Women's Mental Health

Women's Mental Health

Many women experience emotional distress related to infertility, pregnancy, childbirth, and the postpartum phase. The changes that occur during this phase of life include:

  • transition into parenthood
  • changes in family structure and relationships
  • financial pressures
  • lack of sleep
  • hormonal fluctuations
  • limited time for self-care

During these stressful times, you may experience increased symptoms of anxiety or depression, including obsessive or intrusive thoughts, compulsive behaviors, and potentially more severe trauma-related symptoms. Additionally, it is not uncommon for partners of women who experience perinatal distress often to also experience significant anxiety, depression or other stress related challenges.

Infertility challenges pose significant stressors leading to anxiety or depression for women and their partners. Many of the stressors include financial constraints, grief or loss related to difficulty conceiving or miscarriage, physical and emotional effects from hormone treatment, and relationship strain.

Treatment:

There is significant evidence that Cognitive Behavioral Therapy (CBT) is the preferred treatment for the emotional distress that may accompany perinatal distress or infertility issues. CBT is generally short-term (12-24 sessions), structured, and focused on skills-building and symptom relief. It can be beneficial for most women (or their partners) who are struggling with disruptions and challenges during these stressful phases of life.

During treatment, your therapist will help you develop psychological skills to manage your mood, reduce your stress and enhance your overall functioning. In the context of a warm and supportive therapy relationship you will learn coping skills focused on improving thought patterns, and will develop practical problem-solving strategies. We can also collaborate with your physician and other health providers to ensure comprehensive and coordinated care. The goal is for you to feel better and regain control of your emotional life.

Postpartum Depression/Perinatal Mood Disorder

Description

Becoming a new parent is often an eagerly anticipated event in a woman’s life. However, the postpartum period can also bring many stressors for new mothers, including shifting roles, changing identity into motherhood, expectations for one’s self to be a “perfect parent”, hormonal changes, financial constraints of a growing family, increased responsibility of caring for a young infant, and likely lack of sleep. These many challenges can place a new mother at risk for depression during the postpartum period.

Symptoms

If you have postpartum depression, you may find you are not experiencing the happiness and joy you may have anticipated as a new mom. You may experience sadness and difficulty experiencing pleasure in your normal activities. Other symptoms you may experience include:

  • Tearfulness, irritability, or quickly changing moods
  • Difficulty beginning and completing tasks
  • Feelings of isolation
  • Fatigue, sleep disruptions, and changes in appetite
  • Difficulty concentrating and making decisions

Additionally, many women with postpartum depression experience significant feelings of guilt and shame, which often prevents them from seeking help. Many women fear that experiencing these symptoms means that they are incapable of being a loving and good parent. If you are experiencing similar symptoms, you are not alone as a significant percentage of women experience postpartum depression. Research suggests that approximately 12% of women experience postpartum depression. Approximately 4% of fathers experience also depression in the first year after their child is born.

Treatment

Behavioral Therapy (CBT) is a short term, active and effective form of treatment for Postpartum Depression. CBT focuses on building new skills to help you feel better rapidly and improves your ability to function. Your experienced therapist at the Anxiety and Depression Center will help you learn how to identify and shift negative, unhelpful thoughts and to engage in more helpful behaviors. Your cognitive behavioral therapist will help you improve your coping skills to better assist you with navigating through the many stressors and challenges of the postpartum period.

We also offer a telehealth therapy option, that provides flexibility for a busy mother’s schedule.

Postpartum Obsessive Compulsive Disorder/Perinatal OCD

Description

Postpartum Obsessive Compulsive Disorder (OCD), also known as Perinatal OCD, is characterized by the presence of obsessions (intrusive, unwanted thoughts) and compulsions (repetitive behaviors). While many people are familiar with postpartum depression, many are unfamiliar with postpartum OCD. Approximately 3% - 5% of women experience postpartum OCD and approximately 65% of all women experience intrusive thoughts during the perinatal period.

Many stressors often occur during the perinatal period which can increase the likelihood of Postpartum OCD. Fluctuating hormones, lack of sleep, financial constraints, and possible strains and adjustments in the relationship with one's partner can all result in increased stress. Additionally, the tremendous responsibility a woman may feel as a new mother and the strong desire to protect her infant can also increase the likelihood of OCD during this period.

Symptoms

Often Postpartum OCD thoughts are harm or aggression related. These thoughts are typically very distressing and at times can interfere with a mother's ability to properly care for herself and for her infant. Many women fear discussing these intrusive thoughts with others for fear of negative judgment and may experience tremendous guilt and shame as a result of their intrusive thoughts.

Obsessions or intrusive thoughts may include:

  • What if I drop the baby?
  • What if I stab the baby with my knife while preparing the meal?
  • What if the baby stops breathing and dies?
  • What if I drown the baby during bath time?
  • What if I poison the baby unknowingly?
  • What if I molest the baby during diaper changes?
  • What if I accidentally leave the baby somewhere?

Compulsions are behaviors that a mother may perform to decrease the anxiety related to the obsession or intrusive thought. Compulsive behaviors may decrease anxiety in the short term, but typically perpetuate the anxiety in the longer term. Some examples of compulsions are:

  • Checking behaviors, including checking to ensure that the baby is breathing, checking to see that the baby is present and was not left somewhere inadvertently
  • Avoidant behaviors, such as requiring others to change the baby's diaper or avoiding giving the baby a bath, or avoiding being alone with the infant
  • Reassurance seeking, such as repeatedly asking one's partner if the infant is ok
  • Safety Behaviors, such as holding onto the baby very tightly to ensure the baby is not dropped
  • Mental rituals, such as praying specific prayers, counting, mentally reviewing situations to ensure the infant was not harmed
  • Excessive cleaning
  • Unable to transition from one task to another until a feeling of "just right" is perceived

Treatment

Cognitive Behavioral Treatment is a short term and effective form of treatment for Postpartum OCD. In CBT treatment at the Anxiety and Depression Center, you will learn coping skills to hope you decrease distress experienced due to intrusive thoughts and obsessions. You will learn to identify the triggers to your OCD and how to respond to them in a new and healthier way. Your experienced therapist will teach you how to interact with your obsessions in a more helpful way, that can ultimately decrease the frequency and intensity of your obsessions and ultimately decrease the amount of time you spend performing compulsive behaviors.

An important component of treatment for Postpartum OCD is Exposure with Response Prevention (ERP). ERP exercises will help you directly address the obsessive thoughts and compulsive behaviors by engaging in activities that trigger the obsessions, but ultimately not perform the compulsive behavior. Your therapist at the Anxiety and Depression Center will gently and mindfully guide you through these ERP exercises to maximize your progress without bringing on undue stress. ERP will commence only after you have developed the essential skills to effectively manage your anxiety. ERP exercises help your treatment to progress more quickly and allow you to return to living a more fulfilling life as a new mother.

We offer telehealth therapy sessions at the Anxiety and Depression Center, to provide more flexible options for your busy schedule.

Perinatal Anxiety Disorder

Description

Many women experience anxiety during pregnancy, childbirth, and the postpartum period. While many eagerly anticipate motherhood, countless stressors can increase a woman’s chances to develop anxiety during the perinatal period. These stressors include a previous history of anxiety, experiencing a high risk pregnancy or a traumatic childbirth experience, a previous history of miscarriage or fertility issues, fluctuating hormones or another difficult life circumstance. Women who are perfectionistic or have extremely high expectations for themselves may also be at risk of developing a perinatal anxiety disorder.

Symptoms

Perinatal Anxiety Disorders are quite common. Research shows that approximately 1 in 5 women experience an anxiety disorder during pregnancy and the postpartum period. Anxiety disorders include generalized anxiety, social anxiety, post-traumatic stress disorder and panic disorder. Common symptoms of perinatal anxiety include:

  • Persistent worry or feeling overwhelmed
  • Frequent thoughts of danger and an inability to cope
  • Rapid heartbeat, shallow breathing, excessive sweating, difficulty swallowing
  • Panic attacks
  • Irritability
  • Feelings of restlessness, tenseness or shaky limbs
  • Easily startled
  • Feeling “keyed up”
  • Feelings of fatigue
  • Difficulty sleeping
  • Difficulty concentrating or making decisions

If you are experiencing Perinatal Anxiety, Cognitive Behavioral Therapy can help you learn effective skills to manage your anxiety and feel better quickly.

Treatment

Cognitive Behavioral Therapy (CBT) is a short term and effective form of therapy to help you learn skills to manage your anxiety. Anxiety and Depression Center clinicians specialize in treating anxiety disorders and several of our therapists have a sub-specialty in perinatal mood disorders. Your experienced therapist will help you build coping skills to decrease the distressing physical and emotional sensations of anxiety. You will learn how your thoughts and behaviors contribute to your anxiety. Additionally, you will learn new psychological skills that will enable you to change your thoughts and behaviors so that you feel better quickly and can focus on the things that matter most to you as a new mom.

An important component of treatment for Perinatal Anxiety is exposure exercises. Exposure exercises help you directly address your anxiety by engaging in those activities that trigger your anxious response. Your therapist at the Anxiety and Depression Center will gently and mindfully guide you through these exposure exercises to maximize your progress without bringing on undue stress. Exposure exercises will commence only after you have developed the essential psychological skills to manage your distress level in a proficient manner. Exposure exercises help your treatment to progress more quickly and allow you to return to living a more fulfilling life as a new mother.

We offer telehealth therapy sessions at the Anxiety and Depression Center, to provide more flexible options for your busy schedule.

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