The mental health impact on NICU parents

I have such a special place in my heart for NICU families, having started my career working as a social worker in a NICU over 20 years ago. I absolutely loved that job, working alongside some incredible nurses and doctors, and supporting new parents during some of their most challenging days.

Then, when I transitioned into a psychotherapist working as in outpatient psychiatry, and eventually, private practice, I found it invaluable to have this background when I would work with clients whose babies had been in the NICU (or who were still there). Not only would I of course understand the common jargon, equipment, and many of the diagnoses, but also their emotional reactions were so understandable to me.

A new mom's hypervigilance over her baby throughout the night, unable to fall asleep, fearful her baby would stop breathing without the monitors being on guard. A new dad more irritable and on edge, or not feeling confident to jump in and do baby care.

September is NICU Awareness Month.

It is such a helpful way of honoring NICU families and shining a light on what you've experienced and endured. Having worked with so many families whose babies were in the NICU throughout my career, I know how often you share you feel alone and wish others knew what your journeys were really like.

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I know that whether your baby spent hours, days, or months in the NICU, your time there left a mark on you.

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I know how hard it is to have such little privacy during such excruciating (or precious!) moments, feeling like you’re living in a bubble, perhaps having to ask permission to touch / hold your baby sometimes, being unable to feed your baby as you thought you would, and go through your vulnerable postpartum adjustment into parenthood in such a public space.

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You may have felt constantly guilty, like you were never there long enough, or that it was ok to take breaks for yourself.

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Even when you had a great team around you, and bonded with some of your baby’s providers, many of you have shared how overwhelming and traumatic it could be just being there. Hearing the beeping of the machines, seeing the haunted look in other parents’ eyes, constantly feeling on edge.

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Maybe you were in survival mode throughout, and could only let your guard down once your baby came home. Or maybe, that’s when the second stage of hypervigilance began.

Any parent who has had a baby in the NICU can tell you about the impact it can have on their mental health.

Whether it was hours, days, or months spent there, the time in the NICU can be super challenging. 

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NICU parents are at higher risk for PTSD, with studies highlighting that 53% of moms and 33% of dads in the NICU showing symptoms. Moms with a baby in the NICU are also 40 % more likely than other mothers to experience depression, anxiety, and trauma symptoms, and Dads showed similar rates. And in general, parents who experience emergency response interventions, such as their baby being resuscitated, or being whisked away to the NICU, are at higher risk for PTSD.

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It's no wonder, given the uncertainty, powerlessness, ever changing landscape and daily stress that can happen.

And to add to this, is the possibility that you may have had a delayed onset of your symptoms.

Meaning, you may not have felt much of anything but in survival mode while you were in the NICU. It's common for everything to come "crashing down", so to speak, once you get home. We see this in the research, too, where not only Perinatal Mood and Anxiety Disorders, but also PTSD can start up to a year + after having a baby, and a year after a baby coming home from the NICU. Some people don’t experience trauma symptoms until long after they’re out of danger and back into safety. To add to that is that it's common to have symptoms start with times of hormonal changes.

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Common times for symptoms to show up later include when you:

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▫️wean breastfeeding
▫️start back on hormonal birth control
▫️have your 1st menstrual period after baby

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Trauma reactions for NICU parents can be delayed and triggered by so many things.

I often have parents come into my practice months (or more) after delivery, expressing confusion about their symptoms until together we can find clarity about why they are suffering.

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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. And, whether your symptoms start during pregnancy, immediately after birth, or however many months later, you aren’t alone and you don’t have to keep suffering.

We have an entire chapter in our Pregnancy and Postpartum Mood Workbook devoted to these parents for this exact reason. While you may be at higher risk for developing mood symptoms during this challenging time, it doesn’t mean you have to suffer alone. Learning empowering skills to manage your difficult situation and improve your resilience can make all the difference. 

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Finding support can be life changing, too, whether it’s forging a connection with a few of your baby’s providers, attending a NICU support group, connecting with NICU parents online, going to therapy, or finding friends who are also NICU grads. I hope you found your support along the way.

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Whether you had a brief stint, or a long term stay, a minor health concern, a “feeder grower” or a more serious and long term chronic health issue with your baby, I think you are a warrior.💜

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