I first heard about postpartum depression when I was 20. My friend’s sister had recently had a baby and was suffering from it pretty badly. I would go to hang out at his house and his sister was almost always there. Her husband would drop her and the kids off at her mom’s house on his way to work and then come get them on his way home. This enabled her mother to help her with the kids and ensured everyone’s safety. That situation made a huge impact on me and I still think about it often.
What is Postpartum Depression?
Let’s start with what it is not. An estimated 80% of women experience “baby blues” in the first week or two after childbirth. Baby blues is a normal result of shifting hormone levels and brain chemistry combined with sleep deprivation and other physical changes which can result in mood changes, fatigue, weepiness, and worry.
On the other hand 1 in 5 women will experience postpartum depression or perinatal mood disorders. PPD or PMD can start as early as the third trimester or as late as up to a year after birth. Signs of PPD include but are not limited to:
- Loss of appetite
- Intense irritability/anger
- Overwhelming fatigue
- Loss of interest in sex
- Feelings of shame, guilt, or inadequacy
- Severe mood swings
- Withdrawal from family and friends
- Difficulty bonding with baby
- Thoughts of harming yourself or your baby
- PMD can manifest more as postpartum anxiety, so irrational fears about perceived dangers, panic attacks, and obsessive-compulsive behaviors can be present.
Who is at risk?
Women with a history of anxiety or depression are more susceptible to PMD. Emotional stressors such as a high-risk pregnancy or traumatic delivery of the baby, financial or marital difficulties, domestic violence, family substance abuse, and social isolation are frequent triggers of PMD, although it can be present without emotional triggers.
How to minimize risk
- Get plenty of rest. Lack of sleep makes coping with life harder. It is hard to be rational when you haven’t slept in two days. So sleep as much as possible when baby is sleeping. Don’t be ashamed to take naps during the day. Get your partner to watch the baby for an hour or two when they come home from work, so you can sleep. When friends or family are asking how they can help, tell them you need a nap and ask them to watch the baby and/or other kids so that you can get one.
- Make sure that you are eating good meals. We can get so caught up in taking care of everyone else that we forget to take care of ourselves and it may be dinnertime before we remember to eat. Good nutrition is so important to maintaining your health especially if you are breastfeeding. I recently did a review on Real Food for Pregnancy. The author has a great chapter on the postpartum period as well. Plan ahead. Freeze a bunch of good meals or ask a friend to organize a meal train after delivery.
- Get outside for 15 minutes a day. Vitamin D helps lower risk of depression. If your climate doesn’t permit you to get sunshine, a supplement may be necessary.
- Engage in spirituality, whatever this means to you. Practice meditation, spend time in prayer, sing to your praise and worship music, read your religion’s holy book, etc.
- Get some exercise. The endorphins that your body produces while exercising help elevate the spirits. Exercise doesn’t have to be strenuous. Get a 15 minute walk in, do an exercise video on YouTube, do some simple stretches.
- Connect with others. Have a friend over for coffee. Join a new mommies support group. It is too easy to let friendships slide when you have a new baby, human connection is really important to your mental health.
How to tell if you need help
If you aren’t sure, there are some screening tools. The most popular is the Edinburgh Postnatal Depression Scale. Many health care providers use it. My clients receive a copy of it in their welcome folder. I like this new screening form better and plan to implement it soon. If you are still seeing your midwife or obstetrician, talk to them about it. Not only can they help you figure out if you are experiencing PMD, they can give you suggestions on what to do. Even if you are past your 6 weeks postpartum and feel like you need help, don’t hesitate to set up an appointment to talk to them or another health care provider. Pediatricians are now helping to screen for PPD, as many people tend to seek care for their babies more than themselves. Don’t hesitate to talk to your pediatrician while you are there.
What do I do if I have PMD?
Get help. Help varies differently for different people. Sometimes it may be something as simple as the getting more sleep mentioned above. Sometimes it can be way for serious. Mental health websites like this one are now offering help for those suffering from a mental illness. Talk to a friend or a clergy member that you trust. Join a support group. One of my clients found a support group at her local church that supported people in all walks of life. The church provided dinner for her family and free childcare while she was at the meetings. Websites like BetterHelp enable you to talk to a therapist online or to find a local therapist. In the Dallas – Fort Worth area, we have some great counselors that specialize in women, birth trauma, and parenting. Jessica Shepard, MA, LPC with Little Love Counseling and Tiffany Wicks, MS, LPC at Push Counseling & Coaching, PLLC have great reputations in the birth community around here. Don’t be afraid to medicate if necessary. Anti-depressives can be necessary. They are losing the stigma that they held for so long. If at any point, you feel like you are going to harm yourself, your baby, or anyone else, seek help NOW.
Did you suffer from Postpartum Depression or other PMD? If so, what helped you most?