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May is Mental Health Awareness Month, but did you know that the first week of May was Maternal Mental Health Awareness Week?

Mandolin Restivo is the Executive Director of Postpartum Support Virginia. The organization aims to offer support directly to families as well as educate health care providers on how to screen for PMADs or Perinatal Mood and Anxiety Disorders and to where they can refer patients.

“Early parenthood is very hard – period,” Restivo said. “We are always seeing Instagram reels about beautiful births and, you know, really peacefully feeding the baby – and the reality is just very different.”

According to The Blue Dot Project, depression and anxiety impact 1-in-5 pregnant and postpartum people. That’s 20%.

“Suicide is the number one cause of death for birthing people in their first year postpartum and perinatal mood and anxiety disorders are the number one complication of pregnancy and childbirth,” Restivo said.

Kelly Sokol's newest book, "Breach" 

She pointed out that while conversations about PMADs are making their way into the public square and onto social media, we are still ignoring a vital component.

“I think that the conversation is kind of white-washed and geared toward populations that have a lot of access to support already.” Restivo continued, “We’re not having the conversations about how these disorders look different for women of color, look different for special populations like military families.”

She said that military families often face issues like a lack of support systems on top of possible deployment with a young child involved. There is also a lot of pressure for pregnant active-duty people to bounce back quickly after giving birth.

Kelly Sokol is an author based in eastern Virginia. Her novels center on motherhood and the various experiences it holds.

Her newest novel, "Breach," explores a cross-section of military and motherhood.

“Marley [her character] is the very young wife of an enlisted special operator in the Navy, which just adds a tremendous load and weight to her responsibilities than she could have never expected,” Sokol said.

Sokol spoke with partners of the Special Operations community here in Hampton Roads.

“They’ve talked about how in control they’re expected to feel and seem all the time – when nothing in their life is predictable,” Sokol said.

Her characters and their experiences in this novel – and her previous release The Unprotected – touch on feelings and fears that many parents find difficult to talk about.

“I read a scene [from The Unprotected] – and it was a difficult scene – and one of my best friends was attending the reading and she came up to me that night and said ‘I thought I was the only person who ever felt that way. I didn’t know this was something that could happen.’” Sokol recalled.

She said that through her characters and her writing, she’s learned a lot.

“It’s just given me a profound awareness of what folks really can be struggling with and an immense sense of gratitude. These characters have shown me a lot about myself and also about other people,” Sokol continued, “I think it probably helps me carry a little patience around me with me as well.”

Her work draws on a lot of inspiration from the vast journeys experienced in motherhood.

“Like so many writers, I write about my obsession. I think motherhood is very much one of those.” Sokol continued, “I still think we’re uncomfortable talking about the difficult aspect of motherhood. There are so many ways to be a mother. There are so many different experiences of motherhood.”

Just like there is no one way to be a mother, there is no one way to experience postpartum symptoms.

“You can have perinatal mood disorders in your first pregnancy and not your third or your third and not your first,” Restivo said. “It’s also really correlated to your birth experience so, if you have any birth interventions or a traumatic birth experience, you’re more likely to suffer from a mental health issue during your postpartum time.”

Postpartum time can be so unique from person to person that it’s difficult to use standard indicators.

It’s normal for someone who has just given birth to be physically, mentally, and emotionally different than day-to-day. Restivo said there are some signs to look out for.

“Most birthing people will experience something that we know as the “baby blues” for the first two weeks postpartum – signs of that are just feeling teary or overwhelmed, maybe questioning their capability as a parent. But those feelings are not interfering with your ability to live your day-to-day life in normal circumstances. If they don’t resolve after two weeks, that may be an indicator.”

Some people experience something called perinatal rage. Someone might feel very angry or feel flooded with emotions that make them feel the need to yell and release it.

Intrusive thoughts are also something that many people experiencing postpartum issues have reported. Thoughts or images of something happening to the baby can be distressing, but Restivo says they’re much more common than people think and are a symptom of postpartum depression or anxiety.

“If you're feeling extremely worried, if you're noticing that your partner or your loved one is very worried, very emotional, or very angry during this time, those can all be signs,” Restivo said.

Postpartum Support Virginia has a warmline, 703-829-7152, that people can call on behalf of themselves or their loved ones. All of the volunteers that work the line have lived experience with PMADs and can be a warm, listening ear, offer advice, and provide care coordination if needed.

Restivo said the best thing we can do for the new parents in our lives is to be specific and sincere when we offer help. Instead of saying “Let me know if you need anything,” try to offer specific things like taking the kids on a trip to the park every other week, bringing over dinner once a week, or helping with laundry.

“People need real concrete help, and they need to not have to think about what that may be. Be really clear and concrete about what you're willing to offer and when and then, of course, follow through,” said Restivo.

Sokol and Restivo both mentioned the importance of the community’s role in helping people through PMADs or similar circumstances.

“There's so much focus on self-care, that it leaves out the fact that we cannot self-care ourselves out PMADs. We need community care, we need education, and we need mental health support,” said Restivo.

It’s important to remember that not only does it take a village to support our kids – it also takes a village to support our parents.