Postpartum Depression: What You Need to Know

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Postpartum depression is just one of the perinatal mood and anxiety disorders (PMAD) that affect up to 20 percent of pregnant women and those who have recently given birth.

However, less than half receive treatment—even though it's very effective and can have women feeling like themselves again quickly. Without treatment, these illnesses can continue for months or even years.

MYTH: It's normal to be depressed after having a baby.

FACT: Postpartum or "baby blues" are very normal. It's the time during those first two weeks after giving birth when a mom can feel emotional and overwhelmed. But in her core, she should still feel like she's herself. If these baby blues do not resolve or she doesn't feel like herself anymore, that's a warning sign that something else is going on.

MYTH: Postpartum depression is the only mental health condition to worry about following birth.

FACT: Postpartum depression is the most commonly known PMAD, which are a cluster of mental health conditions that can occur during pregnancy and postpartum. The term "perinatal" describes this time in a woman's life. In addition to depression, these conditions include:

  • Anxiety.
  • Obsessive-compulsive disorder.
  • Post-traumatic stress disorder.
  • Bipolar disorders.
  • Psychosis.

MYTH: The main symptom to look for is sadness.

FACT: Persistent sadness is a well-known symptom, but not all women have sadness as a symptom of depression. And, sadness is not necessarily a symptom of the other PMADs. Other symptoms include:

  • Anxiety.
  • Feelings of hopelessness, helplessness or guilt.
  • Feeling overwhelmed or empty.
  • Scary thoughts.
  • Feeling irritable and/or angry.
  • Sleep problems.
  • Chronic fatigue.
  • Loss of interest in normally pleasurable activities.
  • Change in appetite.
  • Difficulty making decisions.
  • Not bonding with baby.
  • Feeling "overly bonded" or excessively worried about baby (checking on all the time, etc.)
  • Crying episodes.
  • Panic attacks.
  • Avoiding friends and family.
  • Persistent self-doubt.
  • Fear of being alone or separated from baby.
  • Problems with concentration.

If a woman is having any of these symptoms, she should get in touch with her physician or a mental health provider as soon as possible. If she doesn't already have a provider, make sure to ask new provider(s) if they have experience working with women during pregnancy and postpartum. Additionally, ask how comfortable they are prescribing medications to women who are pregnant and nursing.

MYTH: Only first-time moms develop PMADs.

FACT: Any woman who is pregnant or up to one year postpartum can develop a PMAD. It can happen with a first pregnancy, a fifth, and so on.

MYTH: There's nothing you can do to prevent developing a PMAD.

FACT: Just as a woman can be proactive about the physical health of herself and her baby, she can also make preparations during pregnancy to take care of her emotional and mental health. She can recruit a support person or team to help identify warning signs, determine and strengthen her resources, reduce or eliminate stress and put health practices in place.

Many factors can increase the chance a person will develop a PMAD, although sometimes one occurs without any risk factors present. PMAD Risk Factors include:

  • A personal history of depression or other mental health issue.
  • Family history of depression or mental health issue.
  • A perfectionistic personality.
  • Lack of support.
  • Relationship issues.
  • Hormonal changes.
  • Thyroid issues.
  • Recent major changes like a birth of baby, move, loss of relationship or job, etc.
  • A complicated pregnancy.
  • A baby in the NICU.
  • Mother of multiples.
  • Previous miscarriage(s), stillbirth or infant/child loss.

MYTH: PMADs will resolve on their own.

FACT: Without treatment, these illnesses can continue for months or even years! Treatment is very effective and can have women like themselves again quickly.

If PMAD goes untreated, there can be serious complications for moms, babies and families including disruption in mother-baby bonding, interruption in the infant's development, family and relationship conflicts—and in serious (but rare) cases—can lead to suicide or infanticide.

MYTH: Women with a PMAD will hurt their kids.

FACT: Extremely rare, psychosis occurs in approximately 1-2 out of every 1,000 deliveries. The onset of symptoms is usually sudden, most often within the first two weeks after delivery. Most women who experience postpartum psychosis do not harm themselves or anyone else. Of the women who develop postpartum psychosis, there is a 5 percent suicide rate and a 4 percent infanticide rate. However, there is always risk of danger because of delusional thinking and irrational judgment.

Symptoms can include hallucinations, delusions, hyperactivity, decreased sleep, rapid mood swings, difficulty communicating at times and confusion.

Postpartum psychosis is a very serious emergency and requires immediate attention. If you or someone you know may be experiencing postpartum psychosis, call your physician, 911, the National Suicide Prevention Hotline (800.273.8255) or the Pine Rest crisis line (800.678.5500) or go to the nearest hospital emergency room.

MYTH: PMADs are not real.

FACT: PMADs are as real as any other medical condition, like a heart disease, cancer, a broken leg or diabetes.

The clincher of PMAD, unlike other diseases, is that one of the symptoms is guilt. Not just guilt a person feels when they make a mistake, but guilt that feels unquenched by simple reassurances. So, when a woman's feelings are dismissed by others, they are even more unlikely to have the energy to seek help or believe what they are experiencing is real.

MYTH: Women with PMADs just need to snap out of it.

FACT: A person cannot snap out of any illness. If a woman could, she would have already snapped out of it. Instead, focus on helpful things you can do and say to support the woman and her family:

  • Be patient! Recovery will not happen overnight.
  • Encourage the woman to talk about her feelings and show you understand by listening and accepting that the feelings are genuine.
  • Sit down with the parent(s) to make a list of what you and/or others can do to help out.
  • Help and/or enlist the aid of other family members or friends with household chores.
  • Care for the baby or assist in arranging childcare so mom can catch up on sleep, take a break or go out. Remember—parents need time away from the baby, too!
  • Offer to go to doctor and therapist appointments with her.
  • Encourage activity. Suggest going for a walk together, out to dinner, watching a movie, etc.
  • Support her in seeking and pursuing treatment (therapy, medication, support group, exercise, eating well, etc.)
  • Let her know she is doing their best and point out the ways in which you see she is doing a good job. (Be specific: "I love how you smile at the baby.")
  • Tell mom it isn't her fault and not to place blame.

Pine Rest has many resources to learn more about PMADs, treatment options, how to support mom (and the whole family) and more on their Website.

Courtesy of Pine Rest.

Photo courtesy of romrodinka.



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