Women’s Mental Health Therapy | Alexandria VA Counselor

Menopause, Fertility, Pregnancy, and Postpartum

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Menopause

At Brickel and Associates, we understand that menopause is not just a biological transition—it can be a time of significant emotional, cognitive, and relational change. Many women experience shifts in mood, sleep, memory, and energy during this stage, which can intersect with past trauma, chronic stress, or ongoing life transitions. Robyn Brickel, MA, LMFT is a Verified Menopause Provider.

Trauma-Informed Care for Menopause

Menopause can bring up unresolved emotional experiences and amplify the effects of trauma or chronic stress. Our therapists provide trauma-informed care that recognizes:

Hormonal changes and their impact on mood and nervous system regulation
Heightened sensitivity to stress or anxiety, especially in women with past trauma
Life transitions, identity shifts, and relational changes that often occur during midlife
The importance of supporting the body, mind, and nervous system together

Therapeutic Approaches

Our clinicians integrate trauma-informed approaches tailored to the unique needs of women in midlife, including:

Somatic and body-centered therapy to support nervous system regulation
EMDR and trauma-processing modalities
Mindfulness, grounding, and emotion-regulation strategies
Support around identity, relational dynamics, and life transitions

Mental Health During Menopause

Common experiences we support include:

Anxiety, depression, and irritability
Sleep disturbances and fatigue
Cognitive changes or memory concerns
Shifts in self-perception and identity
Relationship stress or changes in intimacy

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New mom holds baby on chest while being impacted by postpartum depression.

Fertility, Pregnancy, and Postpartum

Mental Health & Trauma-Informed Care

At Brickel and Associates, we understand that the journey through fertility, pregnancy, and postpartum periods can be emotionally complex and transformative. Expectant parents often navigate hormonal changes, shifts in identity, relationship adjustments, and past trauma that can impact mental health.

Our trauma-informed approach provides a safe, validating space to address these challenges, supporting emotional regulation, attachment, and resilience during this transformative stage of life.

Trauma-Informed Care Across Fertility, Pregnancy, and Postpartum

Our clinicians provide trauma-informed support that recognizes the emotional and physiological complexity of each stage. We offer a safe, validating space to address concerns including:

Fertility-related stress, grief, or loss
Persistent sadness, crying, or emotional numbness
Loss of joy or interest in things you once enjoyed
Intense worry or racing thoughts
Feelings of fear, anger, guilt, shame, or hopelessness
Pregnancy-related trauma or perinatal loss
Intrusive thoughts, worry, or racing thoughts
Sleep deprivation and challenges with regulation
Shifts in identity and parental roles
Relationship changes and co-parenting dynamics
Experiences of discrimination or lack of support
Difficulty bonding with baby or feelings of overwhelm

Symptoms can vary widely and may include sadness, emotional numbness, guilt, shame, anger, fear, compulsive behaviors, flashbacks, intrusive thoughts, elevated mood, or in severe cases, paranoia or thoughts of harm. You are not alone—these experiences are more common than many expect.

Therapeutic Approaches

Our therapy approaches are tailored to meet the unique needs of individuals and families, and may include:

EMDR and trauma-processing techniques for past, fertility, or birth-related trauma
Sensorimotor and somatic therapy to support nervous system regulation
Mindfulness, grounding, and coping strategies for daily stress
Support around relationships and co-parenting
Psychoeducation on reproductive and perinatal mental health

Goals of Therapy

Our therapy aims to help parents:

Enhance emotional regulation and resilience
Process past or pregnancy-related trauma
Support identity and role transitions into parenthood
Improve relationships and co-parenting dynamics
Build skills for self-care and coping with daily demands

New mom plays with baby's feet but seems emotionally disinterested.

Mom sits with young son on her lap in the outdoor sunshine. She is turned away from the camera.

Understanding Perinatal Mood and Anxiety Disorders (PMADs)

Perinatal Mood and Anxiety Disorders are emotional challenges that can occur during pregnancy and up to the first year after birth. While the “baby blues” are common and usually resolve within two to three weeks postpartum, PMADs are more persistent and may require professional support. They affect roughly 10–20% of parents and can include:

Perinatal Depression (PPD)
Perinatal Anxiety (PPA)
Pregnancy or Postpartum Obsessive-Compulsive Disorder (PPOCD)
Postpartum Post-Traumatic Stress Disorder (PPTSD)
Bipolar Mood Disorders related to the perinatal period
Postpartum Psychosis (PPP)

Symptoms can vary widely but may include persistent sadness, difficulty bonding with your baby, racing thoughts, intense worry, flashbacks, compulsive behaviors, rapid mood swings, or thoughts of harm. Pregnancy loss, miscarriage, or infant loss can also trigger similar emotional responses.

“Nobody would believe what an effort it is to do what little I am able.”
— Charlotte Perkins Gilman, The Yellow Wallpaper, 1892

This quote resonates with the lived experience of many who struggle silently during the perinatal period.

Differences Between “Baby Blues” and PMADs

Baby Blues: Affect up to 80% of new mothers, causing temporary mood swings, tearfulness, or sensitivity in the first few weeks after birth. Usually self-resolving.
PMADs: More intense, persistent, and potentially impairing, lasting beyond the early postpartum period or beginning during pregnancy. PMADs often require support through therapy, community resources, and sometimes medication.

Fertility, Miscarriage, and Pregnancy Loss

Emotional health challenges can begin even before birth. Difficulties with fertility, miscarriage, or pregnancy loss can trigger intense grief, anxiety, or depression. These experiences may overlap with PMAD symptoms, making compassionate, trauma-informed support essential. Therapy can help process loss, manage grief, and rebuild emotional balance.

Supporting Your Emotional Wellbeing

You are not alone. With the right support, healing is possible. Therapy can help you:

Navigate intense emotions
Develop coping strategies
Strengthen relationships with your partner or family
Process grief and loss
Restore a sense of balance, confidence, and wellbeing

Organizations such as Postpartum Support International, Postpartum Support Virginia, and The Postpartum Stress Center provide education, resources, and support for families navigating perinatal mental health challenges.

At Brickel & Associates, we provide compassionate, evidence-based, trauma-informed care to support parents in navigating fertility, pregnancy, postpartum transitions, and perinatal mental health challenges.

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