Postpartum University® Podcast

The Invisible Mental Load - Why Mothers Are Breaking Down EP 238

• Maranda Bower, Postpartum Nutrition Specialist

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Your postpartum clients aren't just "busy"—they're breaking down. Here's the truth your assessments are missing: The invisible mental load is a chronic state of cognitive overload that's hijacking her body.

 This isn't a failure of willpower; it's a physiological response to chronic stress that causes everything from unexplained anxiety and low milk supply to pelvic pain and insomnia. Maranda reveals how this unacknowledged cognitive burden triggers the HPA axis, shuts down nervous system regulation, and creates a cascade of physical symptoms. Every postpartum provider—from lactation consultants to functional health experts—must recognize this root cause. Stop treating the symptoms (the fatigue, the rage, the anxiety) and start addressing the overload. Learn the red flags and the Postpartum Restoration Method framework to deliver the lasting solutions your clients desperately need.

Check out the episode on the blog HERE: https://postpartumu.com/podcast/the-invisible-mental-load-why-mothers-are-breaking-down-ep-238/

Key time stamps: 

  • 1:03 -  Defining The Invisible Mental Load & The Shocking Case of Low Milk Supply
  • 3:33 - The Physiology of Cognitive Overload: HPA Axis and Systemic Effects
  • 6:53 - Clinical Patterns Providers Miss: The Hyper-Vigilant Manager, Overwhelmed Perfectionist, and Depleted Default Parent
  • 9:37 - Pelvic Floor Tension & The Bonding "Disconnection"
  • 22:15 - The Red Flags and "Better Questions" for Assessment

NEXT STEPS:

SPEAKER_00:

The postpartum care system is failing, leaving countless mothers struggling with depression, anxiety, and autoimmune conditions. I'm Miranda Bauer, and I've helped thousands of providers use holistic care practices to heal their clients at the root. Subscribe now and join us in addressing what modern medicine overlooks so that you can give your clients real lasting solutions for lifelong well-being. Welcome back to the Postpartum University Podcast. Miranda Bauer here. And today we are diving into something that's showing up in every single postpartum assessment I see, but that most providers are completely missing. And that is the invisible mental load and how it's literally breaking down the mothers that you're serving. Let me start with a scenario from our perinatal mental health training. We have a lactation consultant. She comes to me about a client who's been struggling with low milk supply. Mom is eating well, she's hydrating, pumping regularly, but her supply keeps dropping, even though she's got babies skin to skin on her breast all the time. She feels like it's just not working. Nothing is working. Baby's gaining weight. There's milk leaving her breast. Like, what is happening? So she seems anxious during her appointments. She's asking rapid-fire questions. She's apologizing constantly for not doing the things right. And for many of us, that sounds really familiar, right? And this is what this lactation consultant discovered when she started using our postpartum restoration method assessment. This mom scored through the roof of what we call cognitive overload indicators. She was managing three kids schedules, a return to work transition, a partner who was traveling frequently. She had aging parents she was caring for. And she had become like the family's entire logistical coordinator. So that low milk supply, it was a psych, it was a physiological response to chronic stress from mental overload. And then once we address that root cause, that invisible cognitive burden, her supply recovered within two days. Like that is the invisible mental load. And as providers, we are not assessing for, we're missing one of the biggest drivers of postpartum symptoms. The mental load isn't just being busy or having a lot on your plate, right? We all we all have that. This is the cognitive burden of being the default person who remembers, anticipates, plans, and orchestrates all of family life. And this is what it looks like clinically. Your client shows up late to appointments, seems scattered, can't remember what you discussed last week. And the traditional thinking is that she's not prioritizing her health or she's not following through on recommendations. And the reality is that she's experiencing cognitive overload from managing everyone else's needs while her own brain function is compromised by chronic stress and the neurological, biological changes that are naturally occurring within her brain during the first two to three years postpartum. So the reality is that this mother presents with anxiety, insomnia, digestive issues, frequent headaches. And the standard approach might be anxiety management techniques or a referral for medication. But when we dig deeper using comprehensive assessment, you find that she's making an average of, you know, 200 decisions before 9 a.m. every morning. And her brain is in constant problem-solving mode. Her stress response system is chronically activated. And her physical symptoms are the downstream effects of neurological overwhelm. And here's what every postpartum provider needs to know about the mental load effects physiology. The brain uses 20% of the total daily energy consumption. And when it's constantly processing multiple information streams, making decisions and holding details and working memory, energy demands increase dramatically. I would love, love to see a study that is done specifically on the postpartum brain and energy consumption. Like, how does that change? Are we, does that go up to 20% from 20% to maybe 30%, 40%, because we're having to make so many more decisions? Or because of all of the shifts and the changes that are taking place postnatally, is that going down to 10%? I don't know. I don't know what the answer would be. But what we do know is that this energy consumption and these increasing demands trigger chronic activation of the HP axis, so the hypothalamic pituitary adrenal axis. We've got cortisol and adrenaline remaining elevated. The nervous system stays in sympathetic dominance. And the downstream effects show up as sleep disruption. Even when they have the opportunity to sleep, their mind can't shut off. We have digestive function. So blood flow redirected away from digestion during chronic stress, on top of the gut changes that happen naturally in the postpartum period. We have immune suppression, that constant stress response depletes immune resources, blood sugar dysregulation, because stress hormones interfere with insulin sensitivity, hormone disruption, right? Chronic cortisol suppresses reproductive hormone production. And then we have increased inflammation because that's what chronic stress does. It triggers inflammatory cascades. So when your postpartum clients present with anxiety and insomnia and digestive issues, and they're getting sick a lot, mood swings or fatigue, these might not be separate issues requiring different interventions. They might all be physiological manifestations of cognitive overload. In our perinatal mental health training, we teach providers to recognize specific assessment patterns that indicate mental load overwhelm. So we have the hyper-viligant manager pattern, right? She's got high scores of decision-making frequency, reports feeling responsible for everyone's needs, sleep disruption, despite exhaustion, physical tension, especially in her jaws or shoulders, digestive issues like that are often very stomach-related, irritability that seems, you know, out of character, even rage often falls into this pattern. We have the overwhelmed perfectionist pattern, right? High standards for family management, difficulty delegating, guilt when they're not meeting their own expectations, anxiety about forgetting important details and about every little thing that happens on this list. There's physical symptoms of chronic stress, relationship strains, right? And then we have the depleted default parent, right? They become the go-to person for all family decisions. Partner seems oblivious to household management needs. Mom doesn't know how to communicate those needs, and maybe he just doesn't show up for them. Exhaustion that doesn't rest and doesn't resolve. So fun working with. Anyway, she has a client with persistent pelvic pain that was not responding to treatment. And when she started assessing for mental loads, she discovered this mom was managing care for a special needs child. She was working full-time and she was coordinating all medical appointments for three family members. And pelvic floor physical therapists are absolutely amazing at doing this and kind of doing a whole body sample because they understand how connected our feelings and our emotions are to the pelvic area. There's a whole science out there on this. It's absolutely fascinating what women hold in their pelvic region. So it was chronic muscle tension from carrying stress in her core. And then once they address that cognitive burden through these practical support strategies, this these physical symptoms resolved. That's something that I see so, so frequently. And I also saw it in myself. I have four kids. I had a pelvic floor physical therapist after uh right before my pregnancy with my my third. And I wanted to get stronger. And I will tell you, it was life-changing. Y'all, I have four kids, and people ask me all the time like, I like we have family come over and we have friends and we have a trampoline in the backyard. And I will literally go jump on the trampoline with them. Like my kids absolutely love it. They think it's a blast. I have zero issues. I do not feel like I'm falling out. I am not paying my pants. And you can see the what the response that people have. Like when we have a birthday party or something, and my kid is asking me, I don't normally like go jump on the trampoline, right? But if they ask me to or whatever, I'll go spend five minutes bouncing them around. They think it's a blast. And and the adult women in the room outside are looking at me with their jaw open. Like, how is that possible? Well, I tell you, I did a lot of pelvic floral physical therapy and it was life-changing, not just because I am able to do those things on a regular basis, but also because of so much that I've learned about how I store that mental overload in my pelvic region, how I have stored trauma in my pelvic region. It's absolutely fascinating. Okay, so that's side side story there. Let's look at case two, a postpartum doula that we have. Uh, and she has noticed that her clients seemed disconnected during bonding support sessions. So traditional postpartum depression screening uh was absolutely negative, but she seemed flat. She felt disengaged. And so she started using our assessment tool. They discovered that this mom was mentally managing two businesses, three kids' school schedules, and a household renovation. So her apparent bonding issue was actually a protective disassociation. Her brain was shutting down emotionally. It was not able to process anything else. So it was trying to conserve energy for cognitive demands. And she wasn't able to bond because of that. And when she started asking for more support, and we were able to, well, the this doula was able to give her the tools that she needed to help kind of help her manage all of that and uh give her tasks and delegate to other people and kind of navigate this. It was very quickly that she was able to bond, but not only just bond, right? There was a whole, you know, it was very fascinating to read her story or her client's story about how she also had to let go of all of the guilt that she had for not bonding, right? It goes so much deeper than just like, oh, I'm not bonding and I've got to let go of that, right? It it once we are able to let go of that, letting go of the guilt and the frustration and the pain and the suffering and the shame that comes also from having experienced that. Here's case three, uh, nutritionist. She could not figure out why her client wasn't following meal plans. She was a very motivated client. She had all of the resources, uh, and she wanted to. Like it was, she would come to her meetings super excited, ready to go, ready to implement the next thing. And then she she wasn't implementing the first thing in the first place. And then as the appointments gone on, mom was showing up to her appointment saying, I just don't, I don't understand. Like, why am I not implementing what I said I was going to implement? And I know that I was gonna do this and I did it, and now I'm feeling guilty and I'm feeling bad, and I just don't know what's going on. And so they did this assessment and they revealed that this mom was making food decisions for six people, three who had dietary needs. She was managing two kids' food allergies and planning meals for four different schedules around like sports and school and all of the things. So the issue was not compliance, it was complete decision fatigue. And once they simplified her cognitive load around food decisions, like she was able to improve dramatically, implement what she needed to do for herself. And it was so much easier for her. And she experienced the changes that she came to this nutritionist to experience. When postpartum women are they're uniquely vulnerable to mental load and overwhelm. We've got neurological changes that are are taking place. Pregnancy and postpartum literally rewire areas of the brain responsible for executive function and working memory. So what we call mom brain is real neurological adaptation that affects cognitive capacity, increased demands, right? Adding a completely dependent human on your responsibilities while maintaining all previous obligations creates exponential cognitive load increase. And then we also have sleep fragmentation, right? Every few hours of waking up and having to be up for a while, you've got the cognitive function is more severe than anything we've experienced usually in life during this postpartum period. So decision-making ability, working memory, stress resilience, they all decline because of this one factor alone. And then, of course, of course, of course, nutritional depletion. The brain requires steady glucose and specific nutrients for optimal function. Postpartum moms often exist on coffee and crackers and leftover chicken nuggets from their toddler, right? That creates blood sugar swings that directly impair cognitive performance. Your body exists on hormones and it cannot create those hormones unless it has the nutrients to do so. And then we cannot, cannot, cannot forget social isolation. Traditional cultures, distributive cognitive load among extended family networks. Women worked together, men worked with the women. Modern postpartum mothers carry all of this burden alone. And this is why our parinatal mental health training takes a completely different approach than traditional mental health education. Most perinatal mental health training focuses on identifying psychiatric disorders. And we teach providers to recognize when apparent mental health symptoms are actually physiological responses to chronic cognitive overload. So we use the postpartum restoration method assessment. We identify specific patterns, cognitive demand analysis, decision-making frequent making frequency, like support system evaluation, stress response pattern recognition, identity integration assessment, like all of this, plus more on nutrition and neurological health. It allows you to create interventions that address root causes than just managing symptoms. And it's done within minutes. This is not like you don't have to sit down for 15, 20 minutes to have your client fill out this questionnaire. It is something that is done in a very, very short period of time. And behind the scenes allows you to look at all of the things that are taking place in her body because it's so well developed. And 15 years of work and clinical practice have been put into this, along with uh thousands of women and providers. And it's just absolutely amazing. And he's so here's here's a couple of practical approaches that we teach in our training. So cognitive load redistribution, right? Helping moms identify tasks that can be delegated, automated, eliminated. This isn't about like time management, it's about decision management, uh, decision batching support systems, right? Helping moms identify and communicate their needs to family members who may be completely unaware of the invisible work being done, or they simply don't understand or know what they need to do to step up. Nervous system regulation, this is a huge one, like lots of techniques for downregulating and overstimulated stress response system, uh, boundary setting, identity integration, nutrition support, all of the things. And so when you address mental load as a clinical issue with a lifestyle issue, you're going to see dramatic improvements across multiple areas. Sleep quality improves, even without specific sleep interventions. Anxiety decreases without medication, digestive issues resolve, immune function strengthens, relationship satisfaction increases, maternal confidence begins to build, and those physical symptoms that seem often like very unrelated start to disappear. And I want you to hear some of the red flags, right? These are some red flags. These are indicators that mental load might be the root issue. You have a client with multiple physical symptoms with no clear medical cause, anxiety that's worse during busy family times, depression that seems more like exhaustion than sadness, relationship conflicts around fairness and support, difficulty following through on self-care recommendations, feeling overwhelmed by treatment recommendations, and improvements that don't just disdain when life gets busy. So ask better questions. And we have so many amazing questions in the assessment. And here's some other ones that I really like. Like, walk me through your morning routine from waking up until 10 a.m. Like what happens in your morning? Who in your household notices when you're running low on household items? Like if you got sick tomorrow, who would know how to manage your family's week? Those are fabulous questions. And they are going to really reveal the invisible cognitive work that traditional assessments are going to miss, and even moms miss because they don't have time to sit down and think about these things because they're too busy taking care of the mental load that is their life. So incorporating mental load assessment, it doesn't require completely changing your approach. It requires adding one more lens to how you evaluate postpartum symptoms. And it can be done in a very, very easy way, especially when you have the postpartum restoration method assessment tool. So when you see anxiety, ask about cognitive demands. When you see digestive issues, consider chronic stress from mental overload. When you see sleep problems, evaluate whether the mind can actually rest, even when the body has an opportunity. And the postpartum restoration method assessment tool we provide in our training makes this systematic and comprehensive. So you can identify patterns quickly and create targeted interventions. What we really talk about is recognizing that modern motherhood has created an unsustainable cognitive burden that's literally making mothers sick. And as providers, we have the power to validate this experience, name it as a clinical issue rather than a personal failing, and provide practical strategies for addressing it. And when you help a mom redistribute her mental load, right? I wish there was a class on this. There's no class. We have zero training on how to redistribute our mental load and to take care of our brain in this way, right? You're not just improving her individual health. You're modeling for her family what sustainable support looks like. You're preventing her children from growing up thinking it's normal for moms to be constantly overwhelmed and depleted. Our mental health training dives deep into assessment, intervention strategies for mental load, overwhelm, along with all the other root cause postpartum mental health struggles. And this isn't traditional mental health training that focuses on psychiatric diagnosis and medical referral. This is comprehensive education on identifying and addressing the physiological and circumstantial factors that create mental health symptoms. Okay. So the mental load crisis, it's happening in your practice right now. Shoot, it might even be happening to you. Let's be honest. If you're a mom listening into this, right, we can all relate, even myself, every overwhelmed mom, every anxious client, every woman who sees, you know, the struggling, despite having resources and support, many of them are drowning, an invisible cognitive advance. And as providers, we have this opportunity to see this, to name it and address it systematically, rather than just treat the downstream symptoms. And when we help moms reclaim their cognitive resources and redistribute their mental load, we don't just improve their individual health. We transform their entire family's well-being. And the mother who no longer carries the invisible burden of managing everyone's life, she becomes more present, more engaged, more fulfilled. Her children grow up in a household where responsibility is shared and mothers are valued for what they are able to bring in in terms of peace, not their ability to manage chaos. That's the kind of transformation we are creating through this work. Thanks for listening. And remember, when we heal mothers, we heal the world. Thanks so much for being a part of this crucial conversation. I know you're dedicated to advancing postpartum care. And if you're ready to dig deeper, come join us on our newsletter where I share exclusive insights, resources, and the latest tools to help you make a lasting impact on postpartum health. Sign up at postpartum you the letter you.com, which is in the show notes. And if you found today's episode valuable, please leave a review to help us reach more providers like you. Together, we're building a future where mothers are fully supported and thriving.

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Maranda Bower

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