Is This Postpartum Depression? Signs and What to Do

by Megan Grant, LICSW | April 2, 202

Introduction

The birth of a baby is an event, and life-change that can lead to a plethora of feelings and emotions. It can emote feelings of joy and sometimes fear. These feelings are completely normal for mothers and fathers alike. However, the birth of a new baby can also bring a much deeper sense of sadness that is often suffered in silence. This is known as postpartum depression. 

What is Postpartum Depression and Statistics
The National Institute of Health defines postpartum depression as a depressive episode that begins during pregnancy or the first four weeks after birth; however, women remain at risk of developing depression several months after childbirth. 

Here are a few statistics from PostpartumDepression.org:

• Nationally, 1 in 8 women experience symptoms of postpartum depression after giving birth. However, this rate can be as high as 1 in 5 women in some US states.
• It is estimated that nearly 50% of all mothers experiencing postpartum depression are not diagnosed by a health professional

Data from the Centers for Disease Control and Prevention show that, based on the approximately 3.7 million annual births in the US, the finding that 1 in 8 women experiences postpartum depression, which means over 460,000 mothers are affected each year. However, it is important to understand that these numbers only account for live births. When you factor in mothers who have experienced miscarriages or stillbirth, the number is significantly higher.

Read more statistics here. 

Symptoms

The Diagnostics and Statistical Manual of Mental Health Disorders (DSM-5) clarifies that postpartum depression begins after the baby is born and if depressive symptoms begin prior to birth, it is perinatal depression. When mothers experience a miscarriage or a stillbirth, hormones mix with grief and often trigger perinatal depression.

It is important to recognize the symptoms of postpartum (and perinatal) depression as treatment can be helpful. According to postpartumdepression.org, 80% of individuals with postpartum depression achieve a full recovery with appropriate treatment and support. Symptoms include:

• Depressed mood or severe mood swings
• Frequent crying episodes
• Difficulty bonding with your baby
• Social withdrawal
• Appetite fluctuations
• Insomnia or hypersomnia
• Loss of interest in activities you used to enjoy
• Intense irritability or anger
• Fear that you’re not a good mother
• Hopelessness, worthlessness, shame, guilt, or inadequacy
• Difficulty making decisions, concentrating, or thinking clearly
• Severe anxiety and panic attacks
• Thoughts of harming yourself, recurring thoughts of death or suicide

Postpartum Psychosis

Another condition that must be discussed is postpartum psychosis. Though the condition is rare (1-2 women per 1,000 live births, per the National Institute of Health), it is imperative to recognize these symptoms and get treatment early on as this condition can lead to life-threatening thoughts or behaviors.
Onset is much sooner; symptoms developing within the first week of delivery. Symptoms may include:

• Feelings of confusion or feeling lost
• Obsessive thoughts about your baby
• Hallucinations
• Delusions
• Sleep issues
• Too much energy
• Paranoia
• Attempts to harm self and/or baby

Baby Blues vs. Postpartum Depression

Many new mothers may receive well-intended advice from others that they are experiencing “baby blues” and that it will pass soon. While this is true for some new mothers, it is important to not confuse “baby blues” with postpartum depression.

Many of the symptoms overlap, but their timelines differ. Postpartum depression occurs consistently for two weeks and can last for many months while “baby blues” resolves on its own within a few days or up to two weeks after the baby’s birth. 

What can be done at home to help?

• Find your support people.
  • This group of people, or person, can of course be someone you talk to for help, or to vent. However, your supports can also be there to take things off your plate. They can cook you a meal, get your groceries, sit with your baby while you nap, clean your kitchen, or sit with you. This person is there to make your life a little easier. Some ideas are: a partner or spouse, family member(s), neighbors, support groups, religious communities, etc.
• Eat well.
  • It is common to crave carbohydrates and sweets when experiencing Postpartum Depression and/or Anxiety. When we consume carbohydrates and sweets, it triggers a reward reaction from our taste buds that crave sugar, causing a hit of dopamine in our brains. However, when it wears off, it can cause a crash. 
  • It is important to consume nutritious foods during this time and a lot of protein so your blood sugar doesn’t drop if you are breastfeeding. 
  • If you have been struggling with appetite, try protein shakes or drinks for the time being. 
• Sleep and take breaks.
  • Nighttime sleep is the most valuable sleep to help you recover. Brain restoration also happens when you get five hours of uninterrupted sleep as this allows for you to go through a full sleep cycle. This may sound impossible with a newborn baby, however there are ways to work towards it and eventually achieve it. 
    • Have night shifts with your partner. Split the night up where you take part of the night and your partner takes the other, or alternate nights where you are “on” and “off” with your partner. 
  • If your partner is not at home, enlist the help of one of your support people. It is not always easy to “sleep when the baby sleeps”, so having someone else watch your baby so you can get uninterrupted sleep (use earplugs, sound machine, etc.) is the best way for you to care for yourself and restore your brain. 
  • Recharge your batteries and have someone else, such as your partner or a support person, care for your baby for a while. Take time to do something you enjoy (leave the house or go into a different room) and allow your baby time to bond with someone else who cares for them. 
• Exercise and go outside.
  • When you have had a few good weeks of sleep, you can get back into a moderate to more high-impact workout routine. However, until then (to have the best sleep conditions) have low-impact workouts, such as going for a walk. Go alone, or have a support person walk with you. Exercise boosts serotonin, which improves your mood. 
  • Step outside for a little while to help yourself not feel so isolated. Sometimes being in a house all day with your baby can feel isolating and like the walls are closing in. Take a few moments to step outside and get fresh air. Look up at the sky and take deep breaths. Stretch your arms or look for shapes in the clouds.
• Eliminate stimulation.
  • If the usual sights and sounds feel like too much after you’ve given birth, be kind to yourself and adjust your surroundings as you are able. Turn off the TV, decrease the lights (or add more/open windows if you’re feeling depressed), wear headphones or earplugs to minimize unnecessary sounds (as long as you are still able to hear what you need to hear). 
  • If an event you would typically attend feels overwhelming, give yourself permission to not go for now. As you recover, you will, in time, feel okay to go again. Listen to your needs. You know yourself better than anyone else.
• Have a script.
  • Oftentimes you will get asked (or perhaps you already have!), “What can I do to help?”. You probably don’t always know how to respond to that question. It may be helpful to have your partner, or a support person sit with you and write down a list of things that others can do for you to help. This will allow you to advocate for your needs when asked and not feel burdened with coming up with ideas. 
  • Though supports may have the best of intentions, sometimes their words can be unhelpful. For instance, you may be told to “calm down” or “you just need to relax”. Provide them with a script of helpful phrases that will give them an effective way to give you what you need. Here are some examples:
    • We will get through this.
    • I am here for you. 
    • Hug. 

People who love you will want you to get better and will be relieved to know how exactly they can help.

Treatment

If you are experiencing postpartum depression or anxiety, you are not alone (remember, 1 in 5 women experience it!) and professional help is available. You will recover with proper care. 

Cognitive Behavioral Therapy is best practice for helping with postpartum depression and anxiety. You can find a therapist who specializes in perinatal mental health and cognitive behavioral therapy (CBT) on psychologytoday.com or postpartum.net. Postpartum Support International also has a helpline available: 1-800-944-4773. 

Support groups and Perinatal groups are also helpful. Though a group setting may sound intimidating, it can be helpful to hear experiences of others so you don’t feel isolated, and work through it together. Many are available, including at Therapy Evolved: https://therapyevolved.com/therapy-services/postpartum-support-group/

You are a fantastic mom and you deserve to care for yourself too. 

 

 

Sources

Bennett, Shoshana, and Pec Indman. Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression, Second ed., Moodswings Press, San Jose, CA, 2006, pp. 46–53.