Understanding Postpartum Depression: You’re Not Alone

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Postpartum Depression

It taunted me everywhere. On Facebook, on Instagram, everywhere I looked there were pictures of happy families. My friends smiling brightly in perfectly edited family portraits, posed effortlessly on a picnic blanket in the middle of a grassy field with their husbands and their newborns.

Even when my friends weren’t posting about their fabulous family photoshoot, they were still sharing so many photos of their babies crawling for the first time or laughing for the first time. Everyone seemed so happy.

It must be me, I thought. Something must be wrong with me. I wasn’t a good mother, because I wasn’t having the kind of motherhood experience all my friends seemed to be having. I wasn’t happy; I wasn’t even sure I had any connection with my baby at all.

I never thought this qualified as postpartum depression. I never had any history of depression, anxiety, or other mental illness. The baby books I read talked about baby blues and postpartum depression, but I skipped over those chapters. I wouldn’t need them, I told myself. Anyway, postpartum depression just meant you wanted to harm your baby, and I never felt that way, so I couldn’t possibly have that.

From the moment the nurses handed me my baby after delivery, I just felt numb. I wasn’t angry or happy at all. I simply didn’t feel anything. I waited, thinking maybe I was just tired and hormonal from delivery, but nothing improved after leaving the hospital. In fact, things just got worse because I started getting angry at myself for not feeling anything.

Pictures from the hospital didn’t make me feel anything. Pictures of my baby sleeping in her new crib for the first time didn’t make me feel anything. Nothing worked, and I just felt numb and empty.

Clearly, this must mean that I wasn’t cut out to be a mother. My baby would be better off if I left, and she had another woman as her mom.

Postpartum depression looks different for everyone. Although some people may associate it with feelings of wanting to harm your own child or feeling resentment towards the baby, postpartum depression manifests itself in different ways. Some women simply feel numb and unattached, others experience symptoms of more generalized depression, others might want to hurt their baby or themselves, and some develop postpartum anxiety or psychosis.

No matter what your postpartum experience is like, if something feels weird or off, even if it’s not seen as “normal” for postpartum depression, help is available. This condition can appear different to everyone, even to people who have experienced it before. Nothing is wrong with you as a mother or a person. You just need some support and proper treatment.

What Is Postpartum Depression and How It Affects Your Health

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 7 women experience postpartum depression.

That’s hardly a small or insignificant portion of the population. Postpartum depression affects many women every single day and is often surrounded by stigma that prevents people from openly discussing their experiences with postpartum and acts as an obstacle to accessing proper treatment.

But first, what exactly does it mean to have postpartum depression (PPD)? What does it look like?

PPD, as its name suggests, is a type of depression that occurs after giving birth. This condition should not be confused with a less serious condition known as the “baby blues.” The baby blues is a term used to describe a variety of symptoms that a woman can experience in the weeks following birth and delivery. These symptoms include feelings of anxiety, nervousness, and worry. However, they usually go away much faster than PPD, which is more severe and lasting. PPD often requires professional treatment while the baby blues do not.

The intensity of PPD can make taking care of a baby or yourself difficult, even more so than just general tiredness that is expected with a newborn. The good news is that although PPD is a serious condition, treatment can help mothers overcome this condition and help them feel a lot better in the long run.

Postpartum Depression Symptoms

Although PPD can look different for every individual, there are some symptoms that are commonly seen in cases of PPD. Nevertheless, even if you don’t experience the following symptoms but still aren’t feeling like yourself and find yourself struggling in your daily life and your relationship with your new baby, you could still have PPD.

Common symptoms of PPD include

  • Feeling exhausted but having trouble falling asleep
  • Constantly feeling sad or crying without knowing why
  • Oversleeping
  • Eating too much or too little
  • Unexplained bone aches, pains, and colds
  • Feeling more anxious, nervous, and angry than usual
  • Frequent mood swings
  • Feeling a loss or lack of control
  • Trouble remembering things
  • Trouble concentrating
  • Becoming indecisive over simple choices
  • Loss of interest in usual activities
  • Difficulty connecting with your baby
  • Wondering why you aren’t as joyful as you expected to be once you had the baby
  • Feeling like you’re an unworthy or bad mother
  • Withdrawing from your baby
  • Wanting to escape from everything, including your family
  • Experiencing intrusive thoughts
  • Wanting to hurt yourself or your baby

PPD symptoms can begin as soon as delivery. However, PPD can also appear months after delivery. A mother who is three or even nine months postpartum can still experience PPD, even though she didn’t have any symptoms for those first three to nine months. This condition can come on suddenly and unexpectedly for many women.

What Causes Postpartum Depression?

Many women feel as if they have failed in some way by doing — or not doing — something that a “good mother” should do when they experience symptoms of PPD. Some women might feel as though they didn’t try hard enough to feel connected to their pregnancy. Others might feel as though they didn’t deserve children, even though they have wanted a family for some time.

PPD can affect any mother. No matter the mother’s age, language, income class, education level, race, and culture, she can still experience PPD and deserves to understand her condition, so she can receive treatment. Most importantly, it is never a woman’s fault for experiencing these symptoms and struggling with PPD.

It’s thought that there are a combination of factors that lead to PPD. These factors include stress from responsibilities such as work, traumatic past experiences related to giving birth, the drastic hormonal changes and fluctuations that occur during pregnancy and after delivery, and the heavy physical and emotional toll that goes along with caring for a newborn.

Some women may be at a higher risk of experiencing PPD if they have a family history of depression, have struggled with depression themselves, or had PPD with a previous pregnancy.

Other Levels of Perinatal Mood and Anxiety Disorders

While PPD is perhaps the most well-known variant of perinatal illnesses, mothers can also receive diagnoses for conditions such as postpartum anxiety (PPA) and postpartum psychosis. Together, these conditions fall under the umbrella of what are known as perinatal mood and anxiety disorders (PMADs).

Conditions like PPA and postpartum psychosis are not always as widely known and discussed as PPD, leaving women who experience them feeling uncertain and alone in their struggle. But just like PPD, PPA and postpartum psychosis are real illnesses that affect real people. Professional treatment can go a long way in helping mothers feel better about themselves and help them engage more with their children and family.

Postpartum Anxiety

I didn’t want my husband to leave the house at all, because I was scared something would happen to him, and I would be stuck with a baby that I wasn’t sure I even had a relationship with. He should FaceTime me walking to the mailbox, just in case something happens.

He should stay on the phone with me every time he goes to the grocery store. And of course he can’t go on that business trip. He doesn’t know the area, and what if he’s wandering around lost and something happens to him? We should both just stay at home to avoid horrible situations.

When I see him hold the baby I’m sure he’s going to do something wrong like drop the baby or intentionally shake her. When he tries to help out by changing her diaper, I get all jittery and worry about the way he’s handling her. If I leave the baby alone with him, how do I know she’ll be OK?

Intrusive thoughts and overwhelming fear of something bad happening upon leaving the house are hallmark signs of PPA. The organization, Postpartum Support International, reports that PPA affects approximately 10% of all mothers.

Each individual case of PPA can look different in various individuals, but common symptoms include

  • Constantly feeling worried
  • Continuously racing thoughts
  • Changes in appetite and sleep
  • Increased restlessness
  • Increased sense of dread
  • Fear of leaving the house or going out, even for errands
  • Unusual dizziness or nausea

PPA can make you feel isolated, unsettled, and make you believe you have to manage everything by yourself —  but treatment is available and can help you regain that sense of normalcy in life. You can experience a better mood and find light at the end of the tunnel with proper treatment.

Postpartum Psychosis

Postpartum psychosis is often least talked about when it comes to perinatal mood disorders. Many people are unaware that this is even a possible illness. When compared to PPD or PPA, postpartum psychosis cases are not as common and according to Postpartum Support International, only occur in approximately 1 or 2 out of every 1000 births. That comes out to .1-.2% of births.

Nevertheless, the relative rarity of experiencing postpartum psychosis doesn’t mean that it never happens. Mothers who experience postpartum psychosis are experiencing a real illness that can be addressed through proper treatment.

Common side effects of postpartum psychosis include

  • Delusions
  • Hallucinations
  • Feeling increasingly irritated
  • Hyperactivity (being unusually active)
  • Experiencing a lack of need for sleep or inability to sleep
  • Frequent mood swings
  • Paranoia and increased suspicion
  • Trouble communicating properly

Risk factors for postpartum psychosis include any history of psychotic episodes or bipolar disorder either personal or familial.

A mother struggling with postpartum psychosis can experience breaks from reality. When this occurs, the woman will believe the delusions and hallucinations she witnesses are reality. Psychosis often means that these delusions are real and are what is true. As reported by Postpartum Support International, “a 5% suicide rate and a 4% infanticide rate [are] associated with this illness.”

However, it’s also very important to note that not all delusions are violent. While some individuals can experience violent delusions, not every woman who has postpartum psychosis will be destructive or violent. Plenty of women have this condition but have not hurt themselves or anyone else. Nevertheless, because delusions can become so religiously believed and can lead to irrational judgment and thinking, it’s best that a woman seeks professional treatment, so her condition can be properly assessed and treated by a doctor.

Treating Perinatal Mood and Anxiety Disorders (PMADs)

Experiencing PPD, PPA, and postpartum psychosis can be a challenging experience. Many women feel isolated, unsure of themselves, and simply feel “off” much of the time. The best way for mothers to start feeling better about themselves, their relationship with their children, and their future, is to seek professional medical treatment.

Treatment has proven to be very effective at treating these illnesses and has helped countless women return to an improved mental state and find reprieve from depression and anxiety. There are several typical approaches to treatment for these perinatal mood disorders.

Medication and Therapy

According to the American College of Obstetricians and Gynecologists (ACOG), perinatal mood disorders like PPD are treated through medication (usually antidepressants) and talk therapy. 

Talk therapy is better known by some as psychotherapy. During a talk therapy session, a therapist can help a patient identify their feelings and discuss methods to help manage them. Therapy can also take a variety of forms. For example, some patients may engage in one-on-one sessions, group therapy, or family therapy.

Medication is also used to treat PPA and postpartum psychosis, although the kinds of medications used will differ and may not always be antidepressants. A medical professional can determine the correct and appropriate use of medications for each patient.

One thing to keep in mind is that medication alone will not necessarily address the entire problem. Oftentimes, medication is administered in an effort to help the patient feel a little better and helps them help themselves by engaging with a therapist and making other positive changes in their lives.

Family and Friend Support

The support of family and friends when a new baby is concerned is very important in helping a mother as she cares for her child. In fact, the lack of support from close relations is one of the risk factors that can contribute to the extended duration of PPD and other perinatal mood disorders.

Just like family and friends support a loved one who is physically sick or injured, mothers of newborns can benefit greatly from a healthy support system. With a supportive system in place, mothers who may be struggling with undiagnosed PPD can rely on family members and close friends to help them identify a potential illness and encourage them to get the treatment they need. Knowing that you have someone to support you, cheer you on, and stand by your side as you deal with any kind of illness helps many people see a smoother recovery process.

Room for Improvement: Earlier Detection and More Frequent Doctor Visits

It is not unusual for most OB/GYN visits to schedule a single visit six weeks postpartum. That’s about a month and a half after delivery. In a world where many women with PPD will begin to recover after three to six months, a month and a half of undiagnosed PPD only delays important treatment.

More and more, midwives and postpartum doulas are serving as early detectors for PPD. In contrast to the single six weeks postpartum OB/GYN appointment, many midwives will visit a mother multiple times, even before that six week mark. The goal with these frequent visits is to detect PPD early and get their clients the help they need.

As the demand for better education surrounding PPD grows, more organizations and individuals in this field are recommending expectant mothers to be clear with their OB/GYN about a history of depression or other mental illness during prenatal care visits. ACOG notes that some OB/GYNs may recommend beginning treatment right after delivery, to prevent PPD from beginning or becoming too severe.

More frequent, earlier visits to the doctor are also being called for to help identify symptoms of PPD faster. Critically, family and friends can also contribute to earlier detection by learning about the symptoms of PPD and knowing how to properly support their loved one.

Postpartum Depression Treatment

All kinds of mothers from unique backgrounds and circumstances experience a perinatal mood disorder such as postpartum depression, anxiety, or psychosis. In many parts of society, these illnesses are not always widely discussed and expectant mothers are not always aware of the symptoms they should be looking out for. 

There is no shame in needing help for managing a perinatal mood disorder. In fact, treatment is the best thing you can do to help yourself and your family. With professional treatment, many mothers find themselves feeling like a new person and are able to move forward with a greater degree of confidence about the future as they build healthy, loving relationships with their newborn.

SUN Behavioral Columbus offers best-in-class services to address the mental health needs of all kinds of mothers. With programs such as telehealth for adult outpatient treatment, treatment can be easily accessed and fit conveniently into any busy mother’s schedule. Contact us at (614) 706-2786 to get the help you need.

Frequently Asked Questions

What are the causes of postpartum?

There are lots of factors that can contribute to causing postpartum depression. Some factors include stress from responsibilities such as work, trouble with previous deliveries, drastic hormonal changes and fluctuations that occur during pregnancy and after delivery, and the heavy physical and emotional toll that goes along with caring for a newborn. Financial trouble and a lack of support at home are also major contributors to PMADs.

How long does PPD last?

A study from the “Harvard Review of Psychiatry” found that many cases of PPD seemed to resolve within approximately three to six months. Nevertheless, a significant number of women still experience PPD symptoms after six months, with some even experiencing symptoms three years later.

The duration of PPD will vary on a case-by-case basis. However, some risk factors can prolong the duration. These factors include a history of depression or mental illness, a history of PPD with previous pregnancies, lack of support from family and friends, major life changes, a complicated pregnancy or delivery, and breastfeeding troubles.

How bad is postpartum?

The severity of a case of postpartum depression will depend on the individual. Each woman can react differently based on her body, mental state, mental health history, familial mental health history, and the level of support she has access to.

No matter how severe or mild a case of postpartum depression may seem, it is always best to get properly diagnosed by a medical professional. A medical professional can officially diagnose the condition, take into account each woman’s situation, and suggest the best course of action.

What is the meaning of postpartum?

Generally, the word postpartum refers to the period of time following a mother’s delivery of her child. It is also commonly used to refer to an illness called postpartum depression, a condition in which a mother experiences depression in the time after she’s given birth.

What is prenatal depression and prenatal anxiety?

Like postpartum depression and anxiety, prenatal depression and anxiety are conditions that can occur before delivery. Expectant mothers can experience symptoms of these conditions while they are pregnant, hence the name “prenatal.” Seeking treatment during a pregnancy for these conditions is the best course of action to help a mother get the support she needs to look forward to a healthy pregnancy, delivery, and relationship with her baby.