Five Perinatal Mental Health Myths
Author: Tori Hamilton
Since May is maternal mental health month, I thought I would use this opportunity to shine the spotlight on some common misconceptions that many of us have about perinatal mental health. I hope that by dispelling these myths, we can move towards more open conversations about our own mental health & well-being and support those around us.
I’d like to welcome guest author Tori Hamilton to the blog! Tori is a Registered Nurse, International Board Certified Lactation Consultant, Certified Baby-Led Sleep & Well-Being Specialist, Perinatal Mental Health Professional and mom of three with one on the way. She owns a private practice supporting mothers and their families in Kincardine, Ontario and virtually.
For more of Tori’s amazing content, you can visit her Facebook or Instagram pages. For information about the services she offers, and to book online, you can visit her website.
#1 I don’t need to worry about my mental health since I’m not at risk – MYTH!
Mental health illness does not discriminate! It can affect any parent regardless of race, culture, income level, living conditions, location, or age. In Canada, one in five people experience mental illness in some capacity. All parents, regardless of their background, should be screened for perinatal mental health conditions during pregnancy and again in the postpartum period. Unfortunately, the stigma involved with mental illness along with a lack of funding often prevents families from getting the help they need. While we know that mental health conditions have the potential to affect any parent, we do know that there are some risk factors that increase the likelihood. These include:
Previous or current history of mental illness
Intimate partner violence
Substance abuse
Past history of physical, emotional, sexual abuse
Lack of support
Separation from partner
Unemployment
Lower income levels
Stressful pregnancy (2)
Unplanned pregnancy
Birth trauma
#2 Only the birth mother is at risk of developing a perinatal mental illness – MYTH!
Though this month is focusing on maternal mental health, I think it’s important to note that partners can also experience mood and anxiety changes during and after pregnancy. There is much, much more to learn about the impact fatherhood can play on mental health. The Centre of Disease Prevention in the United States estimates that postpartum depression occurs in 5-10% of all fathers. One study observed that this number increases to 24-50% of men whose partners suffer from postpartum depression (PPD). When looking at paternal postpartum depression, the following key themes were found:
An increased need for education – most fathers were not aware that it was possible for dads to have postpartum depression, or that treatment is available
Gender roles – many dads felt pressure to maintain the tough guy persona
Repressed feelings – men often didn’t want to share their feelings for fear of being shamed or ridiculed
Overwhelm – many expressed feelings of helplessness, loneliness, feeling trapped, exhaustion, and being unable to express themselves
Resentment of baby – though many dads expressed excitement and joy, there were also dads who expressed resentment towards their baby and some suppressed urges to hurt themselves or their baby
Feelings of neglect – many of the dads in this study felt alone, forgotten and neglected (1) not only by their spouses, but by the health care system and society as a whole
#3 Perinatal mental health concerns only arise after baby is born – MYTH!
It’s really important to note that women are at increased risk of mental illness during pregnancy. It is estimated that 15-21% of pregnant women experience at least moderate symptoms of depression or anxiety (4). The term perinatal is inclusive of the time during pregnancy up until the end of the first postpartum year. Research has shown that mood and anxiety disorders that begin during pregnancy most often do not resolve without treatment (3), and is one of the highest risk factors for mental illness once the baby is born.
For many women, depression and anxiety in the postpartum period could be avoided or symptoms lessened if they were provided screening and treatment before the birth of their baby.
#4 Postpartum depression and anxiety will go away eventually on its own – MYTH
A common misconception that many have is that postpartum depression and anxiety will eventually fade on its own, since it’s only encompasses the first year postpartum. However, this is not the case. When left untreated, PMADs (Perinatal Mood and Anxiety Disorders) can become lifelong chronic depression and anxiety disorders.
While many medications used to treat PMADs are considered safe for both pregnant and breastfeeding mothers, it can be a hard “pill to swallow” for some. If you’re having a hard time coping, it’s important that you reach out for support from your health team. They can help you navigate the treatment options available to find the right fit for what you’re going through. There is strong evidence that supports that perinatal mental illness is a treatable condition, with both medicated and unmedicated options available. Even small changes to your daily life can make a big impact. For example, studies have shown that regular physical exercise decreases levels of anxiety and depression (5).
#5 Postpartum depression is the most common maternal mental illness – MYTH
Though postpartum depression has gained the most media attention, anxiety rates are actually higher. In a study recently done comparing depression and anxiety rates before and after the COVID-19 pandemic hit, in pre-pandemic mothers, moderate to high anxiety levels were found in 29%, compared to the pre-pandemic depression rate of 15%. That means that high anxiety levels before the pandemic even started were double that of depressive symptoms. These numbers almost tripled after the pandemic started, jumping up to 72% for anxiety and 40.7% for depression (5). This tells us that we need to continue to evolve our language surrounding perinatal mental health to be inclusive of all conditions, and to offer a wide-variety of supports that can also help with anxiety disorders.
How can friends and family help someone with PMADs?
Social and emotional support plays an important role in moms recognizing their symptoms, reaching out for support and setting up a treatment plan. Often, it can be hard to recognize the severity of symptoms when you are the one experiencing them. Here are a couple of ways that support people (partners, friends, family) can help:
Become more informed about PMADs and the common stigmas and erroneous assumptions held by our society
Make a conscious effort to ask her how she is feelings both physically and mentally
Listen to her concerns and validate her experiences
Help her create a realistic strategy to follow her treatment plan
Go with her to difficult appointments if she wants someone there
Help her find local and online peer support groups
Recognize that some days will be more difficult than others, and that recovery can have ups and downs
Avoid giving unhelpful or critical advice that may impact her negatively
Help her manage day-to-day activities, including parenting duties if requested
Encourage her sustain healthy life habits that she finds enjoyment in, which may include time spent outdoors, exercise, balanced nutrition, spirituality, and ways to release creative energies
Look after yourself. You can’t pour from an empty cup – she needs people around her who have the capacity to lift her up and give her strength
There is so much for us to learn about perinatal mental health conditions. I hope that correcting these 5 myths has helped you become more aware of how common PMADs are, and more confident in supporting those who are living through them or reaching out for help. 7/10 women downplay their mental health symptoms – you never know what someone else is going through unless they share their story with you. When in doubt, always choose kindness and support.
If you’re struggling with your mental health, please reach out to someone you trust. Services are available online, through live chat, text message, and telephone. Services are available for adults, children, youth, and Indigenous persons here.
If you are in immediate crisis, please call 1-833-456-4566.
If you’d like more information about Tori and her services visit her visit her website. You can also book online Facebook or Instagram pages. For information about the services she offers, and to book online, you can .
References:
Brandon Eddy, Von Poll, Jason Whiting, Marcia Clevesy. Forgotten Fathers: Postpartum Depression in Men. Journal of Family Issues, 2019; 0192513X1983311 DOI: 10.1177/0192513X19833111
Johnson, M., Schmeid, V., Lupton, S. J., Austin, M. P., Matthey, S. M., et al. (2012). Measuring perinatal mental health risk. Archives of Women’s Mental Health, 15(3), 375-386.
Woolhouse, H., Gartland, D., Mensah, F., & Brown, S.J. (2014). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: Implications for primary health care. International Journal of Obstetrics & Gynaecology, 122(3), 312-321.
Wisner, K. L., Sit, D. K., McShea, M. C., et al. (2013). Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings. JAMA Psychiatry, 70(3), 490-498.
Davenport, M. H., Meyer, S., Meah, V. L., Strynadka, M. C. & Khurana, R. (2020). Moms are not OK: Covid-19 and maternal mental health. Frontiers in Global Women’s Health. https://doi.org/10.3389/fgwh.2020.00001