Postpartum Depression
It was the middle of the night, early in October 1997.
Sometimes, when I close my eyes, I’m back in my bedroom, listening to the sound of the baby swing creaking as it rocked my toddler back and forth, holding my breath and praying that the gentle noise didn’t awaken the sleeping infant in my arms.
My husband was out of town on a business trip, and I was alone in my house with two babies and two cats, all of whom needed me. And I felt desolate.
Two days later, after I lashed out at my returning spouse and said words that shocked me as they left my mouth, I confided to my mother that I thought I was losing my mind at the young age of 28. Full of shame and sobbing uncontrollably, I watched as my mother gently took my infant daughter from me and led me to a comfy chair in her living room. She smoothed my hair and told me she thought I might have depression and suggested I talk to my OB/GYN at my six-week postpartum checkup.
As always, Mom was right. My doctor confirmed that I was in the throes of postpartum depression. I didn’t know what that was, but she gave me information and some medicine that helped me while my mind and body recovered.
I felt alone, but I was far from it. According to data from the National Child and Maternal Mental Health Education Program, about one in eight women experiences postpartum depression, or PPD. That’s about 13 percent of women who give birth in this country. In fact, the condition is commonly thought of as the most under-diagnosed complication of pregnancy. And it doesn’t always develop after the baby is born – PPD symptoms can start during pregnancy and, if untreated, last for more than a year after a mother delivers her baby.
Baby blues vs. postpartum depression
Often, after a mother gives birth, she can experience mood swings, anxiety, irritability and bouts of crying as she adjusts to dropping hormone levels, sleepless nights and the 24/7 demands of a helpless infant. Those symptoms, commonly called the “baby blues,” usually develop shortly after birth and can last a week or two.
PPD symptoms, however, commonly present before the baby’s birth or several weeks after and are more severe and long-lasting. Causes are varied. Studies indicate that genetics play a part: Women whose mothers or other female relatives have experienced PPD more often develop the condition. So do those with pre-existing emotional issues. Symptoms of PPD can include:
Depressed mood or severe mood swings
Crying too much
Difficulty bonding with the baby
Isolating from family and friends
Appetite changes
Changes in sleep patterns
Extreme fatigue
Disinterest in formerly pleasurable activities
Irritability and anger
Intense fear of not being a good mother
Feelings of worthlessness, shame, guilt or inadequacy
Thoughts of harming self or baby
Recurring thoughts of death or suicide
Complications
In extreme and rare circumstances, undiagnosed PPD can lead to postpartum psychosis, a condition that develops shortly after birth and presents with symptoms such as confusion, obsessive thoughts about the baby, hallucinations and delusions, agitation, paranoia and attempting to harm self and/or baby.
Sometimes, mothers and their families can experience complications with PPD. The other parent can develop PPD – much like the sympathy pregnancy symptoms people often joke about, fathers can exhibit PPD symptoms, too. That’s because emotions within a family are catching. And the baby can become emotionally dysregulated when the parents are depressed or anxious, leading to a fussy, inconsolable baby that increases parental PPD symptoms.
When PPD goes untreated, mothers can develop an ongoing depressive disorder, such as major depressive disorder. They might stop breastfeeding or experience difficulties bonding to their infants, which can lead to problems with infant attachment. Mothers in these situations are at particular risk of suicide.
And studies show that children of mothers with untreated PPD develop emotional and behavioral problems and often have delayed language development.
Prevention and risk factors
So is there any way to prevent PPD? Yes!
The best prevention is risk-awareness and preparation. There are certain risk factors that expectant moms and those who love them should be aware of: a personal history of depression; a diagnosis of bipolar disorder or a previous diagnosis of PPD; family members with depression or other mood disorders; lifestyle stress; health complications with the newborn; giving birth to multiples; difficulties breastfeeding; relationship problems; unwanted or unplanned pregnancies.
The hopeful news is that healthcare providers and mental health professionals routinely screen expectant and new mothers for PPD symptoms, which can lead to more quickly addressing the disorder when it does appear.
While many women are afraid to give voice to the symptoms they’re experiencing for fear of being labeled bad moms or losing the ability to care for their babies, simple screening tools administered by doctors and therapists, such as the 10-question Edinburgh Postnatal Depression Scale and the nine-question Patient Health Questionnaire, can help providers identify symptoms before they become severe.
Taking action
Friends and family can help, too. Pregnancy and parenthood can be difficult in the best of circumstances, and parents who’ve just welcomed a new baby need a supportive community around them, even if it’s not their first rodeo. Instead of asking new parents how you can help, consider taking them a home-cooked meal, preferably one that might last a few days or could be frozen and thawed at a later time. Or use a grocery-delivery service to send over provisions and maybe something special for mom. Gift cards to meal-delivery services are golden during this time, too.
One of the most loving and supportive actions loved ones can take to support new parents is the gift of time. Giving the new mom (and dad) a break to shower or take a walk or even read in peace can be priceless. So, too, is listening when they talk about how they’re feeling, validating their emotions and reminding them that when you’re in the midst of parenting, the days are long but the years are short.
If you’re a new mom, don’t be afraid to reach out for help by calling a friend or family member. Another valuable resource is 988, the national mental health lifeline that can connect anyone anywhere to mental health services. Don’t brush off symptoms of depression and anxiety during pregnancy and after; talk to someone and seek medical and mental health services immediately.
***********************************************************
Sources:
Centers for Disease Control Division of Reproductive Health. (2024, May 15). Symptoms of Depression Among Women. Centers for Disease Control. https://www.cdc.gov/reproductive-health/depression/index.html
Mayo Clinic staff. (2022, Nov. 24). Postpartum Depression. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
Office of Communications. (n.d.). Mom’s Mental Health Matters. National Child and Maternal Mental Health Education Program. https://www.nichd.nih.gov/ncmhep/initiatives/moms-mental-health-matters/moms
