In a world like ours, there are unspoken (and sometimes spoken) expectations that we appear a certain way to those around us. After giving birth, there is the expectation of complete and utter exhaustion, but also that a mom is elated to have an adorable little peanut with whom to cuddle. The newborn is brought home to their new nursery, decorated with love by parents, and filled with toys, clothes, and books from a recent shower.
Even with some warning about post-partum depression from both doctors and family, a lot of moms may feel like they are “in the clear” if they don’t experience symptoms in the first few weeks after labor. This is where things can get confusing. It is not uncommon for women to question their weepiness and emotional roller coasters. One may think, “I’m a strong woman- this can’t be post-partum because that would make me weak and a bad mother.” False. Your experience is also not in isolation. Use this guide to learn more about post-partum depression, as well as strategies to face it head on.
First things first. What causes post-partum depression (PPD)? There is not one single cause for PPD, but rather a combination of different factors. On a biological level, after giving birth there are significant changes in hormone levels. For example, the mother may experience a withdrawal from estrogen, progesterone and other endorphins, which were at high levels during pregnancy. These chemical changes can contribute to mood swings. On a practical level, the mother is most likely sleep deprived and emotionally exhausted after being in labor and parenting a newborn. PPD can also be found with new fathers or even adoptive parents, which highlights that it goes beyond the hormone fluctuations and changes.
Next- how do I know if I have PPD? PPD can arise in the first couple weeks right after birth, and sometimes even as long as a few months later. Some risk factors may include family or personal history of depression, unplanned pregnancy, an unsupportive partner, obstetric complications, or early childhood trauma. It is important to emphasize that these factors are not the cause of PPD, but rather make a mother more vulnerable to experience it. Common symptoms include but are not limited to the following: depressed mood and mood swings, withdrawing from loved ones, excessive weepiness, marked change in sleep and appetite, reduced enjoyment/pleasure in previously enjoyable activities, panic attacks, feelings of shame and guilt, and recurrent thoughts of suicide. Because of the diversity in symptoms and presentations for PPD, it is important to check with your health care provider to find out if your symptoms are due to PPD or another cause.
Third- how often does this happen? Although it is often hush-hush due to stigma, approximately as many as 1 in 8 women experience PPD.
Is this different from the maternity blues? Yes. The “materiny blues” or “baby blues” describes common feelings of worry, unhappiness, and fatigue experinced by many women after having a baby. Infants require a lot of care, so it is 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 mild relative to that of PPD, usually last a week or two, and often go away on their own. Women with PPD intense feelings of sadness and/or anxiety can interfere with her ability to take care of herself, her family, and the baby. Because of the severity of the symptoms, postpartum depression usually requires treatment.
Ok, so now what? Women experiencing these symptoms typically benefit from reassurance that their experience is normal and common. Additionally, emotional support combined with psychoeducation about newborns may help to validate and understand what the mother is experiencing. It is recommended that women seek additional medical and psychological help if symptoms do not recover after two weeks.
At Urban Balance, our practice provides and ensures a safe and open atmosphere for individuals, couples, and families to process the difficulty of this transitional period. Cognitive behavioral therapy (CBT), which helps clients recognize and change their negative thoughts and behaviors, is commonly used to treat PPD. In additional, interpersonal therapy (IPT) may also be used, which helps clients understand and work through problematic personal relationships. Lastly, some psychiatrists may recommend medication to help balance out the chemicals in the brain. While some of these medications are generally considered safe, it is recommend to talk to a health care provider about the risks and benefits.
Still feel like you have more questions? Don’t hesitate to contact us and make an appointment with one of our therapists to follow up on some of your concerns.