Transition to New Parenthood
Becoming a new parent can bring tremendous joy; at the same time, the transition to parenthood is a particularly vulnerable time, given the many changes to activities, sleep, work, behavior, finances, and roles.
Understandably, most new parents will experience some degree of stress and difficulty as they adjust to this major change. This is completely normal. For other new parents, the role transition comes with more serious challenges and distress, and an increased vulnerability to mental illness. Difficult birth experiences, having an unsettled baby, or difficulty feeding can compound the issue.
It’s important to be aware of the potential effects on mental health that can accompany the transition to parenthood. If you do have any concerns, therapy and other supports can help you to care for your wellbeing, for you and your baby.
New parenthood: Effects on mental health
Becoming a parent for the first time is one of life’s major transitions and, unsurprisingly, can cause our mental health to be more vulnerable than usual. Some challenges associated with the transition to new motherhood include:
- Baby blues: The ‘baby blues’ is experienced by many parents, and is not a mental health condition. It involves relatively short-lived challenges with adjusting, labile mood, and fatigue. These symptoms tend to resolve after a couple of weeks.
- Adjustment: Many people find that becoming a parent is not what they expected; they might feel underprepared, exhausted, and overwhelmed.
- Identity changes: Parenthood comes with huge changes in identity and sense of self, as roles change (from working to being a carer, for example). How we spend our time changes drastically.
- Cultural and societal pressures: A common misconception is that all birthing parents are on a natural hormone high following birth. New parents are expected to feel overwhelmingly positive about becoming a parent, which is seen as a natural and instinctive transition. However, this is not the case for everyone, and these pressures can make matters worse while discouraging new parents from seeking help. Any psychological difficulty that interrupts your daily life or causes you distress is worth discussing with a mental health professional.
Some parents have more serious symptoms indicative of a mental health condition, such as:
- Postpartum depression (also called perinatal depression): This is a form of depression, where everyday functioning is affected by symptoms such as sadness, crying, fatigue, changes to sleep and appetite, feelings of guilt or worthlessness, and withdrawing from friends and family. This is a serious mental health condition requiring treatment.
- Postpartum anxiety: This term is used to describe clinical levels of anxiety associated with the transition to motherhood. For some parents, anxiety may be accompanied by panic attacks or OCD. Anxiety disorders can occur alongside postpartum depression.
- Postpartum psychosis: This is a relatively uncommon but serious experience, where parents develop symptoms of psychotic disorders like hallucinations or delusions in the period following birth.
Indications of challenges adjusting to new motherhood
Difficulties transitioning to parenthood may cause symptoms similar to other life transitions and stressful experiences, such as:
- Feeling guilty, sad or crying
- Feeling stressed or restless
- Difficulty concentrating
- Feeling overwhelmed
- Difficulty sleeping
- Changes in appetite
- Feeling anxious or panicky
- Having upsetting thoughts
- Difficulty bonding with the baby, or feeling disinterested in the baby
- Withdrawing from family and friends
Many parents encounter some of these symptoms during the transition to new motherhood, though they tend to resolve without therapy within a couple of weeks. However, if symptoms interfere with your daily activities and last longer than two weeks, it’s important to seek help. You may be experiencing a form of postpartum mental health condition.
Prevalence of mental health challenges for new mothers
It’s very common for new mothers to encounter challenges as they navigate the transition to motherhood. The American Psychiatric Association reports that up to 70% of new mothers experience the baby blues (1).
Postpartum depressive or anxiety disorders are serious mental health conditions, affecting 1 in 5-8 women, while 1 in 1000 new mothers develop a psychotic disorder (2).
Treatment options for transitions to new parenthood
The challenges encountered during the transition to parenthood are usually temporary; new parents adjust and learn to cope with their new situation over time. However, many helpful strategies and supports can improve this process:
- Therapy: Talking therapies in individual or group contexts are helpful for learning new coping strategies, normalizing your experience, and helping with adjustment. See more tips below on types of therapy and selecting a therapist.
- Check-ups: Have regular checkups with your physician to stay abreast of your (and your baby’s) health. Your doctor can explore and treat any physical conditions that may be contributing to your symptoms, and act as an extra support person, alert to any changes in your mood or coping.
- Self-care: There are many steps you can take to care for yourself as a new parent. Pay attention to your diet, and although it is challenging, try to get some sleep and exercise. Rest as much as you can, and try to sleep when your baby sleeps.
- Support groups: Many people find the social support and strategies learned in parenting groups to be very beneficial. If you are in New York City, for example, there is a huge choice of support groups available. Postpartum Support International is a great resource for finding groups in your area.
- Birth supports: Having a doula can be a great support during pregnancy and birth, and can also reduce symptoms of anxiety and depression postpartum.
- Lactation consultants: Working with a lactation consultant can be helpful for parents wishing to breastfeed but experiencing difficulties.
- Social support: Finding support as a new parent is of critical importance. Talking to family and friends can help you feel understood, and don’t be afraid of reaching out to ask for their help. Plan ahead and identify people you can count on for emotional and practical support, to decrease the difficulty of accessing it when you might be exhausted and overwhelmed.
- Hotlines: You can call the Postpartum Support International helpline at 1-800-944-4773. If you’re having thoughts of suicide or need immediate support, call the National Suicide Prevention Hotline at 1-800-273-8255.
Therapy for transitions to new parenthood
Whether you think you may be experiencing a mental health condition, or just need some extra support, working with a therapist can be a great help. Many effective types of therapy can help new mothers navigate this life transition. Common modalities include:
- Cognitive Behavioral Therapy (CBT): CBT is a common evidence-based type of therapy that helps us to become aware of and change unhelpful thinking patterns and behaviors that influence our emotions. It can also help with self-care and building a routine, which is really important for the wellbeing of new mothers.
- Mindfulness Practices: Mindfulness encourages moment-to-moment awareness and deliberate, non-judgemental awareness of the present. This helps during stressful times and enables us not to get caught up in unhelpful thoughts or automatically react to our experiences as problematic.
- Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies. It helps us take an acceptance approach, to respond differently to the difficulties of transitions.
- Psychodynamic therapy: Psychodynamic therapy involves the exploration of past experiences and how they influence current patterns of thought, emotion, and behavior. This can help people who want to gain insight into how their past is shaping their experience of motherhood.
What to look for in a therapist for transitions to new parenthood
There are several factors to keep in mind when selecting a postpartum therapist, including:
Specialization: Look for a therapist who has experience and specialized training in perinatal mental health or the type of therapy that resonates with you. Many therapists have a particular interest in postpartum mental health. They often include this information on their website or online profile.
Qualifications: With so many different provider types available, it can be difficult to decide which type of mental health professional to see. The most important thing is to look for a currently licensed therapist. That said, if you think medication might be needed, make sure you see a psychiatrist. This particular type of mental health professional is able to prescribe.
Personal fit: In addition to training and qualifications, look for a therapist you feel comfortable with. The trusting relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy.
The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also enables you to ask about their experience and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.
Sources and references
- (1) American Psychiatric Association website, “What is postpartum depression?”, accessed online at https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression
- (2) American Psychiatric Association website, 2018, “Position Statement on Screening and Treatment of Mood and Anxiety Disorders During Pregnancy and Postpartum”
- Postpartum Support International’s website
- National Health Service, United Kingdom website, “Feeling depressed after childbirth”, accessed online at https://www.nhs.uk/conditions/pregnancy-and-baby/feeling-depressed-after-birth/
- National Childbirth Trust's website, “Supporting women in the transition to motherhood: a research overview”, PDF accessed online at https://www.nct.org.uk/sites/default/files/related_documents/Bollen%20Supporting%20women%20in%20the%20transition%20to%20motherhood-%20%20a%20research%20overview%20pp%2016-20%20Mar%2015.pdf