Overwhelming emotions during pregnancy and postpartum? You are not alone, and it may be a good thing! By Dr. Arela Agako

We've all heard the stereotype of the "emotional pregnant person." We've seen the movies where pregnant or postpartum people are depicted as crying at the drop of a hat or cycling through different emotions in seconds.

Yet, until recently, very little research was done on changes in emotions during pregnancy or postpartum (otherwise known as the perinatal period). During the perinatal period, individuals experience significant hormonal changes that have been shown to also impact the nervous system. For example, all the hormonal changes lead to cortisol (stress hormone) levels equivalent to people with cortisol dysfunction, such as Cushing's Syndrome (Dickens & Pawluski, 2019). It is no wonder that perinatal individuals may notice changes in their emotional sensitivity.

Due to hormonal changes, perinatal individuals may be more likely to experience heightened emotions during this time. Research shows that, particularly in the last trimester of pregnancy and the first few weeks postpartum, individuals are more likely to respond to pleasant and unpleasant events with a higher emotional reactivity than non-perinatal individuals (Rosebrock et al., 2015; Wilkinson, 1998). Further, according to recent research, perinatal individuals are more likely to experience more significant daily fluctuations in their emotions than individuals who have never been pregnant (Bowen et al., 2012; Li et al., 2020).

 So what does this all mean? Is it a good thing or a bad thing to experience higher emotions during the perinatal period? The answer was surprising!

Recent research by this writer and her team (Agako, 2022) attempted to answer this question by comparing emotions in perinatal individuals with and without mental health difficulties. We found that experiencing heightened emotions towards emotionally provoking content during the perinatal period, particularly towards content relevant to the perinatal period, is associated with better mental health outcomes. We speculate that this result may be rooted in evolutionary theory. Experiencing increased emotional sensitivity may make individuals more likely to attune to and be more responsive towards their babies, increasing chances of offspring survival. Perinatal individuals who struggled more with mental health reported a lower emotional intensity in response to emotionally provoking content. However, they were also more likely to report having difficulties managing their emotions, feeling like they lacked strategies to manage emotions, and feeling less satisfied in their marital relationship.

 How does this tie together? It appears that perinatal individuals may be more emotionally sensitive during this time; however, it seems to be a good thing and leads to fewer mental health concerns for most people. In a society that emphasizes being "rational" instead of "emotional," we can benefit from changing our thinking to appreciate our emotions more, particularly during the perinatal period. Yet, for a subset of perinatal individuals, emotions are perceived as out-of-control, and they have more difficulties managing them. If you believe you are in the latter group, seeking perinatal mental health care around difficult emotions can help improve how you feel during this time. We will be sharing tips for how manage our emotions more effectively in the next blog post. And remember, for better or worse, changes in emotions during the perinatal period are to be expected!

To learn more about Dr. Arela Agako, you can find her bio here.

To inquire about working with her or any member of the Well Parents team, reach out here!

References:

Agako, A. (2022). An investigation of emotion dysregulation during the perinatal period: Implications for perinatal mental health and psychological treatments (Doctoral dissertation).

Bowen, A., Bowen, R., Balbuena, L., & Muhajarine, N. (2012). Are pregnant and postpartum women moodier? Understanding perinatal mood instability. Journal of Obstetrics and Gynaecology Canada, 34(11). doi:10.1016/S1701-2163(16)35433-0

Dickens, M., & Pawluski, J. L. (2019). The HPA axis during the perinatal period: Implications for perinatal depression. Endocrinology, 159(11), 3737-3746. doi:10.1210/en.2018-00677

Li, H., Bowen, A., Bowen, R., Balbuena, L., Feng, C., Bally, J., & Muhajarine, N. (2020). Mood instability during pregnancy and postpartum: A systematic review. Archives of Women's Mental Health, 23(1). doi:10.1007/s00737-019-00956-6

Rosebrock, L., Hoxha, D., & Gollan, J. (2015). Affective reactivity differences in pregnant and postpartum women. Psychiatry Research, 227(2-3). doi:10.1016/j.psychres.2015.04.002

Wilkinson, R. (1998). Mood changes in mothers and fathers through childbearing: Are the blues so blue? Psychology & Health, 14(5), 847-858. doi:10.1080/08870449908407351