Understanding Postpartum Depression
Giving birth to a child is generally a joyous occasion. However, up to 30% of all new moms and up to 20% of all new dads may experience difficulty adjusting to their role of being new parents. Perinatal mood disorders can happen regardless of education, socioeconomic status, culture, religion or personality – the statistics remain constant anywhere in the world. Even though post partum depression (PPD) is very common, only a small number of women who experience symptoms ever receive the help they need.
It is unlikely that PPD has one single cause but rather it is a combination of factors. Some of the risk factors may include –a stressful event around the time of birth, sleep deprivation, colicky babies, absence of support from family or friends, isolation, hormonal changes or a personal history of mental illness. PPD typically occurs 1-3 months after childbirth but can surface anytime in the first 2 years.
Many people have heard of the “baby blues.” This is usually described as a brief, temporary moodiness, sometimes with sadness, crying and irritability that affect 60-80% of new mothers. Unlike PPD, the baby blues are not actually an illness and will go away on its own, usually within 2 weeks. Support from others, a nap, or getting out of the house can help a mom suffering from baby blues.
PPD is an illness. It is crucial that moms who are suffering know that they are not to blame, they are not alone and they will be well again – this is treatable! Symptoms of this illness usually start from two weeks to several months after delivery. Women who suffer PPD experience their pain in many different ways, both physical and emotional. Some of the warning signs for PPD may include irritability, sadness, crying spells, extreme disappointment with breastfeeding difficulties, feelings of inadequacy or hopelessness, sleep problems, change in appetite, fear of being alone, and lack of connection with the baby or increased anxiety. It is important to note that the symptoms and their severity can change over the course of the illness. Symptoms may not resolve on their own, support and intervention are required.
There are two related anxiety disorders that can accompany or follow PPD. Some women may also develop panic disorder or obsessive-compulsive disorder (OCD). Nearly 10% of new moms with PPD report feeling depressed and hopeless about their panic attacks, which usually come on without warning and can last 10-30 minutes. Symptoms can include episodes of extreme anxiety, shortness of breath, chest pain, trembling, excessive worry or fears. Of the 3-5% of new mothers that suffer from panic disorder and OCD, many report having intrusive thoughts or mental pictures about harming the baby. These thoughts are usually met with tremendous horror and guilt. They may also obsessively count, check things repeatedly, clean or have other repetitive thoughts.
In rare cases (.1-.2% of new moms), PPD can take a severe form called postpartum psychosis. Some of the symptoms include extreme confusion or agitation, visual and/or auditory hallucinations, delusional thinking or frantic energy or activity. Postpartum psychosis may cause the woman to harm herself or the baby. This will not resolve itself and it does not self-resolve. It often requires immediate intervention, medication and/or hospitalization.
The first step to treatment is recognizing and admitting that a person does have some form of perinatal mood disorder. Tremendous relief and hope can come from recognizing that the emotional and physical pain experienced are symptoms of an illness that can be treated. Once there is an acceptance that PPD is a real illness, it may be easier to follow the recommended treatment.
Let’s not forget about dad! Research indicates that between 5-20% of men experience symptoms of depression, either leading up to or following the birth of their child. Unfortunately, many men never seek help or support during this crucial period. Untreated depression can lead new dads to withdraw from the parenting process or have difficulty adjusting to their new role. Possible causes include feeling burdened, increased financial responsibility, feeling left out and missing a sexual relationship with the mother of his newborn. Dads with depression often demonstrate anger or irritability, sleeping more or less than usual, emotional withdraw, sadness or worry. Many are the same symptoms moms go through with PPD!
Getting needed support and treatment is crucial. The doctor who delivers the baby and the physician caring for the baby are required by law to offer a screening tool after the baby is born for the first year during scheduled check-ups. It is not easy to tell someone what you are going through but it is very important to share your feelings with someone you trust. It is important to find caring, compassionate care givers who understand all aspects of perinatal mood disorders – included are physicians, nurses, therapists, PPD support group facilitators, lactation consultants and clergy. Treatments may include individual or family therapy, medication and/or PPD support groups or online support groups until the symptoms resolve.
If left untreated, PPD can lead to chronic mood disorders, poor parent-child bonding, marital trouble, child neglect or at the worst case, physical harm to mom and/or baby. In addition to finding compassionate professional help, it is helpful for the entire family to be involved in the education and recovery process. It is common for family members and friends to also experience confusion, doubt, anger and frustration when someone they love is diagnosed with a perinatal mood disorder. Support and understanding from loved ones are vital to the healing and recovery.
Anyone can suffer from perinatal mood disorders. It is essential to recognize symptoms early and intervene as soon as possible so patients learn they are not to blame, they are not alone and they will be well again with time and treatment. There is hope and help for those in need.
