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Mothers’ Mental Health: Some Thoughts and Solutions


Last weekend was International Mother’s Day. The word ‘mother’ includes ‘other’, which aptly summarizes the incredible contribution of mothers to children, families, and society at large. It is essential to recognize these contributions and to pay close attention to mothers’ mental well-being. Women, especially mothers, are nearly twice as likely as men to experience depression and anxiety. This discussion explores the connections between motherhood and mental health across different stages of motherhood. 


Before Pregnancy 

Common mental health problems during this period are similar across the female population. However, individuals with pre-existing mental health issues require additional support and monitoring before, during, and after pregnancy. 


Pregnancy and Mental Health 

Depression and anxiety may develop or worsen during pregnancy, particularly if there is a pre-existing mental health condition. There are also important considerations regarding the continuation of mental health medications during this time. 

Childbirth and Mental Health 

Mental health issues, especially depression, can intensify around childbirth and afterwards. The risk is particularly high for those with a history of mental health problems, although depression can also occur for the first time. The most critical period is the first few weeks to six months post-delivery. Hormonal changes during childbirth can cause rapid mood fluctuations. It’s important to distinguish between postpartum depression and the less severe ‘baby blues’. There are also concerns about the effects of antidepressants on newborns through breastfeeding. Although early detection of postpartum depression is well-recognized, the need for ongoing specialized care is sometimes overlooked. Losing a child during pregnancy or delivery, or experiencing complications during childbirth, can lead to profound grief and mental health issues, potentially overlooked in many general hospital settings. 



Mental Health After Delivery 

The arrival of a first child is a significant life transition for many new mothers, which can bring about stress and sleep deprivation, exacerbating or triggering mental health issues. Mothers with no prior mental health problems, as well as those with existing conditions, may find it challenging to access adequate long-term care and support. The mother’s mental health can also affect other children in the family.  10% to 20% of deliveries can result in postpartum depression.  


The Empty Nest Period 

The ’empty nest’ period, when the last child leaves home, presents its own challenges and may coincide with menopause, a time which can also be linked with depression 10% to 20%   of women. 


What Are the Solutions? 

While motherhood is fraught with challenges, it also brings significant rewards. Most mothers view motherhood positively. However, when a mother suffers from mental health concerns, a proactive approach is necessary. This involves evidence-based treatments alongside supportive measures. Investing in maternal mental health benefits society by enhancing children’s health and can prevent mental health issues in future generations. mental health solutions and suggestions are summarized below.  



Before Pregnancy: Any pre-existing mental health issues must be addressed. Family physicians can advise whether medications for mental health can be continued during pregnancy or may consult with a specialist. 

During Pregnancy: Health visitors and the obstetric team can detect early signs of mental health issues. Those with a history of mental health problems may need closer monitoring by their family physician or a psychiatrist. Treatment options include not only medications but also cognitive behavioral therapy and interpersonal therapy, which are gold standards in managing anxiety and depression. 

Childbirth: This period is crucial for the emergence of depression. New research offers hope with treatments like Zuranolone, a hormone-based antidepressant that acts rapidly to treat postnatal depression, though it is not yet available in Canada. Standard antidepressants need careful consideration regarding their presence in breast milk. Psychological treatments like cognitive behavioral therapy and interpersonal therapy are valuable options and can be delivered online or in group settings. 

Depression Later in Life: Recommended treatments include antidepressants and cognitive behavioral therapy, with non-drug options like transcranial magnetic stimulation also available. Psychological therapies, particularly cognitive-behavioral treatments, provide useful skills for managing life and preventing relapse. For those with recurrent depression, mindfulness-based cognitive therapy can prevent depressive relapse. In perimenopausal depression, medications like Effexor or venlafaxine have been effective in managing mood and physical symptoms. New hormonal treatments for mental health are also under development. 


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