Parents, it’s been a long two years—especially if you became a parent for the first time during the COVID-19 pandemic. People who entered parenthood in 2020 and 2021 have dealt with changing guidelines, limited support, social isolation, and so many more challenges. And let’s be honest: new parenting is challenging enough without also having to navigate a worldwide pandemic in the process.
In spring 2022, new parents still face a great deal of uncertainty. Although COVID infections are down, big questions remain around how to live and parent in a way that feels safe and healthy. Anxiety, stress and depression are common right now, as people figure out life in this new normal.
Our curriculum advisor, holistic psychiatrist Dr. Aparna Iyer, has some great insights into how to care for your mental health in this new phase of the pandemic. We spoke with her about what she’s seen in her practice with new parents’ mental health, dealing with anxiety, and why it’s so important to check in with yourself on a regular basis.
MC: What have you noticed over the past two years, with new parents and mental health?
AI: I’ve noticed that a lot more people, including moms, are seeking mental health support. It seems that many of us who heavily relied on their social lives to support them through stressful life situations have found that they suddenly needed to pivot when the pandemic struck and they could no longer access their supports the way they may have before. Those who were otherwise not inclined to seek mental health treatment suddenly felt a unique type of pressure to do so, especially when faced with life stressors such as familial changes, marital changes, financial, job insecurity, etc. I’ve seen this associated with a huge drop in mood and increase in depression.
Anxiety in moms seems to have risen as well, and for clear reasons. Moms during the pandemic have felt additional stressors – such as balancing the need for social support when they need it the most against the fears of exposing themselves or their babies to coronavirus. In these situations, a lot of the moms have felt the loneliness that comes with needing to be completely self-reliant, whereas in the past, they may have been able to ask family members for help when needed.
While it’s natural and healthy for moms to have some anxiety around their children’s well-being and safety, the pandemic seems to have given rise to even more anxiety around protecting our children. All of a sudden, the thought processes needed to keep our children safe seem ever more complex. On one hand, you want to protect them from infections. But on the other hand, we also want them to be around other children and have as normal a childhood as possible.
MC: How about anxiety for new mothers? It’s common, but is it increasing?
AI: Anxiety is not inherently bad and is in many ways healthy, helpful and evolutionarily adaptive for new moms. For example, a certain level of anxiety could lend itself to more focus or productivity or, for moms, it can result in ensuring that we’re paying attention to keeping our children healthy and safe.
However, heightened, relentless anxiety that impacts our functioning can impact our health. The data generally shows that when women are suffering from anxiety, it is not a contained illness. It spills over and impacts our families. It impacts the health and development of our children as well.
While all mothers experience anxiety, anxiety disorders (the severe and high anxiety I described earlier) are also really common in new moms. The data also clearly shows that more new moms are reporting heightened anxiety symptoms since the onset of the pandemic.
MC: So how can we know what the threshold is?
AI: Like most things, knowing what’s “good” anxiety and “bad” anxiety is rarely ever black and white. This becomes even harder to determine for many moms during early motherhood for a number of reasons.
The reality is that there is an adjustment period to this whole motherhood thing! This is a really big transition—changes when it comes to the workplace, changes in our relationship, changes in our identity. So it’s expected that you will have a rollercoaster of emotions and nervousness. But we can’t base our concerns for moms on simple or typical criteria, per se, such as having low energy or poor sleep because – really – which new mom can claim to have endless energy or excellent sleep?
Instead, we look at symptoms as crossing over into disorder when it starts to impact our functioning. Some examples of this are: a) if your symptoms persist, b) if you start having thoughts that don’t feel like your own, c) if your recurrent anxiety starts to debilitate you. The most emergent situation is if you start having thoughts of harming yourself or harming your baby, in which case you need medical intervention right away.
The good news is, because motherhood is so darn hard, I think many moms would benefit from setting the bar low for when we seek professional support. I don’t think you need to be experiencing a disorder or have an official mental health diagnosis to seek some additional postpartum support. Everyone could use a little bit of extra support from time to time!
When seeking support, it could look like whatever works for you. For example, you can seek intermittent, short-term, as-needed therapy. Or it could be psychiatric medications, frequent therapy, a long-term therapy relationship. The data shows that there are so many variations in the type of support that people seek and that they all have the potential to be helpful and protective.
MC: What advice do you have for people who have entered or are entering parenthood in the pandemic, for mental health?
AI: I think that what I generally recommend even pre-pandemic for families is to recognize that entering into motherhood is going to feel different than anything you’ve ever experienced before. My own personal biggest mistake was assuming that my ability to stay up late studying and handle huge amounts of stress through my medical schooling and career meant I would automatically be able to handle a baby and late night awakenings with ease – but I was so wrong!
I always advise moms to be prepared to need a lot of help and support postpartum, since we cannot always completely predict how much or how little help we might actually need postpartum. So, think about that support and how it may be different with COVID-19 as a factor.
For example, If you are not comfortable with relying on in-person family or friend support (such as if you and your family members might have different views on vaccination, for example), you may choose to be more reliant on professional support, even virtual support like virtual therapy, virtual support groups, or great services like Major Care!
MC: Where do you think are good resources for people to figure out how to make decisions for risk management if they’re pregnant or newly postpartum? What advice do you have for people as things are opening up more, but people may still feel anxious?
AI: A lot of the anxieties around health and safety during the pandemic are based in reality. We just have to give ourselves a little bit of grace and acknowledge that this is hard!
After over two years of helping moms with tough decisions around families and the pandemic, I feel it’s fair to say that there are no clear or easy answers. Instead, there are decisions that may feel right for your individual family, while the person next to you might make a totally different decision. And perhaps that might be right for their family, but not necessarily yours and vice versa.
To help guide you through medical and family decision making for your pregnancy and beyond, there’s really no replacement for having a really trusted medical professional (like your OB, pediatrician, midwife, etc) to help guide you through some of those pieces. I am so grateful to my patients who trust me to guide them through the most challenging parts of this emotional roller coaster we call parenthood!
MC: What mental health tips do you have for new parents in general, whether they just had a baby or they’re a couple of months out? In general, but specifically as the pandemic continues to shift, if we have new waves of infection, if things become endemic.
AI: I have four big mental health tips for new parents at this point in the pandemic:
First, as we settle into a longer term picture with the pandemic, we have to accept that there are generally no risk-free options when considering how to avoid infection. While this may be quite anxiety provoking, we can try to settle into a mindset of risk management, which entails using the data to truly understand medical and infectious risks of various decisions before weighing our the risks and benefits and making a decision.
Second, protecting your mental health and the mental health of the individuals and your family is also very much a part of that risk management. Remember that we as humans are not islands so we’re not meant to be isolated from each other. For this reason, it’s important to stay connected as much as you can, whether it’s a face-to-face connection or a virtual or phone connection.
Third, the data really shows that there are some significant things that we can do from a lifestyle perspective to protect our mental health, but the one I want to emphasize today is exercise. It doesn’t even need to be intense exercise. It could just be movement, if that’s all you can manage at the moment, and of course, the movement needs to be pre-approved by your personal physician. I personally applaud my patients when they take the first step towards movement, whether it’s a slow paced walk around the block or a higher intensity workout at the gym – what a great commitment to one’s mind and body!
Fourth, check-in with your emotions regularly. I call this “taking inventory” of your emotions. This pandemic has been so, so hard, and it has been said that the world has been experiencing a collective grief around all of our losses from the past two years. Even if you may not be aware that you are experiencing any sadness or difficult emotions, it is helpful to stop yourself once in a while so you can do a quick “inventory” of your emotions, to look inward with intention and make sure that you are feeling as well as you possibly can.
Dr. Aparna Iyer is a Dallas-area board-certified concierge psychiatrist focusing on reproductive and holistic emotional wellness. She is a curriculum advisor for Major Care, as well as speaker and writer. She provides consultation on implementation of mental health wellness practices (including maternal mental wellness) in the corporate setting. You can follow her on social media here and learn more on her website.
Please note that the above information reflects the opinions of Dr. Aparna Iyer only and not necessarily of any of the institutions with which she is affiliated. This information is not medical advice and does not replace the advice of your own personal physician. For any medical concerns, please contact your personal physician.