Finding Balance: The Intersection of Hormones, Parenthood, and Mental Health

The Journey into Perinatal Psychiatry

What inspired you to specialise in perinatal psychiatry, and what drew you to open your own practice?

I’ve always been fascinated by the way hormones shape mental health. Early in my training, I learned that while men tend to have one peak in mental illness incidence in their early twenties, women have two peaks—one in their mid-20s and another around 50. The second peak was often dismissed as “empty nest syndrome,” which struck me as both inaccurate and dismissive.

At the same time, I was seeing a cluster of women in their late 40s on my inpatient ward, presenting with first-episode mania, depression, or psychosis. When I raised this with my seniors, who were wonderful psychiatrists but mostly men, the response was indifference. It was clear to me that psychiatry wasn’t paying enough attention to hormones.

Later, I was fortunate to train in perinatal psychiatry, where the role of hormones is especially visible. Then I became a mother myself, which made it all personal. The perinatal period can be joyful, but it can also be deeply disorienting and overwhelming. Experiencing the effects of hormonal shifts on my own brain, alongside my clinical training, convinced me this was the field where I could make the most impact.

What makes perinatal psychiatry so powerful is the ripple effect. When we support a mother’s mental health, we’re not only helping her but also supporting her child, her partner, and often generations to come. That’s incredibly meaningful work. Founding Lunea was a natural extension of all this passion. I wanted to create a service that provides expert women’s and perinatal care that is flexible, timely, and compassionate. In many ways, I’m doing it for the women who came before, whose symptoms were dismissed or minimised. I want to make the system better for the women who come after.

Common Mental Health Challenges in New Parents

What are some of the most common mental health challenges you see in expectant and new parents?

I have lost count of the number of times I have heard the word “overwhelmed.” Of course, there is depression and anxiety, problems with sleep, but nothing can prepare you for the sheer chaos of parenting. It’s also harder now that many of us no longer have the traditional “village” around us, which leaves new parents feeling isolated at a time when support is most needed.

Supporting Parents: Community and Healthcare Systems

How can healthcare systems and communities better support parents during the perinatal period?

Accessibility and responsiveness are key. Too often, services are fragmented, with physical health in one silo and mental health in another. Parents need holistic, joined-up care. On a community level, practical supports matter as much as clinical ones. Things like childcare, workplace flexibility, and peer support groups can be protective factors that prevent small struggles from becoming crises.

The Role of Partners and Families

What role do partners and families play in supporting perinatal mental health, and how can they be better equipped?

They are everything. Research consistently shows that strong partner and family support is one of the most protective factors against perinatal mental illness. In practice, that means inviting partners into sessions, involving them in treatment planning, including medication decisions, and giving them strategies to support recovery. Sometimes it’s as simple as helping them understand what their partner is going through so they can respond with empathy rather than frustration.

Neurodiversity in the Perinatal Period

Unique Challenges for Neurodivergent Parents

What unique challenges do Autistic and ADHD parents face during pregnancy and early parenthood?

Neurodivergent parents often face additional layers of challenge during the perinatal period. For Autistic parents, sensory sensitivities can make aspects of pregnancy, birth, and newborn care overwhelming. Examples could be the body changes of pregnancy or the noises and lights of the medical environment. For ADHD parents, the demands of early parenthood, such as constant interruptions, lack of routine, and sleep deprivation, can amplify existing difficulties with organisation, attention, and emotional regulation.

Recognising Symptoms in Neurodivergent Individuals

Are there specific signs or symptoms of perinatal mental health issues that present differently in neurodivergent individuals?

Yes, things can look quite different. For example, Autistic parents may experience postnatal depression but present more with withdrawal, sensory overload, or rigidity in routines, which might be misread as “just autism” rather than recognised as treatable mental health symptoms. Having said that, you also need to be mindful of not stereotyping individuals based on a diagnosis they have. Just like with neurotypical patients, you need to personalise your assessment and care plan.

Accommodations for Neurodivergent Parents

What kinds of accommodations or supports can make a meaningful difference for neurodivergent parents?

Even small, thoughtful adjustments can make a difference. For example, for parents with ADHD, practical supports such as written summaries, reminders, and breaking down treatment plans into smaller steps may help focus and adherence to plans. Involving partners or family members can also be a great help, particularly when it comes to keeping track of symptoms, routines, or medications. Most importantly, I try to centre validation and choice by asking parents what works best for them rather than making assumptions.

Understanding PMDD and Coexisting Conditions

The Intersection of PMDD and Neurodiversity

PMDD is often underdiagnosed and misunderstood. How does it intersect with neurotypes such as ADHD and Autism?

PMDD and neurodivergence often amplify one another. Many women with ADHD or Autism are more sensitive to hormonal shifts, and PMDD symptoms such as mood swings, irritability, or sensory overwhelm can be intensified. Sometimes we see that the luteal phase can worsen executive function challenges or sensory sensitivities that are already present.

Managing PMDD Effectively

What are some effective approaches to managing PMDD, especially when it coexists with other mental health or neurodiversity?

Managing PMDD usually takes a mix of approaches. Tracking cycles helps women anticipate tough days and plan ahead. Medications like SSRIs (a type of antidepressant) sometimes just in the luteal phase are often effective, and hormonal treatments can help too if chosen carefully. Therapy, mindfulness, and pacing strategies can ease the day-to-day impact.

Hormonal Changes Across the Lifespan

How do hormonal changes across the lifespan—such as during pregnancy, postpartum, and menopause—impact PMDD symptoms?

Brain sensitivity to hormonal changes sits at the core of PMDD. Symptoms often ease in pregnancy when hormones are more stable but can return sharply after birth with the sudden drop, sometimes overlapping with postnatal depression or anxiety. In perimenopause, fluctuating oestrogen and progesterone may trigger new symptoms or worsen existing ones. Across all stages, the common thread is sensitivity to hormonal shifts.

Trauma-Informed Psychiatry

Implementing a Trauma-Informed Approach

What does a trauma-informed approach look like in your practice?

A trauma-informed approach, for me, is really about going at the woman’s pace. Building trust takes time, so I pay close attention to cues: if someone is uncomfortable, we slow down. I might explain why I’m asking certain questions, so it never feels like information is being taken without context. It’s about creating a space where a woman feels safe enough to share and where she knows she has control over what’s discussed. It’s also about restoring agency in the patient, ensuring they know they are in control of their care and that decisions are not being made without them. Trauma-informed care is an attitude of respect, patience, and collaboration.

Incorporating Holistic Factors into Care

How do you incorporate cultural, spiritual, hormonal, and lifestyle factors into your psychiatric care?

Women’s mental health is never just about biology. Who we are is shaped by culture, spirituality, and the communities we belong to. Hormones also play a huge role, yet psychiatry has often overlooked women’s hormones—although awareness is thankfully growing. Lifestyle factors matter just as much. Sleep, nutrition, movement, and social support are powerful drivers of recovery. I bring these into every treatment conversation because even small changes in daily routines can make a meaningful difference to how women feel.

Integrative Approaches: Yoga, Meditation & Somatics

Movement Practices for Recovery

How can movement practices like yoga and somatics support recovery from perinatal mental health challenges?

Movement practices can be powerful because they reconnect women with their bodies at a time when many feel disconnected, such as after birth, during hormonal shifts, or when trauma has left the body feeling unsafe. Yoga, gentle stretching, and somatic practices help regulate the nervous system, lower cortisol, and improve sleep. From a trauma-informed perspective, these practices also restore a sense of agency. For women navigating postnatal depression or anxiety, even a few minutes of mindful movement can interrupt spirals of stress and ground them back in the present.

The Role of Mindfulness in Managing Conditions

What role does mindfulness play in managing conditions like PMDD, ADHD, and Autism?

Mindfulness is not a cure-all, but when adapted thoughtfully, it can be transformative. For example, in PMDD, mindfulness helps women notice and name emotional shifts before they escalate, creating space for more intentional coping strategies. For those with ADHD, it can help someone slow down and notice more of what’s happening internally.

Personalised Practices for Hormonal and Neurodiversity Challenges

Do you recommend specific practices or routines for clients navigating challenges related to hormones or neurodiversity?

I emphasise personalisation; what works for one woman may not work for another.

This conversation was part of Keshia's Yoga in Motion fundraiser, supporting perinatal mental health awareness and care. If you'd like to follow along or contribute, you can find more details here.

If you would like to see Dr Louise for a consult, please send referrals to intake@lunea.com.au.