Psychology Degree Guide: Postpartum Depression
For the first few days of your new baby’s life, everything passed in a whirlwind of excitement while you were strewn with flowers, cards, kisses, and congratulations. Now, a week later, you’re home from the hospital. You can’t remember the last time you slept long enough to dream and your brand new bundle of joy is crying from the crib…again. You roll over and look at your husband with a sigh. Whose turn is it to get up this time?
Few events in life, if any, will affect your life like the birth of a child. Everything has changed: your body, your lifestyle, and your relationship with your partner. Having a baby is meant to be a joyous event, but it can trigger a landslide of strong emotions, from excitement and anticipation to anxiety, fear, and even depression.
The good news is you are not alone. Lots of new mothers experience a mild form of post-childbirth depression called the “baby blues,” which is a completely normal reaction often attributed to drastic changes in your hormone levels. Baby blues are considered a normal phase of early motherhood, and usually the effects start within three to four days after birth, and fade in a couple of weeks. However, sometimes women are beset with more severe, longer-lasting symptoms. This is known as postpartum depression, or PPD, and as many as one in eight women experience it, according to Postpartum Support International.
What Causes Postpartum Depression?
Many women feel embarrassed to admit having postpartum depression, but the Mayo Clinic stresses that PPD is not a result of a character flaw, but simply a relatively common complication of giving birth. It can develop following the birth of any child, not just your first. While doctors haven’t identified a single cause for PPD, contributing factors include the myriad physical, emotional, and lifestyle changes a woman undergoes following the birth of her child.
Few emotional triggers rival the stress of new parenthood. Suddenly you are in charge of a tiny helpless being that needs you to do literally everything for it. Understandably, many new mothers and fathers are prone to anxiety about their abilities to care for an infant. And now that you are a mom, are you still who you used to be? Identity crises can lead many women to feel that their lives are no longer in their own hands. Add sleep deprivation to the mix, and you can quickly find yourself overwhelmed.
Physically, a woman experiences a significant drop in several influential hormones, notably estrogen and progesterone. This change in hormones leaves her feeling sluggish, tired, and distinctly lethargic. Then there’s the lifestyle change. Caring for your baby will take up most of your free time, while your family may have difficulty adjusting to the new center of attention.
PPD can be broadly divided into three levels based on severity and duration of symptoms. As previously mentioned, the “baby blues” is a light form of PPD that involves mood swings which incorporate crying spells, irritability, difficulty sleeping, and a lack of concentration.
PPD may stem from the baby blues, but the symptoms are both greater in intensity and longer lasting. The key difference between the baby blues and PPD is that the latter interferes with your ability to care for your infant and yourself. These symptoms include actual insomnia, loss of appetite, and extreme mood swings and irritability. Furthermore, you might find yourself having a difficult time bonding with your baby, or have thoughts of harming yourself or your child. Feelings of guilt or inadequacy are common, as is a pointed withdrawal from your support system of family and friends. PPD can last for more than a year if it goes untreated, so it is essential to see your doctor if you’re feeling depressed after more than two weeks.
The most extreme level of PPD is postpartum psychosis. This condition is rare and quite serious, as symptoms include hallucinations, delusion, confusion and paranoia. Postpartum psychosis is often characterized by actual attempts to harm oneself or the baby. If you experience any of these symptoms, they should be addressed promptly.
Recovery time will vary depending on the severity of your PPD. Typically, the baby blues fade on their own within a couple of weeks. You should accept help from your support system, rest as much as possible, and avoid alcohol, since it can worsen mood swings.
PPD generally fades after a couple of months when treated appropriately. The treatment combination most often used is counseling and medication. Speaking with a mental health professional can help you find appropriate coping strategies to deal with your feelings. Sometimes, anti-depressants are prescribed. While they are proven to treat PPD, some mothers are hesitant to take medication since it will enter your breast milk, although there are certain anti-depressants that present very little risk of side effects. Finally, hormone therapy can help balance out the rapid drop in hormones (notably estrogen) that goes hand-in-hand with childbirth. Your doctor can help you weigh the potential benefits and risks of hormone therapy.
Postpartum psychosis requires immediate hospitalization wherein a combination of anti-psychotics, electroconvulsive therapy (ECT), and other medications may be used to stabilize your condition.
Moms suffering from PPD have many resources available to provide information and support. See Postpartum Support International (PSI), the Postpartum Resource Center of New York, and the Online Postpartum Depression Support Group for dozens of resources to help you cope. Additionally, the March of Dimes has information on PPD and how to care for your newborn. You can access literature about PPD, including titles like “Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood” by Karen Kleiman & Amy Wenzel, at the PSI Bookstore. A PPD Brochure provides an overview of the condition, and the Maternal & Child Health Library (MCH) contains a large database of materials related to early parenthood, including articles on PPD.
If you think you might be suffering from symptoms of PPD but you haven’t seen your doctor yet, start with this PPD Self-Assessment Test, created by Spectrum Health.
New fathers are often overlooked, but PPD affects men, as well. Happily, some resources are available for new dads dealing with the effects that PPD has on their partner. PSI offers a Phone Forum for Fathers on the first Monday of every month. Follow the link for instructions on how to phone in. Furthermore, the Postpartum Dads Project blog takes the father’s perspective on PPD and focuses on helping him deal with the challenges of marriage and fatherhood. Similarly, PostpartumDads tells individual stories of men dealing with adverse effects of PPD in their partners. Additionally, Boot Camp for New Dads is a father-to-father workshop to get new fathers into shape for raising kids.
For Health Care Professionals
Doctors and health care professionals can use the Keys to Postpartum Depression Training Program created by the University of Washington, as well as these PPD Screening Tools. For more information, check out the Perinatal Depression Information Network.
Special Treatment Centers
Some cases of PPD may require specialized treatment. See the Massachusetts General Hospital Center for Women’s Mental Health in Boston or the Women and Infants Day Hospital in Providence as starting points.