Postpartum Mental Health Disorders: Ending the Silent Suffering of New Moms by Dr. Nancy Irwin

Ask people what they think the most common complication of pregnancy and childbirth is and you’re likely to hear things like gestational diabetes, high blood pressure, or anemia. These are indeed common problems for pregnant women and new moms. But you might be surprised to learn that the most common complication of pregnancyis actually mental health disorders—conditions like depression, anxiety, addiction, and, in rare cases, postpartum psychosis.  Up to one in seven women will experience depression or anxiety during pregnancy or in the first year after giving birth. And too many new moms suffer in silence. Just 15 percent get professional help. 

Why? Because unnecessary, harmful stigma lingers around postpartum depression. New moms don’t seek help for a variety of reasons, including embarrassment, guilt, and worries about being labeled mentally ill. Yet, if left untreated, postpartum depression and other mental health conditions can lead to dire consequences, including self-harm and suicide. There are also real consequences for the babies of these mothers, who are more likely to have low birth weight and are at increased risk of delayed brain development and learning and behavioral problems later in life. 

Substance Abuse and Postpartum Depression 

Co-occurring substance abuse and postpartum depression is also common but underdiagnosed and undertreated. Research has shown a strong correlation between postpartum depression and substance use disorders (SUDs). Even new mothers without postpartum depression have high prevalances of alcohol and illicit drug use, according to data from a national survey. Here’s what the survey found about alcohol and drug use among new moms:  

·     Alcohol use ranged from 30.1%−49%.

·     Drug use ranged from 4.5%–8.5%.

·     14.9% of postpartum women aged 15–44 years with a baby less than one year old reported binge drinking; 8.5% reported use of illicit or nonmedical drugs in the past month.

·     Prevalence of drug use was highest among white new mothers, followed by black and Hispanic new mothers. 

·     Women who stop using illicit drugs or binge drinking during pregnancy tend to resume these behaviors after childbirth. 

While postpartum women had lower prevalances of alcohol and drug use than non-postpartum women, it’s still a real concern for new moms to be using drugs and alcohol, for several reasons. First, because alcohol and drug use increase a woman’s risk of postpartum depression.  Second, because new mothers with postpartum depression may be at especially high risk for SUDs.  Finally, because substance use can limit a mother’s ability to stay emotionally connected to her infant, adjust to her baby’s needs and behaviors, and anticipate or follow her baby’s development. 

Addressing Postpartum Mental Health Issues  

What can we do about the epidemic of postpartum depression and other mental health disorders?  A crucial starting point is for healthcare professionals to recognize and properly screen for risk factors of postpartum depression, which include:  

·     Personal or family history of depression

·     History of sexual or physical abuse

·     Alcohol or drug abuse

·     Pregnancy that is unwanted or unplanned 

·     Stressful life events or a trauma during pregnancy

·     Pregestational or gestational diabetes

·     Complications during pregnancy, such as preterm delivery or pregnancy loss

Next, it’s critical to ensure all women, regardless of socioeconomic status, have access to treatment.  There’s some good news on the intervention front. The United States Preventive Service Task Force (USPSTF) now recommends that clinicians provide or refer pregnant and postpartum women at increased risk of perinatal depression to counseling interventions.  The Task Force found that certain types of psychotherapy, including cognitive behavioral therapy and interpersonal therapy, are effective at preventing perinatal depression. And, as we know, prevention is key. 

You’re Not Alone in Your Struggle

Pregnant women and new moms who are struggling with co-occurring depression or anxiety and a substance use disorder need care from a provider that understands the science of addiction and mental health.  Motherhood should be a joyous time for women, yet too many new moms suffer in silence under the burden of postpartum depression, substance use disorders, and other mental health problems.  If there’s one takeaway, let it be this: Postpartum mental health disorders are common, they’re treatable, and you’re not alone. Help is available.  

Dr. Nancy Irwin is a licensed clinical psychologist and primary therapist on staff with Seasons in Malibu, a rehab center providing world-class addiction treatment and dual diagnosis care. Dr. Irwin is a trauma expert and treats the underlying cause of addictions. She works with a team of psychiatrists, addiction specialists and therapists at Seasons in Malibu, creating unique, personalized treatment programs for every client.