What's Postpartum Depression and How Do I Deal With It?
The months following the birth of a baby are ones of great adjustment. Changing body chemistry and shape (do stretch marks go away?), lack of quality sleep, and numerous other stressors lead many women to experience postpartum depression in the year following childbirth and delivery, even with celebratory holidays like Mother's Day and World Breastfeeding Week. Depression is a mental health condition, and chronic depressive disorder can be serious. You may be wondering, "can online therapy improve postpartum depression?" and the answer is yes.
Sadly, inadequate information, postpartum depression statistics, and understanding of the nature of postpartum depression, along with a pervasive stigma in our society about its exact cause, leave many women to suffer alone. Postpartum depression, also called the “baby blues” is a mental illness and is never the fault of the mother - nor is it an indication of their worthiness being a mom. However, it is a condition that impacts the mental health of new mothers. Let's talk about what is postpartum depression, as well as how to identify it in yourself or others.
Untreated postpartum depression after giving birth can cause mood swings, fatigue, insomnia, delusions, agitation, and depression in mothers which can lead to paternal postpartum depression in fathers or partners. Sometimes, mental health treatment is helpful for both parents. Healing is available for postpartum depression, and no mother or father should feel shame for pursuing treatment or medicine as help for this medical condition. It is real; it is common; and it is treatable.
How Many People Experience Postpartum Depression?
Postpartum Depression, also called perinatal depression or postnatal depression, is incredibly common. The National Institute of Mental Health encourages women dealing with postpartum depression to get professional help.
While some estimates cite postpartum depression statistics as high as 20% (one in five women), the American Psychological Association states that 15% (one in seven women) experience postpartum depression. Women with a history of depression are more susceptible to acquiring postpartum depression. In some situations, people have been known to develop drug abuse problems when using drugs to deal with depression on their own, but that’s never the best way. Professional help is needed to deal with any kind of depression.
When Does Postpartum Depression Occur?
Postpartum depression signs can happen at any time during the baby's first year of life - not just immediately after giving birth. In fact, postpartum depression tends to spike around the time the baby is five months. Getting the “baby blues” so long after the birth comes as a surprise for new mothers, and they often need emotional support. Sometimes, this is not enough and treatments like antidepressants and psychotherapy are required. Postpartum depression can be especially difficult to deal with if there were pregnancy complications before the birth or there were difficulties with a previous pregnancy.
What Are the Symptoms?
Most women experience some level of "baby blues" during the first two weeks after childbirth due primarily to the hormonal shifts that occur during that period. The primary symptom is an underlying feeling of sadness and lack of energy.
Postpartum depression, however, is marked by persistent feelings past the initial two-week mark, and the symptoms are much broader than simply "sadness." In fact, many women don't recognize that they may be suffering from postpartum depression simply because sadness isn't their primary symptom. Postpartum depression often doesn't look like people think it does. Symptoms of postpartum depression often include:
- Anger, rage, or irritability
- Difficulty sleeping or restlessness - even when exhausted
- Lack of pleasure in any or all regular tasks and activities
- Shift in appetite or behaviors around food
- Feeling "flat" - no strong feelings of either happiness or sadness
- Unexplained crying and hopelessness
- Extreme worrying, fear, or anxiousness
- Intrusive thoughts of serious harm or death coming to the baby
- Not feeling connected or loving toward the baby; inability to experience bonding with the baby
- A general feeling of "this isn't what I expected it to be"
Furthermore, due to the inability of mothers with postpartum depression to appropriately tend to their children, children may have a delay in language development within the first year. Research shows that with treatment, this is preventable.
In more extreme cases of untreated postpartum depression (typically associated with postpartum psychosis), symptoms and side effects of mental health conditions can include:
- Thoughts of suicide or of harming the baby
If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7, or you can text the word “HOME” to 741741 to reach the Crisis Text Line.
These are all signs of a treatable mental health condition. Anyone who has thoughts of suicide or harming themselves or their infants should call the National Suicide Prevention Lifeline at 1-800-273-talk (8255) immediately for help with these risks. It can be lifesaving.
Postpartum depression has symptoms similar to bipolar disorder, which is one of the more well-known mood disorders that also causes rapid mood swings. Both bipolar disorder and depression are listed in the Diagnostic and Statistical Manual as mental health conditions. It’s important to get a proper diagnosis from your doctors so as not to mistake postpartum depression for bipolar disorder or vice versa.
It's important to note that most high-profile media stories highlight women who suffer from postpartum psychosis, giving many sufferers the impression that if they are not experiencing these extreme symptoms, they're not experiencing postpartum depression. This is simply not a true statement about postpartum psychosis. The truth is that postpartum depression symptoms occur on a spectrum, and a woman may only suffer a few of the above symptoms. A mental health provider can help women and men regardless of how severe their symptoms are.
Postpartum psychosis is actually quite rare in comparison with postpartum anxiety or postpartum depression. Having noted that, postpartum psychosis surfaces quickly after labor and birth, and it can be quite serious.
A healthcare professional will usually ask women some important questions related to postpartum depression behavior at an early postpartum checkup, or they may ask mothers to complete a depression screening questionnaire. Health care providers are interested to know if mothers have a history of depression, experienced major depression, or have had any other types of mental disorders. A health care provider may also ask if a woman has symptoms of depression such as extreme sadness, depressed mood, or other health problems. It’s important to be honest about these questions so you can get the proper help and advice for how to handle your newfound special needs. A common treatment method for postpartum depression is Brexanolone, an antidepressant used specifically for this mental health condition.
What Causes Postpartum Depression?
There isn't one single cause or predictor of postpartum depression, but rather it is caused by a combination of complex risk factors. Here are some of the culprits:
Women make jokes and hear endless flippant remarks about "hormones," but the truth is that they are real, and they are powerful. After delivering a baby, hormones can cause severe mood swings and intense emotions. Women undergo vast physical changes during pregnancy, which can also impact how they feel about themselves.
There are many physiological changes that occur during and after pregnancy, not the least of which are incredible fluctuations of hormones that cause very profound chemical changes in a woman's body. In many ways, these changes in women’s health are miraculous. In other ways, they can wreak havoc on someone.
More specifically, the hormones estrogen and progesterone are significantly elevated during pregnancy, and then have a rapid drop down to normal levels within 24 hours of childbirth. Fluctuating hormone levels are a huge adjustment for a woman's brain chemistry to adapt to, and they are the primary contributor to postpartum depression.
In addition to having issues with hormones, women can also experience problems with their thyroid gland after pregnancy. Postpartum thyroiditis is a condition where the thyroid gland becomes inflamed after a birth. Only a small percentage of mothers acquire this condition.
Some of the practical challenges of parenting a newborn exacerbate the hormonal effects, and the net result can be postpartum depression. These include:
- Lack of sleep
- Added stress of parenting a newborn
- Added challenges in the parental relationship
- Loss of flexibility/free time
- Lack of a good support system
- Lack of time to exercise
- Poor nutrition
- Confusion about your newfound role as a mother/loss of sense of self
- Strong desire or pressure to be the "perfect parent"/Type A personality
Teen moms and women living in poverty have higher rates of postpartum depression. It's likely that the added stress experienced by these groups of women as they enter motherhood exacerbates the other factors and leads to their increased risk of postpartum depression. To compound things further, some teen moms lack the support of their mothers, a close loved one, or other families. Such things can also contribute to postpartum depression or another mental health condition. Human services are usually a good resource for women’s mental health and child health.
Medical History and Genetics
Just as with traditional depression, there is a genetic component, and women who have a family history of depression, or postpartum depression are at an elevated risk to struggle with the illness themselves. Similarly, women who have suffered from depression in the past have a higher likelihood of struggling post-birth, as well as women who experience premenstrual dysphoric disorder (PMDD) with their regular menstrual cycles. PMDD is an extreme form of PMS and an indicator of a woman's chemical brain response to hormonal fluctuations.
Struggles with fertility and difficulty conceiving also increase a woman's likelihood of experiencing postpartum depression. Finally, a traumatic or medically difficult birth experience is also a risk factor. Regardless of the cause, it’s important to get postpartum depression treated as soon as possible.
How Can I Deal And Make Positive Progress?
It’s always best to take good care of your mental health, especially when dealing with the “baby blues”. Hormone levels may eventually go back to pre pregnancy levels, but until they do, interpersonal therapy can be of immense help.
There are many things you can do to combat postpartum depression - it's not something you just have to suffer through. If you believe you are struggling with symptoms of depression, the first step is to speak with your doctor about your concerns. Your primary care provider will ask you more detailed questions to see if a diagnosis of postpartum depression is right for you, and they can give you information about postpartum depression facts to help you make informed decisions about the benefits and costs of each treatment option.
Some women can combat their postpartum depression with simple lifestyle adjustments - other women need more comprehensive medical intervention to treat depression. Regardless, it's important to remember that postpartum depression is, at its core, a chemical issue - and if you are not able to improve your symptoms of depression without medical support, it is NOT a personal failure. Support groups are designed to help with all kinds of issues including postpartum depression, and they can be very helpful along with individual therapy.
Postpartum depression is a complex relationship of multiple factors - and treatment for postpartum depression is equally complex. Here are some things you can do to combat the illness and return to wellness.
Be open about your struggle with postpartum depression with other mothers in your social circle. Your family and friends may want to help, but it may be harder for them to identify with you. While you might have to battle the illness, you do not have to battle shame. Think about it - if as many as one in five women suffers from postpartum depression, the likelihood that you know women who have gone through it is incredibly high.
Make it a priority to spend time with friends and family. While it might not be possible to do all of the things you did pre-baby, gathering with others in a social setting is healthy. If you don't have a lot of friends who are mothers, contact your birthing hospital or your obstetrician and ask them about local parent/baby groups in the area. They are a great way to connect socially (and commiserate about the challenges of parenting a baby) with other moms. Unfortunately, not all friends and family will be supportive. Online support groups or online education videos can also help patients who are dealing with stress after a child’s birth. You may also be able to find a support group for fathers who need support after having a child. Online support groups are a convenient and time-saving option for both you and your partner when you need support. Most people find that joining support groups is incredibly helpful.
You may also want to consider a local support group for women struggling with postpartum depression. These are very supportive, non-threatening groups that allow you to learn more about the illness, and what it looks like in everyday life, so you feel less alone in your struggle. They are also a wealth of information on local professional resources to help you. You don't need a diagnosis to attend - they welcome all new mothers. Ask your local hospital, doctor, or obstetrician for help finding one in your local area.
Make Simple Lifestyle Adjustments
Physical and emotional issues can really take a toll on a new mom, but there are a few things you can do to try and combat postpartum depression on your own. These include:
- Ask your partner to take an overnight feeding (pump if you're nursing) to help you get a longer stretch of restorative sleep
- Schedule regular exercise
- Get outside in the sunshine and go on walks to help make you content
- Pay attention to your nutrition; eat healthily and avoid alcohol
- Find ways to exercise regularly
- Eat a small piece of dark chocolate (yes, really!)
Seek Professional Help
Sometimes lifestyle adjustments don't help, or adequate social support is hard to come by. A primary care provider may not be equipped to address a mental illness such as postpartum depression.
The Preventative Services Task Force and the Centers for Disease Control recommend getting therapy for postpartum depression. Counseling or talk therapy has been proven to be incredibly helpful in treating postpartum depression. A counselor or therapist can not only help you work through the major lifestyle transition of adding a newborn to your family, but they can also walk alongside you and help you to find ways to implement some of the lifestyle changes listed above - because it can seem overwhelming to do it on your own.
A trained counselor at BetterHelp will help you identify the root causes of your negative feelings, give you guidance to process them effectively, and coach you on ways to improve those specific aspects of your life. And while there are many options available, the reality is that making time for appointments while caring for a newborn can be incredibly challenging. Navigating nursing and napping schedules, along with finding childcare, can make it feel nearly impossible to leave the house. Thankfully, there is quality and professional therapy available online to provide postpartum depression treatment, which is a perfect solution for a new mother to get the help she needs.
Medications are also available to help with postpartum depression. Your doctor can recommend and prescribe one that will work best in your situation, but even if you choose not to try medication make sure you keep them in the loop. Explain to your doctor that you feel you are experiencing signs of postpartum depression but would like to try non-medicated strategies to treat it before deciding whether you need medication. They will be able to tell you what symptoms to watch for to tell if your illness is getting worse and if you might need additional medical support.
The bottom line is you don't have to go through this alone. Postpartum depression is a common illness that can be treated in many ways. If you are struggling after the birth of a baby or having trouble sleeping, seek help. Take action. Call your doctor. Contact a counselor.
After all, this should be one of the most joyous times of your life. Don't let postpartum depression steal that from you. Take charge and take it back.
Below are some commonly asked questions on this topic:
What does it mean when you have postpartum?
What is the effect of postpartum?
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What are the types of postpartum?
How long are you considered postpartum?
How long do you suffer from postpartum?
How do I cope with postpartum?
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How do I feel better postpartum?