Congratulations! If you are reading this then you are a new parent (or will soon be) and have watched your partner navigate pregnancy and possibly ease into the post partum time period. This is a time filled with great joy, major role adjustments, sleeplessness, a new kind of love and one heck of an emotional rollercoaster. As the spouse of a woman going through these changes, you have a first row seat to their emotional experience and how they are handling the transition into parenthood. Your role is one of the most important ones at this time, as you have the ability to notice symptoms of a pregnancy or post partum mood or anxiety disorder firsthand. You may be the only person that knows her well enough to see the small changes that are taking place within her daily mood or personality. You may also be the only one that she is comfortable enough to be vulnerable with and to share these thoughts or emotions with.
So, how do you identify the difference between post partum hormones and a post partum mood or anxiety disorder?
As the partner, it is helpful for you to be on the lookout for any symptoms of a perinatal mood or anxiety disorder. Below, is a list of signs that your significant other may be experiencing difficulty adjusting to having a new baby.
Is she getting frustrated more often?
Most people don't realize that constant frustration is often a symptom of anxiety. Women (or men) who are feeling anxious most of the time, are naturally "on edge" because their body is in a constant state of "fight or flight." When something stressful happens, their brain and body sends the signal that it is time to panic and they begin to feel overloaded. Feeling unable to withstand these stressful events or to overcome any obstacles that may be thrown their way are likely to result in frustration. Anger can also result if she feels unable to express her inner emotions and has to “bottle it up.” This frustration can be exhibited in the form of arguing with others, getting frustrated at herself or feeling frustrated when things do not go to plan (which they typically don't do with a new baby). Getting help in managing the anxiety and engaging in healthier coping skills can reduce the frustration that she is expressing.
Can she be found crying excessively or for "no reason"?
The "baby blues" can occur during the two weeks following birth. During this time, women are naturally more weepy, as their hormones are beginning to shift from pregnancy into the post partum time period. If, however, this crying has been lasting for longer than 2 weeks, if her predominant feeling for most of the day is not joy and if the crying is accompanied by other signs of depression or anxiety (like some of the ones listed below), then help should be sought out.
Does she have distressing, anxious thoughts?
All new parents experience a degree of anxiety. I mean, how could you not worry about this tiny little being that you are now responsible for? These thoughts, however, will be more than just worries about the regular care for baby. They will be thoughts like “what happens if I accidentally drop my baby down the stairs?” or “what if I accidentally hurt the baby because I’m so tired?”. These thoughts will cause her anxiety and may even lead her to engage in unhealthy behaviors to self soothe. Some of these behaviors could be avoiding staircases/anxiety provoking situations, not letting anyone else provide care for the baby, counting or repetitively checking on the baby or on other things within the house. These distressing thoughts and any accompanying behaviors will begin to interfere with her ability to accomplish normal daily tasks of living.
Is she struggling to see the positive things that she is doing as a mother?
Many parents doubt themselves at different times over the course of their child’s life, mostly because we are always wanting to do or be better for our children. Despite this, however, most of us are able to see the good that we are doing for our family each and every day. If a mom is struggling with a perinatal mood or anxiety disorder, she may not be able to see all of the wonderful things that she does daily--from meeting her children's basic needs, to nurturing them, to helping them flourish and grow. If she can't identify the things that she is doing well every day, then she may be blocked by depression.
Has she been feeling overwhelmed with completing daily tasks?
Although most of us can relate to feeling overwhelmed, when a mother is feeling this way, it will feel all encompassing. She may struggle to shower or keep up on basic hygiene (and not from a lack of time/baby cooperation), she may feel stressed out with performing things that she used to do almost effortlessly. You may notice her shutting down emotionally because she feels that she just can't do "good enough."
Has she been struggling to bond with the baby?
There is a large percentage of women who never experience this symptom, but, for some women this piece of motherhood that is supposed to come naturally can feel foreign and forced. Most women completely love and adore their baby, but they don't feel totally connected to them. They may struggle to talk to or play with the baby. They may not have a desire to cuddle them, spend time with them or to try to understand baby's cues. Or, maybe they have an immense desire to feel connected to their baby but the depression or anxiety is making this difficult to do. For some women, this bond takes time to develop and can be helped along by easing the symptoms of their anxiety or depression.
Does she isolate from you or other loved ones?
When many people are experiencing intense anxiety or depression, they tend to isolate away from others. They often feel that others will not understand them or their feelings, and they do not want to risk judgement. For some women, the emotional energy that it takes to engage in social interactions may be lacking. They may feel guilty about leaving their baby (a sign of anxiety) and have no desire to connect with others. You may also notice that she has withdrawn from you and that she no longer connects with you emotionally in the same way that she used to.
Is she feeling worried most of the time?
As mentioned before, most new parents feel worried about the new life that they are responsible for. This differentiates from that because if a woman is experiencing post partum anxiety, she will be feeling anxious for most of the day every day. This could include non-stop thoughts/worries, racing heart, feelings of panic, irritability, being overwhelmed, and distressing or intrusive thoughts about bad things happening. You may notice her constantly checking things to ensure accuracy or safety, repeating what she is saying, difficulty focusing, trouble sleeping and regularly second guessing herself.
Does she feel down or depressed for most of the day, every day?
Although bouts of depression or a sad mood are common in the post partum time period, feeling depressed or down for most of the day every day is not. You would notice that she may be feeling this way because she may be struggling with a lack of motivation, may be crying more than normal, could be making comments about feeling hopeless/not good enough or any other negative comment, or could have just a more flat demeanor than she normally has. If these feelings persist, they are indicative of an underlying post partum depressive disorder and should be treated.
Is she experiencing intense anxiety when memories of pregnancy/delivery/NICU experiences surface?
Unfortunately, there are also parents who do not get the "textbook" pregnancy and delivery and are faced with obstacles from the start. They may seem strong and in control during the traumatic events, but under the surface there is a lot of anxiety and depression that can be brewing and can easily be triggered afterwards. If anyone is remembering a traumatic pregnancy, delivery or post partum experience, they will usually experience symptoms of panic or intense anxiety during the recall of that memory. They may cry, get angry or irritable, withdraw or shut down. These memories could get in the way of living the life that she wants and can stop her from being able to live in the moment.
Has she stopped doing the things that she used to love?
An important distinction to make here is that many new parents need to discontinue activities that they previously loved because of time and logistics. When a woman is experiencing post partum depression, however, she will no longer have a desire to do things, even if she has the time.
Is she putting herself down a lot and not seeing her own worth?
If a woman is experiencing post partum anxiety or depression, she likely does not see the value in what she is adding to her family. She may be vocalizing that she doesn't do things well enough, that she is failing or may criticize anything about herself. This could include anything from feeling down about her body image to her contributions to the family financially to her abilities as a mother. **Please note that if she is experiencing any suicidal thoughts or thoughts of wanting to end her life, help in the form of 911 or the emergency department needs to happen ASAP.
Is she not acting like her normal self?
You know her better than most everyone else. You know her normal routine and moods. If something just seems "off" about her lately, pay attention to it. This is likely your intuition telling you that something isn't right with her.