Postpartum Mental Health Issues Are Real... Dr. Michelle Glantz Explains When It's Time to Seek Help

Dr. Michelle Glantz is a Los Angeles based Clinical Psychologist and mother of two. She works in private practice specializing in the treatment of anxiety disorders, trauma, life transitions, and perinatal mental health disorders -- with a goal of helping expecting or new parents work through underlying conflicts that surface around their transitions into parenthood.

As a mother herself, Dr. Glantz combines a professional and personal approach to her practice and understands firsthand the struggles and difficulties around assuming a new role as a parent.

Because adults aren’t the only ones who go through life’s trials, Dr. Glantz also works with children and adolescents struggling with anxiety and/or mood disorders. It is her belief that including parents in the therapeutic healing process along with their children helps them to better communicate and understand the complexities of development their child is experiencing.

We caught up with the doctor to ask what red flags to look out for and how to know when it’s time to seek help...

What are some signs that a postpartum woman should seek a psychologist? How common is feeling this way?

If a new mother is experiencing feelings of depression or anxiety that overwhelms her capacity to care for herself and/or their baby then it’s time to talk to someone. Perinatal Mood and Anxiety Disorders represent the continuum of mood disorders occurring during pregnancy (antepartum) and post-birth (postpartum).

The peak time for symptoms to occur is 3-6 months postpartum. There can also be a spike in PPD symptoms associated with weaning in breastfeeding moms.

Most women (up to 85%) will experience some degree of moodiness/instability during the first few weeks postpartum. These feelings usually resolve on their own but it never hurts to have extra support through therapy, if possible.

Types of postpartum mental health issues and possible symptoms include:

Baby Blues

• Refers to a period of emotional instability that frequently occurs after delivery
• Peaks 3-5 days after delivery and is often related to milk production
• Symptoms are transient and usually resolve within 2 weeks
• Tearfulness and mood swings
• Doesn’t greatly impact mother’s functioning and care of baby

Postpartum Depression

• Mood, tearfulness
• Agitation, anxiety, worry, irritability
• Sleep difficulty (exhaustion and insomnia)
• Appetite changes
• Hopelessness
• Shame
• Scary thoughts
• Poor concentration

Postpartum Anxiety

• Worry
• Panic attacks
• Anxious thoughts about safety of self or baby
• Restlessness
• Physical symptoms including upset stomach, headache
• Sleep and appetite disturbance

Postpartum Obsessive Compulsive Disorder

• Intrusive thoughts/obsessions: often about the baby that don’t fit one’s character
• Compulsions: often involve cleaning, worry about germs/contamination
• Fearful about infant’s safety
• Hyper-vigilance
• Worry about being left alone with baby

What are some key factors you should look for when finding the right mental health professional?

Trust, good therapeutic rapport, comfort, expertise in treating your particular issue, and professionalism are all deal breakers when searching for the right licensed professional.

As we transition to going back to the office and/or school, what are some tips parents can bring into the home to help with this major change?

Get back into a routine. Routines are safe and familiar and can help reduce anxiety. Focus on what you, yourself, can control and also help children identify what they, themselves, can control. This may include setting goals, staying organized, making plans, and providing visuals. Exploring the positives of each day and providing reassurance to the rest of the household that you are all in this together will create a sense of camaraderie and teamwork.

It may also be important to revisit social distancing rules and good hygiene practice, especially with the younger kids. Doing so, can help children feel more comfortable about their safety at school and other public places. 

What are some signs parents should be on the lookout for when it comes to determining if their child needs to see a psychologist?

• Somatic complaints (kids usually don’t show the same signs of depression and anxiety as adults -- common warning signs may be trouble sleeping or school refusal)
• Sudden and significant changes in behavior or interests
• Harmful acts to self, others, or animals
• Changes in mood. Increase or decrease in eating/sleeping
• Anxiety and excessive worrying
• Decline in academic performance

What are some simple tips that can be helpful to calm stress in a moment of high anxiety?

Breathing Exercises - 555 Breathing (into the belly, not into chest). Practice deep breathing (exhale should be longer than the inhale).

Progressive Muscle Relaxation - Progressive muscle relaxation is a method that helps relieve tension in our bodies. In progressive muscle relaxation, you tense a group of muscles as you breathe in, and you relax them as you breathe out, working on your muscle groups in a certain order. When your body is physically relaxed, it leads you to feel less anxious.

Self-Soothe with Senses - Find a pleasurable way to engage each of your five senses in order to soothe your negative emotions.

1 | Vision: Go for a walk and pay attention to the sights.
2 | Hearing: Listen to something enjoyable such as music or nature.
3 | Touch: Take a warm bath or get a massage. Holding ice can also ground you to the present moment.
4 | Taste: Have a small treat.
5 | Smell: Flowers, perfume, aromatherapy, and lavender are shown to promote relaxation.

Distract - Negative feelings will usually pass, or at least lessen in intensity over time. It can be valuable to distract yourself until the emotions subside. Marsha Linehan, creator of Dialectical Behavior Therapy, coined the acronym A.C.C.E.P.T.S. to remind us how we can use distraction to reduce stress.

Activities - Engage in activities that require thought and concentration. (Hobbies, puzzles, projects, work, or school.)

Contributing - Focus on someone or something other than yourself. (Volunteer, do a good deed, contribute to a cause or person.)

Comparisons - View your situation in comparison to something worse. Remember a time you were in more pain and remember that the negative feelings didn’t last forever. Think about when someone else was going through something more difficult.

Emotions - Do something that will create an opposite emotion. If you’re feeling sad, watch a funny movie. If you’re feeling nervous, listen to soothing music or get a massage.

Pushing Away - Push negative thoughts out of your mind. Write your thoughts on a piece of paper, crumble it up, and throw it away.

Thoughts - When emotions take over, try to focus on positive or neutral thoughts.

Sensations - Use safe physical sensations to distract you from intense negative emotions. (Hold an ice cube in your hand, or eat something sour like a lemon.)

It’s important to note that the above skills may not completely take away distress or negative emotion. Instead, they are used to reduce intense emotions when they feel intolerable in the moment. Sometimes, emotions can feel too intense and we are unable to participate in important daily activities, so a temporary distraction is key.

Remember, our emotions are useful guides which indicate how to proceed in life and so we do not want to ignore them indefinitely. I always tell my clients to think of emotions as signs on the road. If there were no traffic lights or signs, how would we know where to go? The same principle applies to how we use our emotions to guide us. 

What are the self care steps you never skip?

I try never to skip any! But when I do, I pay close attention to what I’ve ignored and am gentle with myself until I can come back to it. I also enjoy exercise, yoga, dancing, and spending time with friends.