Postpartum Depression

The words ‘Postpartum Depression’ bring up all kinds of thoughts and feelings for many….for families with new infants, for birthing people who have had a traumatic birth experience…..for people who have special needs children who were premature….and for women and families with perfectly normal, healthy deliveries and healthy infants. Postpartum Depression (PPD) and Postpartum Mood Disorders (PPMD) are quite common. In fact, PPD can happen to anyone, regardless of age, ethnicity, marital status or income. Regardless of what Hollywood and specific actors claim. Research does suggest that there are some biological and environmental factors that may be associated with PPD such as:

Family or personal history of depression-prior to becoming pregnant

Increased stressors (like recovering from childbirth combined with not sleeping and not eating enough because you’re caring for another being, or even things like a divorce or illness in the family)

Hormone changes related to pregnancy

Medical complications during pregnancy or delivery

Mixed feelings about the pregnancy-whether it was planned or unplanned

However, while PPD can affect people of all backgrounds, people in poverty or who have poor access to education and health care may run a higher risk. Data suggests 25% of people of this demographic will develop postpartum depression. One study found that women of low socioeconomic status were 11 x more likely to develop PPD symptoms than women of higher socioeconomic status.

The key here is that PPD is real and it is NOT your fault and it can happen to anyone. It does not occur because of something one does or does not do. Let’s look at the facts about what PPD is:

Postpartum depression is a mood disorder that can affect women after childbirth. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others.

What are the symptoms of postpartum depression? Some of the more common symptoms a woman may experience include: Feeling sad, hopeless, empty, or overwhelmed Crying more often than usual or for no apparent reason Worrying or feeling overly anxious Feeling moody, irritable, or restless Oversleeping, or being unable to sleep even when her baby is asleep Having trouble concentrating, remembering details, and making decisions Experiencing anger or rage losing interest in activities that are usually enjoyable Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle  pain Eating too little or too much Withdrawing from or avoiding friends and family Having trouble bonding or forming an emotional attachment with her baby Persistently doubting her ability to care for her baby Thinking about harming herself or her baby.

How is postpartum depression different from the “baby blues”? The “baby blues” is a term used to describe the feelings of worry, unhappiness, and fatigue that many women experience after having a baby. Babies require a lot of care, so it’s normal for mothers to be worried about, or tired from, providing that care. Baby blues, which affects up to 80 percent of mothers, includes feelings that are somewhat mild, last a week or two, and go away on their own.
With postpartum depression, feelings of sadness and anxiety can be extreme and might interfere with a woman’s ability to care for herself or her family. Because of the severity of the symptoms, postpartum depression usually requires treatment. The condition, which occurs in nearly 15 percent of births, may begin shortly before or any time after childbirth, but commonly begins between a week and a month after delivery

How can a woman tell if she has PPD? This is a great question! This is something than can only be diagnosed by a well trained medical care provider. If you or someone you can for has symptoms that could be PPD, they need to be a evaluated by a professional. This may include a Nurse Midwife that cared for the birthing family during delivery, an Obstetrician, a Primary Care Physician and by a Psychiatrist. This is not something that should be ignored or should be diagnosed by a lay person (someone not trained). Ignoring symptoms of PPMD or PPD doesn’t always go well, either. PPD can last for months or years. In addition to affecting the mother or father’s health, it can interfere with the ability to bond and connect with your new baby and may cause the baby to have issues with feeding, sleeping and may affect her behavior as she grows.

Postpartum Depression is common! There are more than 3 million diagnosed cases in the US alone, each year. In fact, nearly 70-80% of women will experience, at the very least, the baby blues-after delivery. The reported rate of clinical postpartum depression is 10-20% in new mothers.  One recent study found that 1 in 7 women may experience PPD in the year after giving birth. With approximately 4 million live births occurring each year in the United States, this equates to almost 600,000 postpartum depression diagnoses. AND PPD does not just affect women. Approximately 10% of new fathers experience symptoms of depression during the postpartum period. HALF of men with partners who have PPD will go on to develop PPD themselves.

Some additional stats about the more serious form of PPD-Postpartum Psychosis:

• Between 1-2 women of every 1000 will develop postpartum psychosis—a severe and potentially deadly disorder.
• Women who have a history of bipolar disorder are 40% more likely to develop postpartum psychosis.
• Tragically, 10% of postpartum psychosis cases result in suicide or infanticide.
• One study found that over 60% of women with postpartum depression also had signs of an anxiety disorder, a condition which isn’t always associated with depression.
• Postpartum obsessive-compulsive disorder is believed to occur in 3% to 5% of childbearing women

The truth of the matter is, we can do better in the US. Treatment for PPD centers either around talk therapy (seeing a qualified social worker, therapist, psychologist or psychiatrist) and medication. Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are two ways shown to help people deal with PPD and develop strategies to cope. Antidepressants (or SSRI’s) are another way to deal with and recover from PPD.

If were going to change the statistics around PPD and Postpartum Psychosis-we have to talk about it. We have to reach out for help. This includes hiring a POSTPARTUM DOULA. This is a woman who is trained in normal postpartum healing and recovery, is trained in normal growth and development of newborns and can help you in your daily routine until you get more steady on your feet. A postpartum doula isn’t a nanny-although she can help you care for your newborn. A postpartum doula isn’t a maid-although she will help you do some light housework, light meal prep and organization around your home. She is a listening ear, an extra pair of hands and a safe place for you to talk, if you want to talk. She can also just handle everything while you rest….something we all need which is essential for proper healing and restoration.

To find a local certified, insured postpartum doula visit: Ann Arbor Postpartum

If you or someone you know is in crisis or thinking of suicide, get help quickly. Call your doctor. Call 911 for emergency services or go to the nearest emergency room. Call the toll-free 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255);  TTY: 1-800-799-4TTY (4889). Also, visit: Postpartum Depression for more facts and to take the PPD quiz.

RESOURCES:

Postpartum Depression. (n.d.). Retrieved from https://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx

Goyal, D., Gay, C., & Lee, K. A. (2010). How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers?. Women’s health issues: official publication of the Jacobs Institute of Women’s Health, 20(2), 96-104.

Genetic Predictors of Postpartum Depression Uncovered by Johns Hopkins Researchers – 05/21/2013. (2013, May 21). Retrieved from https://www.hopkinsmedicine.org/news/media/releases/genetic_predictors_of_postpartum_depression_uncovered_by_johns_hopkins_researchers

Schimelpfening, N. (2018, November 26). Types of Postpartum Depression and How to Cope. Retrieved from https://www.verywellmind.com/postpartum-depression-types-1067039

Baby Blues: Causes, Symptoms and Treatment. (2016, May 18). Retrieved from http://americanpregnancy.org/first-year-of-life/baby-blues/