What If You’re Sad During the ‘Happiest’ Time of Your Life?

The time between pregnancy and a baby’s first birthday can be very tough for a new mother. Experts from Michigan Medicine share the challenges and ways to get support.

Pregnancy and birth, followed by the whirlwind of your baby’s first year, may be the most beautiful — and challenging — introduction to motherhood you’ll have. But there is no rule that says you’ll feel happy every moment of every day. In fact, being a new parent is hard and many women experience depression during this unique time.

There are very specific challenges that come up during the perinatal period, the months of pregnancy and 12 months after birth, says University of Michigan’s Zero to Thrive Perinatal and Reproductive Psychiatrist, Samantha Shaw-Johnston, MD.

“People who have a history of mood or anxiety disorders are more likely to struggle with mental health challenges in the perinatal period, but even those without a history may experience similar difficulties,” she says. “There are huge hormonal changes in pregnancy and postpartum that make women more vulnerable.”

How do I know if it’s depression?

From a sense of restlessness to debilitating anxiety, mental health challenges can look different in different people.

Some believe they’re alone in navigating mental health challenges after having a baby, but it’s actually quite common, says Dr. Shaw-Johnston. One in five women struggle with mental health challenges in the postpartum period.

She shares five signs that an individual is experiencing challenges with their mental health:

  • Change in appetite, such as eating more or less
  • Finding little joy in once-loved hobbies
  • Self-blame
  • Struggling to sleep
  • Poor concentration

“Different levels require different levels of treatment,” Dr. Shaw-Johnston says. “If your supports don’t seem to be enough, and it’s hard to do the things you want or need to do, it’s time to reach out to a healthcare provider.”

What’s causing it?

Increased risk for depression comes from being isolated, Dr. Shaw-Johnston says. People are social creatures and we thrive on interactions with others, but caring for a baby can feel lonely at times because your baby can’t talk or support you emotionally.

And your family and friends may live too far away to support you in the day-to-day tasks of parenting.

“Historically, people lived in the same communities as generations of their family and have had built-in supports,” she says, “Now you might be living across the country from your family, so it makes sense that things are harder right now to get all the support you need to raise a family.”

The constant stream of unrealistically positive messaging about motherhood distorts the full reality, too, says Alyssa Stevenson, MD, who is also a University of Michigan’s Zero to Thrive Perinatal and Reproductive Psychiatrist.

“Often, motherhood is depicted in social media and TV shows as a wonderful, amazing, life-altering time,” she says. “Sometimes what people are putting on social media is so different from the reality.”

Genetics, family background, and emotional shifts all come into play in the transition as well, Stevenson says. The importance of getting people screened for mental health conditions cannot be overstated.

Effect on the family

One person’s struggles with mental health issues can affect the entire family in ways that seem subtle but are developmentally important.

In the first stage of development, infants express their needs through crying, Dr. Shaw-Johnston says. It’s important, though not always easy, to be receptive to those needs relatively quickly and reliably, and babies thrive on feedback from caregivers.

“When people are struggling with their mental health, sometimes they might not be as emotionally present in that situation, and their facial reactivity is reduced,” Dr. Shaw-Johnston says. “Infants can see that it’s an unfamiliar response and that can be distressing for the infant.”

Other family members can be affected, too. When the mother is depressed or anxious, she may struggle to maintain a routine, so responsibilities might fall on other family members.

It’s important to know that mental health conditions can be treated. Recognizing the warning signs and getting access to quality care gives pregnant women, moms and families a chance for a happier and more satisfying perinatal period.

“It’s one of the times when a woman is most vulnerable to struggling with mental health,” Dr. Stevenson says. “We’re trying to take care of people in very vulnerable spaces.”

Vital services for maternal health

“At Michigan Medicine we’re lucky to have standardized screening for depression during pregnancy and in the postpartum period,” says Dr. Shaw-Johnston.

Michigan Medicine features Zero to Thrive, a perinatal and infant-and-early-childhood mental health center, built on the premise that the period from pregnancy through early childhood is an especially sensitive time. Zero to Thrive’s goal is to knock down barriers so that patients can get the help they need.

Obstetricians and gynecologists identify troublesome issues in perinatal patients, and the provider can leverage MC3’s perinatal services, a provider consultation service to help identify mental health conditions that can be treated in pregnant and new moms.

“You don’t have to navigate for yourselves,” Dr. Stevenson says. “You can ask your provider and they can directly reach out to the MC3 program and, that day, your provider will talk to a perinatal psychiatrist who will talk through the issues and give recommendations.”

Mental health conditions are common, Dr. Stevenson says, and it’s of paramount importance that people know they are not alone.

“A lot of people are going through this stage of life at this time,” she says. “We have treatments to help you. We have a lot of research and many different ways to address your issues and treat your symptoms.”

Want to learn more? Watch these helpful videos about stress management, deep breathing and mindfulness. Expertise brought to you by Michigan Medicine. Learn more about Zero to Thrive and MC3.

Metro Parent Editorial Team
Metro Parent Editorial Team
Since 1986, the Metro Parent editorial team is trained to be the go-to source for metro Detroit families, offering a rich blend of expert advice, compelling stories, and the top local activities for kids. Renowned for their award-winning content, the team of editors and writers are dedicated to enriching family life by connecting parents with the finest resources and experiences our community has to offer.


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