Not everyone experiences immediate onset of mental health symptoms.

Mood symptoms (such as bipolar, anxiety and depression) can start up to 2 years after having a baby, not just during the pregnancy or immediately after giving birth. Common times for the onset of symptoms include: 1) when weaning breastfeeding 2) when starting back on birth control after pregnancy 3) around the 1st menstrual period after baby. However, symptoms can occur at other times as well such as during the pregnancy or once a time of crisis is over (more on this below). Why this is so important to talk about is women are often seen by their birth provider within the first few weeks after delivery (or around 6 weeks generally, if they had a vaginal delivery), and then will not have any more contact with their own provider unless they have complications from birth.  Many women will go on to develop symptoms of Perinatal Mood and Anxiety disorders  (PMADs) WAY out of this window of care, and may not know first, how to recognize these symptoms as part of a PMAD, and second, no one may be asking her at that point how she is doing. Many people (even providers sometimes, sadly), will erroneously think that if the mood symptoms start months or even a year after the birth of a baby, that they are not related to the Perinatal time, and will therefore miss screening the woman and getting her to a Perinatal Mental Health specialist.  It’s important to get help no matter when the symptoms start, and if you think this is happening with a loved one, talk to her, information is power!! And please hear this, if you are having symptoms months after having the baby, THIS IS NOT THE BABY BLUES (louder for those in the back!).  For a review of basic PMADs information, please go to my link here  and also postpartum.net and postpartumhealthalliance.org for additional information and support / resources. I loved being on this podcast episode of Newbies on New Mommy Media to talk about delayed symptoms of Perinatal Mood and Anxiety Disorders (PMADs) a few years ago.  It's such an important topic and one that many parents don't know about so it was an honor to be able to shed some light on this important topic.  

Delayed onset of PTSD

While we’re on the subject of delayed symptoms, did you know that Posttraumatic Stress Disorder can also also have a delayed onset? Much like the calm before the storm, some people don’t experience Post Traumatic Stress Symptoms until long after they’re out of danger and back into safety.  It's almost like the body knows to keep going in survival mode until it's safe to "feel all the feelings" and decompensate. An example of this is a hyper-vigilant mama of a preemie who reports she "crashes and burns" after her baby finally comes home from the hospital.  She relives the anxiety of the NICU experience months after they’ve come home and she can’t sleep, having racing thoughts, feeling hypervigilent and constantly fearful and on guard.  However, while her baby was in the NICU she actually looked like she "kept it all together" on the outside, visiting daily, being vigilant and attentive.  This could also look like a woman who replays her traumatic delivery as she prepares to conceive again telling herself she is not safe but until she reached this next stage of planning, she felt like she "handled" the delivery ok and compartmentalized it. Another new mama might be triggered when going to OB appointments thinking about her miscarriage the last time she was there, similar to the soldier who starts having nightmares once she’s on home soil, etc.   A trauma reaction can be delayed and triggered by so many things. Whether you’re experiencing symptoms immediately after a distressing event or long after you “should” feel safe (and aren’t!), it’s important to get help. You aren’t alone and don’t have to keep suffering. A few places to go for help: Emdria.org to find a therapist specializing in EMDR therapy for trauma Postpartum.net to find a therapist worldwide specializing in Perinatal Mental Health Postpartumhealthalliance.org to find a therapist specializing in Perinatal Mental health in the San Diego area.