Postpartum mental health concerns common

FINDLAY — The death of actor Hayden Panettiere, who spoke about her experience with postpartum depression, occurring as the nation watches the trial of Lindsay Clancy, a Massachusetts mother on trial for the January 2023 deaths of her three young children, has put postpartum mental health in the national headlines this month. But less visibly and publicly, women across the nation, including Northwest Ohio, experience postpartum mental health challenges regularly. These can include postpartum depression, anxiety, OCD, PTSD and psychosis. "Baby blues" for up to two weeks following a birth are common, said Ashley Bush, owner of Bloom Women's Counseling, Consulting, and Wellness. She said more serious postpartum mental health concerns can strike anyone, although some mothers are more at risk. These include women with a personal or family history of mental illness, those whose child is born with complex medical needs and those who have had a traumatic birth. A few years ago, the Hancock County Board of Alcohol, Drug Addiction and Mental Health Services pulled together local professionals to discuss how to close the gaps in perinatal mental health. Laura Reinhart, a nurse practitioner and director of nursing at Hancock Public Health, facilitated many of the discussions. Reinhart said we have become more aware than we once were, as a society — but there is still a lot more we can do. Jennifer Swartzlander, deputy director of the ADAMHS board, said it helped for everyone to put their heads together and find ways to strengthen communication between different agencies. One thing that came out of the meetings was a push to distribute informational magnets at health fairs and other events displaying the 24-hour National Maternal Mental Health Hotline. To reach this hotline, call or text 833-852-6262 (833-TLC-MAMA). Rachel Nye, of the Tiffin area, gave birth to her second child, Olivia, on March 20. "I was like on cloud nine," she recalled. "Everything felt so perfect. Life was so perfect, I was so happy. Until the ugly hit on Day Five." She began experiencing symptoms that led her to the emergency room and prompted doctors to test for dangerous medical complications of pregnancy. Nye didn't sleep for about three days while undergoing a variety of tests, and spent much of that time imagining the worst. She described the entire ordeal as "terrifying." By the time she was discharged, "my nervous system just felt like it was shot," she said. Her physical health did start to improve over time, but she remained anxious, and had trouble eating or sleeping, she said. "It was so debilitating," she said. She found a support group on Facebook for women experiencing postpartum mental illness. Some of the mothers there recommended the Postpartum Support International website at https://postpartum.net. From there, Nye was able to search for providers specializing in postpartum mental health. She had already gone to her primary care physician, who she described as "amazing," but continued to struggle. Noting that postpartum mental health has a hormonal component that other mental health conditions don't, she was determined to find someone with a Perinatal Mental Health Certification, or PMH-C. A perinatal mental health specialist diagnosed her with postpartum obsessive-compulsive disorder (OCD). Nye said having a name for it helped bring a bit of closure. This healthcare provider was able to help with medication management and offered suggestions for possible therapists. While Nye, who works as a medical assistant, knew something was wrong and advocated for herself, this isn't always the case. With any mental health concern, the person who is struggling may not pick up the phone to reach out for help, Reinhart said. "When you're struggling with depression or anxiety, it's just hard enough to do the routine of the day," she said. Swartzlander encouraged family and friends to be aware. It's natural to be tired with a new baby, she noted. "Yes, of course they're going to have less energy," she said. "But you know if it's reaching a level that seems disturbing or concerning." She said others close to the struggling new mother can call the maternal mental health hotline, or reach out to other resources, on the mom's behalf. Bush added that fathers, too, can experience postpartum depression. "There's a lot of stress on women, obviously, and I specialize in that. But … I don't know that we like to talk about the fact that we as a society also put a lot of stress and pressure on men in the postpartum phase as well," she said. "I think a lot of men feel torn between 'I need to support my wife and be here with her' — like, 'physically, she needs my support' — but 'I also have to financially support my family.'" When fathers feel unable to accomplish both of these things, that stress can affect their mental health, she said. When a mother is struggling with her mental health postpartum, the father is more at risk, she said. She added that our society has changed. Parents today may live far away from extended family, and may not have a lot of ties in their community. "We used to have elderly neighbors come over and hold the baby, or your church family would come over and help you. … As a society, we have grown away from being there to support these familial structures the way we used to," putting undue pressure on the parents, she said. These additional stresses can, themselves, worsen mental health, she said. Sometimes a perinatal mental health issue is caused primarily by hormones, other times primarily by the major life transition of becoming a parent, and often by a mixture of both, she said. She added that pregnancy changes a woman's body. But our supermarkets are full of magazine photos of new mom celebrities, boasting of their "flat tummy, six weeks later!" Women who previously struggled with eating disorders or body image may find that these challenges reappear after giving birth, she said. Nye noted that studies show that 1 in 5 postpartum women will experience a perinatal mental illness. "And the majority of those women won't come forward, or they'll downplay how they really feel," she said. She urged others who are struggling to tell someone else, and to prioritize "sleep, nutrition and safety ... You have to sleep." She said she is now "not 100% back to my old self yet," but doing significantly better. She said she finds herself more appreciative of her family, and the experience has changed how she approaches her work. "I've always been a patient advocate, but this has just changed everything," she said. She noted that the medical assistant is the first person a patient sees, and the middleman when a patient calls to communicate with a physician. She said the healthcare system can be challenging, and she encourages people to advocate for themselves. "If you feel like something doesn't feel right, don't let it go," she said. She said she worries that women without her background might have a harder time. "I have thought that, and that breaks my heart, which is why I feel so strongly about this topic," she said. "I feel like I was fortunate to have that little bit of medical background. … When I knew something wasn't right, I was on it." Along with self-advocating, she said it made a real difference to find the support of others in the Facebook support group. "That was life-changing, to find this network of women. … Some of them have made it through to the other side, but they stay in the support group to help others," she said. She continues to talk regularly with several of them. "I feel like the more we share our stories, that will hopefully encourage other women," Nye said. "Because, I mean, 1 in 5 women! Think of how many babies are born every day. One out of five of those women can have a postpartum mental illness." Bush, as a mental health professional, has worked with clients who have had a variety of experiences. But she pointed out the significance of perinatal mental health in particular. When asked to consider a question like, "What are the things that we can do to really change the world 20, 30, 40 years in the future?", it's helping mothers become healthier and functioning at their best that first comes to mind, as this means "giving the children the best chance they have of having a happy, healthy parent," she said. Mental health professionals, after all, often work with adults who did not have these types of parents. "The children are the future," Bush said. "If you want to see what the future looks like, you have to look at the children. … Wouldn't it be great if we had adults that didn't have to heal from their childhood?"