Holistic Perinatal Psychiatry: Supporting Women Through Pregnancy and Postpartum in Denver

Perinatal psychiatry can help support your mental health from pregnancy to postpartum.

It’s true. 

Pregnancy and new motherhood don't always feel the way people say they “should.” While others talk about how blessed and excited you must be, you might be feeling anxious, overwhelmed, or uncertain instead. That disconnect between expectations and reality can feel isolating.

Maybe you're pregnant and struggling with worry rather than excitement. Or perhaps you've welcomed your baby but find yourself exhausted, anxious, or questioning your abilities as a mother. You love your child deeply, yet you don't feel like the confident, joyful mother you imagined you'd become.

If this sounds familiar, please know you're not alone—and you're not failing. Many women experience these challenges during pregnancy and after childbirth. What you're feeling is common, understandable, and most importantly, very treatable with the right support.

Understanding Perinatal Mental Health

Perinatal mental health encompasses the emotional well-being of women during pregnancy and the first year after birth. This period involves some of the most dramatic physical, hormonal, psychological, and social changes a woman will ever experience—often all at once.

Perinatal mood and anxiety disorders (PMADs) are among the most common complications of pregnancy and childbirth, affecting up to 20% of women. Yet they remain under-recognized, under-diagnosed, and under-treated, often dismissed as "normal" pregnancy emotions or "baby blues."

The reality is that while some emotional ups and downs are normal during this time, persistent symptoms that interfere with your ability to function, bond with your baby, or enjoy life are signs that you need and deserve professional support.

The Denver Difference: Unique Challenges for New Mothers (Real Talk.)

Living in Denver presents specific considerations for perinatal mental health that many providers don't fully address:

Social Isolation: Many Denver residents are transplants without extended family nearby. The loss of traditional support systems can significantly impact perinatal mental health, especially when combined with Denver's fast-paced, individualistic culture.

Outdoor Culture Pressure: Denver's emphasis on active lifestyles can create additional pressure for new mothers who may not feel ready to return to hiking, skiing, or other activities. The gap between Denver's "outdoorsy mom" ideal and the reality of early motherhood can contribute to feelings of inadequacy.

Weather and Seasonal Factors: Colorado's dramatic weather changes and long winters can impact mood, while intense summer sun can affect sleep patterns for both mothers and babies.

Altitude and Pregnancy: Research shows that high altitude can affect pregnancy in multiple ways that may impact mental health. The physiological stress of altitude can exacerbate anxiety, affect sleep quality, and impact energy levels—all of which can worsen perinatal mood disorders.

Common Perinatal Mental Health Conditions

Perinatal mental health disorders exist on a spectrum, from mild adjustment difficulties to severe conditions requiring immediate intervention. Understanding the different presentations can help women recognize when they need support.

Perinatal Depression

Depression during pregnancy or postpartum affects 10-15% of women and can look quite different from depression at other life stages.

During Pregnancy:

• Persistent sadness, emptiness, or numbness
• Excessive worry about the baby's health or development
• Difficulty bonding with the pregnancy
• Loss of interest in preparing for the baby
• Thoughts about not wanting to be pregnant
• Physical symptoms like fatigue, changes in appetite, or sleep disturbances beyond normal pregnancy changes

Postpartum Depression:

• Feeling disconnected from your baby or difficulty bonding
• Persistent sadness, hopelessness, or emptiness
• Overwhelming fatigue that doesn't improve with rest
• Loss of interest in activities you used to enjoy
• Difficulty making decisions or concentrating
• Thoughts about harming yourself or your baby

Perinatal Anxiety

Anxiety disorders are actually more common than depression during the perinatal period, affecting up to 18% of pregnant and postpartum women.

Common Manifestations:

• Excessive worry about the baby's health, development, or safety
• Racing thoughts or inability to "turn off" your mind
• Physical symptoms like rapid heartbeat, shortness of breath, or dizziness
• Hypervigilance about potential dangers
• Difficulty sleeping even when the baby is sleeping
• Avoidance of activities due to worry
• Need for excessive reassurance from healthcare providers

Postpartum Obsessive-Compulsive Disorder (OCD)

Postpartum OCD affects 3-5% of new mothers and involves intrusive thoughts coupled with compulsive behaviors aimed at preventing harm to the baby.

Symptoms Include:

• Intrusive thoughts about accidentally or intentionally harming the baby
• Excessive checking behaviors (breathing, temperature, safety)
• Repetitive cleaning or sterilizing
• Avoidance of situations where you might be alone with the baby
• Seeking constant reassurance about your thoughts or behaviors

Important note: Having intrusive thoughts about harming your baby does NOT mean you will act on them. These thoughts are ego-dystonic (go against your values) and are actually a sign of how much you care about your baby's safety.

Birth Trauma and PTSD

Up to 45% of women report their birth experience as traumatic, and 4-6% develop full PTSD symptoms.

Risk Factors:

• Emergency interventions during birth
• Feeling powerless or out of control during delivery
• Poor communication from medical staff
• Previous trauma history
• Lack of support during birth

Symptoms:

• Intrusive memories or flashbacks of the birth
• Nightmares about the birth experience
• Avoidance of reminders of the birth
• Hypervigilance or being easily startled
• Difficulty bonding with the baby if they're associated with the trauma

The Science Behind Perinatal Mental Health

Understanding why perinatal mental health conditions occur can help reduce self-blame and stigma:

Hormonal Changes

Pregnancy and postpartum involve dramatic hormonal fluctuations that directly affect mood-regulating neurotransmitters:

• Estrogen and progesterone levels increase 100-1000 fold during pregnancy, then plummet rapidly after birth
• Cortisol (stress hormone) increases during pregnancy and can remain elevated postpartum
• Oxytocin and prolactin fluctuate with breastfeeding, affecting mood and bonding
• Thyroid hormones commonly become imbalanced postpartum, affecting energy and mood

Sleep Disruption

Sleep is crucial for mental health, and the sleep disruption of new parenthood can trigger or worsen mood disorders. Research shows that sleep deprivation affects emotional regulation, decision-making, and stress resilience.

Social and Psychological Factors

• Identity shifts: Becoming a mother involves profound changes to sense of self
• Relationship changes: Partner dynamics shift significantly with a new baby
• Social support: Lack of support is one of the strongest predictors of perinatal mental health problems
• Previous mental health history: Women with a history of depression or anxiety are at higher risk

Treatment Approaches in Perinatal Psychiatry

Treating perinatal mental health conditions requires specialized knowledge about medication safety, the unique challenges of this life stage, and the importance of the mother-baby relationship.

Medication Considerations

One of the most common concerns for pregnant and breastfeeding women is medication safety. The good news is that many psychiatric medications are safe during pregnancy and breastfeeding, and the risks of untreated mental illness often outweigh medication risks.

Safe Options During Pregnancy:

• Certain SSRIs (like sertraline and citalopram) have extensive safety data
• Some older tricyclic antidepressants may be preferred in certain situations
• Specific anti-anxiety medications can be used short-term when needed

Postpartum and Breastfeeding:

• Most antidepressants are compatible with breastfeeding
• The amount that passes into breast milk is typically very small
• We monitor both mother and baby when medications are used during breastfeeding

Decision-Making Process:
We consider multiple factors when discussing medication:

• Severity of symptoms
• Previous treatment response
• Personal and family psychiatric history
• Pregnancy complications or risks
• Breastfeeding goals and circumstances
• Social support and coping resources

Therapy and Counseling

Therapy is often the first-line treatment for mild to moderate perinatal mood disorders and can be highly effective:

At Conscious Psychiatry, we embrace and practice Acceptance and Commitment Therapy (ACT): Helps women accept difficult emotions while taking action aligned with their values as mothers.

Holistic and Supportive Psychiatric Approaches

Nutritional Support: Proper nutrition is crucial during pregnancy and postpartum, and certain deficiencies can worsen mood symptoms:

• Omega-3 fatty acids support brain health and may prevent postpartum depression
• Vitamin D deficiency is common, especially in Denver's altitude, and affects mood
• Iron deficiency can cause fatigue and mood symptoms
• B vitamins support energy and neurotransmitter production

Sleep Hygiene: While perfect sleep isn't possible with a newborn, optimizing sleep when possible can significantly impact mental health.

Exercise: Gentle, appropriate exercise during pregnancy and postpartum can improve mood, reduce anxiety, and boost energy levels.

Social Support: Connecting with other mothers, family support, and professional help can make a tremendous difference in recovery.

Denver-Specific Resources and Support

Denver offers excellent resources for perinatal mental health, though knowing how to access them can be challenging during this vulnerable time:

Local Support Groups

• Postpartum Support International (PSI) Colorado chapter offers support groups throughout the metro area
• MOPS (Mothers of Preschoolers) groups provide community and connection
• New mother support groups through local hospitals and community centers
• Online support communities for mothers who can't attend in-person groups

Specialized Providers

Denver's growing awareness of perinatal mental health has led to increased specialized services:

• Perinatal psychiatrists and psychiatric nurse practitioners (hey - that’s us!) 
• Therapists specializing in perinatal mental health
• Doulas trained in mental health support
• Lactation consultants who understand the intersection of feeding and mental health

The Conscious Psychiatry Approach to Perinatal Care

At Conscious Psychiatry, we understand that perinatal mental health care isn't just about treating symptoms—it's about supporting women through one of the most transformative periods of their lives.

Our Comprehensive Approach:

Preconception Counseling: For women with mental health histories who are planning pregnancy, we help optimize treatment and develop plans for managing mental health during pregnancy.

Pregnancy Support: We provide ongoing mental health care throughout pregnancy, adjusting treatments as needed and preparing for postpartum care.

Postpartum Expertise: Our providers understand the unique challenges of the postpartum period and provide specialized care that considers breastfeeding, sleep deprivation, and the demands of new motherhood.

What Makes Our Psychiatric Treatment Different:

Medication Expertise: Our providers have specialized knowledge about psychiatric medication safety during pregnancy and breastfeeding, helping you make informed decisions about treatment.

Trauma-Informed Care: We understand that many women have trauma histories or experience birth trauma, and we approach care with sensitivity to these experiences.

Cultural Sensitivity: We recognize that cultural backgrounds, family dynamics, and personal values all influence the perinatal experience.

Flexible Scheduling: We offer appointment options that work for new mothers, including telehealth when appropriate.

Insurance Coverage: Our services are covered by insurance, making specialized perinatal mental health care accessible.

When to Seek Help

It can be difficult to distinguish between normal adjustment challenges and clinical mood disorders during the perinatal period. Consider seeking professional help if:

During Pregnancy:

• You're experiencing persistent sadness, anxiety, or mood changes
• You're having thoughts about not wanting to be pregnant
• You're unable to take care of yourself (eating, sleeping, basic hygiene)
• You're using alcohol or substances to cope
• You're having thoughts of harming yourself

After Birth:

• Your symptoms are getting worse instead of better after the first two weeks
• You're having difficulty bonding with your baby
• You're experiencing intrusive thoughts about harming your baby
• You're avoiding your baby or feeling afraid to be alone with them
• You're having thoughts of harming yourself
• Family or friends have expressed concern about your mood or behavior

Breaking the Silence: Reducing Stigma

One of the biggest barriers to perinatal mental health treatment is stigma—both societal and self-imposed. Many women struggle with shame about not feeling the "right" way about pregnancy or motherhood.

Common Myths to Challenge:

• "Good mothers don't have these problems"
• "I should be grateful and happy all the time"
• "This means I don't love my baby"
• "I should be able to handle this on my own"
• "Medication will harm my baby"

The Truth:

• Perinatal mood disorders can affect any woman, regardless of circumstances
• Having a mental health condition doesn't reflect your love for your baby
• Seeking help makes you a good mother who wants to be healthy for her family
• Treatment is effective and can dramatically improve quality of life for the whole family

Hope and Healing in Motherhood

Perinatal mental health conditions can make you feel like you're failing at the most important job of your life. But here in Denver, surrounded by a community that increasingly recognizes the importance of maternal mental health, you have access to compassionate, effective care.

Recovery is not only possible—it's probable with appropriate support. The mountains around our city remind us that even the most challenging journeys can lead to beautiful destinations. Your path through perinatal mental health challenges is part of your unique motherhood story, not a deviation from it.

With proper treatment, women with perinatal mood disorders go on to be loving, capable mothers who are often more compassionate and resilient because of their experiences. Your struggles don't define your motherhood—your courage in seeking help and working toward healing does.

You deserve to enjoy this precious time with your baby. You deserve to feel like yourself again. And most importantly, you deserve support without judgment as you navigate this transformative journey.

The help you need is available, and taking that first step toward care is an act of love—for yourself, your baby, and your family.

About Conscious Psychiatry | Perinatal Psychiatric Providers

Conscious Psychiatry provides specialized perinatal mental health care throughout the Denver metro area, offering compassionate, expert support for women during pregnancy and the postpartum period. Founded by Jordan Gough, PMHNP-BC, our practice combines deep expertise in reproductive psychiatry with understanding of the unique challenges facing Denver-area families.

Our Mission: To ensure that no woman suffers alone during pregnancy or postpartum. We provide evidence-based, compassionate mental health care that honors the profound transformation of becoming a mother while addressing the very real challenges this transition can bring.

Specialized Perinatal Services:

• Preconception mental health planning
• Pregnancy psychiatric care and medication management
• Postpartum depression and anxiety treatment
• Birth trauma and PTSD support
• Postpartum OCD treatment
• Breastfeeding-compatible medication management
• Partner and family support
• Collaborative care with OB-GYNs and pediatricians

Why Choose Conscious Psychiatry for Perinatal Care:

• Specialized Expertise: Advanced training in reproductive psychiatry and perinatal mental health
• Medication Safety Knowledge: Extensive knowledge of psychiatric medication safety during pregnancy and breastfeeding
• Holistic Approach: We address not just symptoms, but the whole experience of becoming a mother
• Trauma-Informed Care: Sensitive to birth trauma and previous trauma histories
• Denver-Specific Understanding: We understand the unique challenges facing Denver-area families
• Insurance Coverage: Making specialized perinatal mental health care accessible and affordable

Supporting Denver Families: From expectant mothers in downtown Denver to growing families in the suburbs and mountain communities, we provide culturally sensitive, evidence-based perinatal mental health care tailored to each woman's unique needs and circumstances.

Located in the Denver metro area, Conscious Psychiatry is your partner in navigating the mental health aspects of pregnancy and early motherhood. Contact us today to learn how we can support your journey to maternal wellness.

References

Perinatal mood disorder prevalence and treatment:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6653693/

Medication safety during pregnancy and breastfeeding:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085950/

Postpartum OCD and intrusive thoughts:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796769/

Birth trauma and PTSD:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551004/

Altitude effects on pregnancy:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3631421/

Therapeutic interventions for perinatal depression:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214672/

Nutritional factors in perinatal mental health:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6471046/

Social support and perinatal mental health:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867107/

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