wanting to seem “too crazy” to be safe for your kids.
I would very strongly encourage you to seek help from a trained perinatal professional. That person is going to hear that you are worried about falling down the stairs with your kid and know that it is an intrusive thought. Lean on your support system and find community support.
Can you get postpartum depression or anxiety much later after the birth of your child?
The textbook range is up to one year post birth. However, my firm belief is that there is no cut date that says at 365 days post birth, everything changes. If you are feeling anxiety or depression 2 years after your baby’s birth, it is not too late to seek help.
Does postpartum depression go away on its own? What could happen if I choose not to get professional help?
I am sure that it can, however - perinatal mood disorders including Postpartum Depression can linger for a very long time and have really serious health consequences. Think about those symptoms we discussed prior - experiencing those long term can really cause a strain on your relationships, on your physical health and on your overall life satisfaction.
What if i don't want to go to a counselor or take medication forever?
Great question! I see lots of clients who are not in therapy or on medication long term. When you start seeing a therapist or taking medication, there is no contract that says this is now how you live your life.
I think one way of looking at this is the cost of not doing something. Take the example of medication - it is really easy to think about the cost of taking a medication (potential side effects, the stigma around it, maybe worry around breastfeeding). But what might the cost be of not taking it? (stress including stress hormones that might be in breastmilk, continued depression/anxiety, difficulty thriving in parenting and other aspects of life etc).
I was doing really well and then I slipped backwards. I’m worried I’m never going to get better. Is it normal to have setbacks?
100%! Progress is not a straight line up. It is messy - that doesn’t mean you're sliding back or failing.
What should I say to my friends or family who say “you’re fine; this is normal” when I tell them I am not okay?
That’s going to depend on your relationship with that person. If it’s your mother or mother-in-law saying that, you may have a different reaction then if it was someone else. I would say to find those support systems that are going to help you, allow you to express yourself, and get you the support that you need. Then you can go back and work on self-advocacy with that particular person. It’s also important to remember that it’s okay to have boundaries. If this person isn’t a safe person to talk to about breast/chest feeding or formula feeding, or if this person has really strong opinions on sleeping and it’s not helping you the way you need help in that current moment, then consider taking space from that relationship and work to try to find other support systems that will help you by listening instead of providing unhelpful advice.
Sometimes those in your inner circle, while they have good intentions, will offer advice and feedback that is counter to what you need. As a new mom and a new parent, it can be really hard to even get to the point where you’re saying to someone “I think I’m not okay”, and then to hear back “you’re fine” is really disheartening. To me, it’s amazing when new moms go and find support because they’re going against a lot of barriers.
It’s ok if you’re not feeling like you’re okay. There’s nothing wrong with you. You’re not a bad mom. You might need help, and that’s okay. So many of us relate to needing help postpartum. It’s very common, and with treatment it’s something that you won’t always be feeling.
The message to those around the postpartum people: if they’re saying they’re not fine, they’re not.
They need help. They need you to listen and be supportive. It’s not just the new mom that needs to be working on herself, it’s everyone around her. Knowing common symptoms of PMADs to be watching for and supporting would definitely be helpful. I would also recommend listening to your partner and validating what they are saying. Encourage them to seek help while reminding them how valued they are as a person and parent.
If you don’t know who to go to, but need someone, you can contact us at Rooted Willow Community. We will help connect you with the support that you need.
Anna is a pregnancy options therapist and perinatal therapist in Maryland. She began her mental health career in Dallas, TX working at a crisis center. After the birth of her son, she realized her passion for perinatal mental health therapy. She struggled immensely with postpartum anxiety, and felt the shame and stigma of not being a "good enough" mom.
After the overturn of Roe vs. Wade, she decided to expand her education and skillset to include more aspects of reproductive health, including pregnancy options and post abortion support. She is passionate about helping individuals navigate unintended pregnancies. She believes everyone deserves evidenced-based education, a nonjudgemental space, and safe resources to choose what is best for each individual.
If you want to connect with Anna, you can email her at anna@annacmalingtherapy.com or find her on her website or Instagram.
