Postpartum Depression

Overview of Postpartum Depression: Depression affects between ten and twenty percent of pregnant women and new mothers. Depression is not simply feeling sad, low, blue or down in the dumps for a little while. True depression is more intense and lasts longer than a few days. Depressed people will show at least four or five of the following symptoms:

• feeling restless or moody

• feeling sad, hopeless, and overwhelmed

• crying a lot

• having no energy or motivation

• eating too little or too much

• sleeping too little or too much

• having trouble focusing or making decisions

• having memory problems

• feeling worthless and guilty

• losing interest or pleasure in activities you used to enjoy

• withdrawing from friends and family

• having headaches, aches and pains, or stomach problems that don’t go away

Many women have the “baby blues” in the days or weeks after childbirth. If you have the baby blues, you may:

• have mood swings

• feel sad, anxious, or overwhelmed

• have crying spells

• lose your  appetite

• have trouble sleeping

The baby blues go away after a few days. The symptoms are not severe and do not interfere with functioning in a significant way.

The Medical Model and Postpartum Depression: Postpartum depression, which may occur anytime in the first year after childbirth, is a true depression, which lasts and interferes with functioning. It may also include:

• thoughts of hurting the baby

• thoughts of hurting yourself

• not having any interest in the baby

• baby blues that don’t go away after two weeks

• symptoms of depression get more and more intense

• strong feelings of sadness or anger come on one or two months after delivery

• it is hard for you to function at work or at home

• you cannot care for yourself or your baby

• you have thoughts of harming yourself or your baby

Postpartum depression can be serious, and should be discussed with professional. Postpartum depression can sometimes be so severe as to lead to a break with reality. This is rare, occurring in about 2 or 3 of every 1,000 births. It usually begins in the first 2 weeks after childbirth. Women who have bipolar disorder or schizoaffective disorder have a higher risk for postpartum psychosis. Symptoms may include:

• seeing things that aren’t there

• feeling confused

• having rapid mood swings (highs and lows several times a day)

• actually trying to hurt yourself or your baby

Post partum depression can have many causes:

• Depression tends to run in families.

• Stressful life events, such as death of a loved one, caring for an aging family member, abuse, and poverty, can trigger depression.

• Hormonal factors unique to women may contribute to depression in some women. Women are at greater risk of depression at certain times in their lives, such as puberty, during and after pregnancy, and during perimenopause. Some women also have depressive symptoms right before their period.

Hormonal changes may trigger symptoms of postpartum depression. When you are pregnant, levels of the female hormones estrogen and progesterone are higher. Hormone levels return to normal after just one day after birth.

Other causes may contribute to postpartum depression, such as feeling:

• tired after delivery

• tired from a lack of sleep

• overwhelmed

• unsure of your ability to be a “good mother,” or an unrealistic need to be a “perfect mom”

• stressed by changes in your routine

• stressed by your change in identity and sense of self

• less attractive to your partner due to weight and body changes

• stressed from a lack of free time

• disappointed by the reality of parenthood compared to expectations

• stressed by the expectations of family

• angry or confused due to a lack of help from your partner of family

• isolated

• worried about money

• stressed by changes in your relationship or your partner’s reaction to the birth

Certain factors may increase your risk of depression during and after pregnancy:

• a personal history of depression or another mental illness

• a family history of depression or another mental illness

• a lack of support from family and friends

• anxiety or negative feelings about the pregnancy

• problems with a previous pregnancy or birth

• marriage or money problems

• stressful life events

• young age

• substance abuse

On the other hand, certain choices can help prevent post-partum depression:

• Get sleep when the baby is sleeping, even in the middle of the day (if possible).

• Ask for help from your partner, family, or friends.

• Take some time for yourself when you can.

• Try to avoid any major changes in your life besides what is necessary to adjust to having a child. Moving, changing jobs, and other major changes add stress unnecessarily.

• Eat a healthful diet.

• Get some exercise.

• Talk with someone about your feelings, even if you are mostly feeling fine.

Women who are depressed during pregnancy have a greater risk of depression after giving birth. If you have been taking medications for depression, you may have to stop during pregnancy, and this can allow depressive feelings and thoughts to return.

Some women may be afraid to talk about their depression, fearing they will be viewed as “bad mothers”, and believing they are “supposed to be happy”. If you are depressed after childbirth, it is important to talk to someone before the problem worsens. It is very common for women to struggle with their new role, particularly in our fast-paced, individualistic, high-achievement society. If you feel sad, angry, or numb for more than a few hours at a time, please seek help from your doctor or a therapist.

Case Example of Postpartum Depression:

June, 27, comes for therapy accompanied by her husband. They recently had their first child together, and since the second week, June has been overwhelmed by sadness, even crying anytime the baby wants to feed, and once becoming enraged at the baby’s crying to the point that her husband took the baby in another room. June is mortified, ashamed and afraid. The therapist normalizes these feeling, explaining what Post Partum Depression is. The therapist takes a history and finds out some important information: The birth was difficult, and June felt very anxious and alone in the hospital. She did not like her doctor. She believes her mother disapproves of her husband and her parenting values. And her husband recently got a promotion and cannot help much at home, for which she resents him somewhat. Talking about all this helps, and the therapist builds on this small bit of progress by suggesting some self-care and coping skills. June’s husband also agrees to take some time off work to help out, and June is referred to a support group for new mothers.

Therapy for Postpartum Depression: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of postpartum depression. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for postpartum depression or any other issue, it is helpful to familiarize oneself with these elements.

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Postpartum Depression Article Summaries