Casting Light on America’s Maternal Mental Health Crisis

Every year some 4 million women give birth in the United States, and as many as 20% will suffer from some type of maternal mental health disorder during the postpartum period. The American Academy of Pediatricians refers to postpartum depression as “the most common but most underdiagnosed obstetrical complication in the country.” Only 15% of the 800,000 women who suffer from maternal mental health disorders in any given year will undergo therapy for their conditions, adding statistical strength to this assertion. In fact, postpartum depression is not the only type of maternal mental health disorder. Postpartum anxiety disorders are also common among new mothers, and in rarer instances a more serious illness known as postpartum psychosis may also be diagnosed. The latter is an extreme condition that if left untreated can lead to hospitalization, suicide and even infanticide, but thankfully it only affects about one out of every 500 women who give birth. Postpartum mental disorders are distinct from the “baby blues,” a moderate-intensity condition marked by fatigue and depression that affects up to four out of five new mothers. The onset of true maternal mental health disorders can occur anytime up to a year after a child is born, and it is believed to be caused (at least initially) by hormonal changes that persist throughout the first few months of the postpartum period.

Signs and Symptoms of Maternal Mental Health Disorders

The statistics on mental health disorders related to new motherhood are alarming. But numbers alone don’t reveal the true level of suffering caused by these debilitating and life-altering conditions. Symptoms of these disorders can be intense and inescapable. Their seriousness is illustrated by the fact that 5% of suicides among women of reproductive age were suffering from a postpartum mental illness at the time of their death. Some of the most common signs of maternal mental health troubles include:

  • Persistent feelings of sadness or emptiness.
  • Excessive crying, often without apparent provocation.
  • Constant anxiety and worry, over anything and everything.
  • Moodiness and irritability.
  • Poor concentration and memory.
  • Insomnia and daytime sleepiness.
  • Random fits of anger.
  • Early-stage eating disorders.
  • A wide variety of physical aches and pains, all without clear cause.
  • Powerful feelings of inadequacy as a mother.
  • Suicidal thoughts or feelings of intense hostility, sometimes focused on the child.

Postpartum depression is in no way distinct from other forms of major clinical depression, and in its most severe form it can cause total incapacitation. Postpartum anxiety is similarly overwhelming, and like postpartum depression it manifests during a period when victims are already coping with the tremendous physical, emotional and psychological demands of caring for a newborn.

Obstacles to Treatment for Postpartum Depression and Anxiety

This last factor may help explain why maternal mental health disorders are both underdiagnosed and undertreated. Women with infants are literally on-call seven days a week, 24 hours a day, and as a result they’re chronically sleep-deprived, don’t get out as much, may not always eat properly and often fall out of their normal exercise routines. In these circumstances, symptoms of depression and/or anxiety may seem like a side effect of the demands of motherhood, and victims may assume (incorrectly) that their distress will fade once their responsibilities lighten. Another problem is that women with children may feel such a strong sense of responsibility to their kids that they neglect their own health needs, including those related to their emotional well-being. From their perspective it may seem self-centered or self-indulgent to ask for help at a time when their dependent sons or daughters are supposed to come first. Needless to say this assumption is counterproductive and contradictory, since untreated maternal mental health disorders naturally inhibit a woman’s ability to care for her child. Moms and newborns are at the peak of interdependence, and anything that adversely affects one will inevitably impact the other.

Official Responses to the Maternal Mental Health Disorder Epidemic

The medical profession hasn’t ignored maternal mental health disorders, but it has seriously underestimated their frequency. Even now most new mothers are not screened for postpartum mental health issues by physicians during aftercare, meaning that women suffering from these conditions have been forced to self-diagnose and seek out expert assistance on their own. Fortunately, the winds of change are in the air. In January 2016 the U.S. Preventive Services Task Force, a panel that offers guidelines for evidence-based medical practice, officially recommended screening for depression for women receiving medical care following childbirth. This wouldn’t have happened without the determined efforts of maternal health advocates, who’ve been striving tirelessly to publicize the suffering of women caught in the trap of postpartum depression and/or anxiety. In another encouraging sign, the U.S. Congress is currently considering legislation that would provide grants to states to help fund maternal mental health screening and treatment programs. The Bringing Postpartum Depression Out of the Shadows Act has gained bipartisan support in both the House and the Senate, and its passage would send a powerful message that postpartum mental illness is an important public health issue worthy of acknowledgment and intervention.

Getting Treatment for Maternal Mental Health Disorders

Publicity about the occurrence of maternal mental health disorders is vitally important, since these conditions are highly responsive to treatment. With some combination of therapy, peer group support, improvements in diet and exercise habits, alternative therapies like meditation and yoga and occasionally medication, new mothers suffering from postpartum mental illness can learn to cope and ultimately recover from their conditions. If you’re experiencing the debilitating effects of postpartum psychological distress, you don’t have to suffer alone or in silence. Psychiatrists, psychologists and therapists with a background in maternal mental illness can help you overcome your symptoms and return to wellness — and please remember that your good health is every bit as important to your newborn son or daughter as it is to you.

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