MOTHERHOOD
From bliss to the blues
Nancy Gottesman, Fit Pregnancy
Posted Mon, 04 Feb 2008

Josie Smit, 32, describes herself as rational and not prone to emotional knee-jerk reactions. Yet when the Durban mother was pregnant with her now-two-year-old son, Fin, all bets on her moods were off.

"TV ads really affected me. Happy or sad, they always made me cry," recalls Josie.

Emotional rollercoaster

It probably sounds familiar. While pregnant, you will experience a gamut of emotions — many of which may be completely new to you. After delivery, the emotional rollercoaster ride continues.

What's to blame? For one thing, you might be experiencing financial and other worries as well as a total upheaval of your old, familiar life. For another, your body and brain are going through major physical adjustments.

"Hormonal changes play a huge role in your moods during and after pregnancy," explains Dr Lucy Puryear, author of 'Understanding Your Moods and Emotions When You’re Expecting'. "All women are different, but in some the emotional changes can be extreme."

To help you cope with the potential swings in your temperament, here's a guide to your new feelings and attitudes, why and when each happens and how to cope when the going gets rough.

Your pregnant personality

Blissfully happy

Why you feel that way? Once a fertilised egg implants in your uterus, the developing placenta begins to secrete hormones essential to your baby's growth. One of these hormones is oestrogen (another is progesterone). Oestrogen can produce a sense of wellbeing. "Then again, a lot of women are just really excited and happy about being pregnant," explains Dr Puryear, "especially those who've been trying for a while".

Coping strategies? Who needs them — enjoy it while it lasts.

Teary and irritable

Why you feel that way? "Hormones appear to play a significant role in the precipitation of emotional issues during pregnancy," explains Dr Geetha Shivakumar, a psychiatrist who conducts clinical research in perinatal mood disorders.

"Common symptoms are irritability, sadness or anxiety, and they may be more prominent in certain months of pregnancy," Dr Shivakumar adds. For example, during the first trimester the fluctuating levels of oestrogen and progesterone in your bloodstream can make you especially moody.

Coping strategies? First, explain to your partner that you're experiencing some pretty heavy emotions. By making sure that he understands your fickle humour has nothing to do with him, you can nip any potential relationship tension in the bud. The same goes for other family members and friends.

Secondly, take care of yourself: regular exercise and a healthy diet can help abate the negative feelings and intensify the positive ones. "Good physical wellbeing is important for emotional wellbeing," says Dr Shivakumar.

"Preliminary data also suggest that eating food that contains omega-3 fatty acids may improve mood symptoms." Certain kinds of fish are among the best sources.

Finally, if you have a history of depression, be sure to tell your doctor, since it can not only recur during pregnancy, but also linger and become more severe after you give birth.

Surprisingly sexual

They don’t call the second trimester the 'honeymoon phase' for nothing. During this stage, the size of your tummy is still manageable and your breasts may be larger, so your partner might find you incredibly sexy. For you, the increase in blood volume during pregnancy leads to, well, more blood flow — everywhere.

"Your nipples and genitals are more sensitive, so you may feel more sexual," says Dr Puryear. "Plus, the uterine contractions during orgasm feel more intense when you're pregnant."

Coping strategies? Get your doctor's OK, then go for it!

Fatigued and foggy

In the early stages, the placenta produces yet another hormone — human chorionic gonadotropin (HCG). Rising levels mean the pregnancy is progressing. That's the good news. The bad news is that in tandem with progesterone, HCG may also cause the crushing exhaustion and morning sickness many women experience in the first trimester.

The fatigue can cause the drop in acuity many women complain about, but it may not be the only reason you’re not as clear-minded as you used to be. "Your priorities change," explains Dr Puryear. "You were once focused on meetings and deadlines; now you’re fantasising about baby names and being a mother."

Coping strategies: If you have a job, compartmentalise. Try to keep work at work and concentrate on baby and 'mommy' tasks when you're at home. It's also helpful to write down your thoughts and to-dos; this will not just help you feel organised but will also prevent you from forgetting them entirely.

Most importantly, move your body even if you don't feel like it. To give your energy and mood a boost, exercise. If you're extremely exhausted and sluggish, tell your doctor, who may want to perform tests to rule out conditions such as anaemia (caused by having too few red blood cells) or hypothyroidism (a low-functioning thyroid gland).

Your mind on motherhood

Constantly cuddly

Once your baby is born, your body begins to produce a hormone called oxytocin (aka the 'cuddle hormone'), which induces feelings of intense love for and bonding with your baby.

"Oxytocin causes your milk to let down and makes you feel an attachment to your newborn," Dr Puryear says. Take note: women who breastfeed produce more feel-good oxytocin than those who bottle-feed.

Coping strategies: None required. Do hug, kiss and cuddle your heart out; despite what some say, you can't 'spoil' a newborn baby.

Absent-minded (aka 'baby brain')

Oestrogen and progesterone levels begin to fall dramatically immediately after the placenta is delivered. Then, breastfeeding keeps oestrogen levels low. This prompts a state of forgetfulness that some women describe as total stupidity. "Low oestrogen levels may contribute to this 'cognitive clouding'," Dr Puryear affirms.

Coping strategies: Don't even think about multi-tasking. Focus on caring for your newborn and say 'later' to extraneous tasks such as laundry, cleaning your house, writing thank-you notes, etc. If possible, take a daily short walk; it will help clear your head.

Lacking in libido

You’ve heard the adage that a new mom's biggest fantasy is sleep? In addition, breastfeeding lowers oestrogen levels, which in turn lowers libido. "Plus, if you're breastfeeding, you have another human being on you all day long," says Dr Puryear.

"At night, you just may feel, 'I just don’t want another person on me.'" Many new moms describe this as feeling 'touched out'.

Coping strategies: Tell your partner how you're feeling, physically as well as emotionally. "Your spouse may not realise there are physiological reasons you're not interested in sex," says Dr Puryear.

"If you don’t tell him, he may think you don't love him anymore." Schedule some time away from the baby for intimacy; it doesn't have to involve sex. Even just lying together and cuddling will make him feel wanted and needed. And, if it does lead to sex, it's a bonus.

Down and blue

If even small hormonal changes can affect your mood when you're menstruating, imagine what a rapid decline in oestrogen and progesterone can do to your disposition. Within 24 hours of your baby’s birth, these hormones drop to pre-pregnancy levels, which can leave you feeling sad and stressed. "After we brought our son home, my husband was excited but I felt overwhelmed and isolated," recalls Josie. "I kept asking myself, 'Why don't I feel like he does?'"

"Sadness, fatigue, anxiety — most first-time mothers experience these symptoms," says Dr Shivakumar. "Such feelings tend to resolve within two weeks."

Coping strategies: Sleep. Hand the baby over to your partner and doze whenever possible. A few hours of much-needed rest will do wonders for your outlook. If symptoms are severe, last longer than two weeks or start four weeks after delivery, you may have post-natal depression and should seek immediate medical attention.

For more info, visit the website of the Post-Natal Depression Support Association of South Africa at www.pndsa.co.za or contact its national helpline on 082 882 0072 for a support group near you.