Postpartum Depression: a Multifaceted Problem

Infant holding mother's fingerMany people believe that postpartum depression is caused by the hormone shifts that occur in a woman after she gives birth. In our culture, we attribute women’s emotions to sex hormones, while we attribute men’s emotions to whatever situation they happen to be in (this link opens a PDF). But these myths, and the biological determinism that it is part of, actually make matters worse. People who assume that emotions are primarily caused by biological changes that are outside of their control tend to cease active coping. The way we define a problem shapes how we look for solutions, and it can lead us down blind alleys. It is much easier to assume that postpartum depression happens to women who give birth as a result of those hormone shifts than it is to really take a hard look at the ways our culture is not helping couples make the transition to family. And the reality is that postpartum depression happens just as often to adoptive mothers as it does to birth mothers (that’s 15% in our culture), and it happens to fully 10% of dads (which is twice the amount of depression found among men at other times in their life).

There are three legs to a tripod and there are three sides to depression: the biological, the psychological, and the social. The very most recent research shows that the biological vulnerabilities to depression are temperamental—meaning the hardwired ways that people are born sensitive to being startled, vulnerable to sleep disruption, reactive to interpersonal upsets, and so forth. But it is very important to understand that there is no single gene for depression and there is no gene that, when combined with stress, results in depression. This means that we have to be a whole lot more circumspect and cautious about how much depression we attribute to genetics.

Genetics are outside of your control. That might let you off the hook if you’re prone to self-blame, but it won’t do you much good when you’re trying to cope. Genes are permanent—you’re born with yours, and outside of some pretty extraordinary circumstances, they’ll remain with you for all of your life. Genes are also pervasive—they’re part of every fiber of your being and you can’t get away from them. Genes are permanent, they’re pervasive, and they’re personal, but they’re outside of your control and any attribution for a negative event (depression is a negative event) that is permanent, pervasive, and personal is, in and of itself, a risk factor for depression. Did you get that? Your attributions, how you explain the bad stuff that happens to you, what you say causes the rotten feelings you have, those explanations can be the very things that put you at risk for depression.

By the time you reach adulthood you have likely developed habits: habits in how you think, habits in how you relate to others, and habits for coping with the unpleasant things that happen. If you have learned to think pessimistically and to take responsibility for bad stuff that isn’t even under your control, then you’ve probably rehearsed the habits of thought that put you at risk for depression. By the time you reach adulthood you’ve also probably developed some pretty powerful preferences for coping and for relating to others. Some of those coping styles, if overused, inflexible, or not sufficiently contextual, will also set you up for depression. So the good news is that most of the risk factors for depression are learned and can therefore be unlearned. And the bad news is that learning new habits costs a bit of effort, has a learning curve associated with it, and can therefore be frustrating at times.

Join me for a journey of into the many factors that cause so many women and men, birth parents and adoptive ones, to get depressed after bringing home baby. We’ll explore aspects that have to do with history and culture as well as the standard habits of thought, habits of relating, and habits of coping that modern research shows us to be the traps that lead to depression. Join me in this journey if you believe that accurate understanding leads to better, more effective treatment, or if you want to really be empowered to stop depression in its tracks and manage your risks to prevent depression in the future.

References
1. Barrett, L. F., Bliss-Moreau, E. (2009.) She’s emotional. He’s having a bad day: Attributional explanations for emotion stereotypes. Emotion, 9(5), 649-658.
2. Risch, N., Herrell, R., Lehner, T., Liang, K.-Y., Eaves, L., Hoh, J. (2009.) Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: A meta-analysis. JAMA, 301(23), 2462-2471.

Related articles:
Taming the Brain
Even Dads Can Get Postpartum Depression
Some Thoughts On Embracing Motherhood: Tips for the Sleepy New Mom

© Copyright 2012 GoodTherapy.org. All rights reserved. Permission to publish granted by Sara Rosenquist, PhD, ABPP, therapist in Raleigh, North Carolina

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Lynn

    Lynn

    March 6th, 2012 at 4:21 PM

    I still have a hard time imagining being depressed after bringing home a baby because it is such a wonderful gift!
    Think about all of the families who would love to be able to have a child and can’t. Why can’t they be the ones who are given this most precious child?
    And for those who don’t even want to help themselves, well, those are the ones who make me even sadder.
    They would rather sit around and stew in their own perceived misery than fight to get themselves back.

  • Randee

    Randee

    March 6th, 2012 at 5:31 PM

    Genetics may be beyond your control, but that doesn’t mean that that gives you the out to give up. To the contrary it should give you something to work against, to battle, and to overcome.

  • Rick

    Rick

    March 6th, 2012 at 5:49 PM

    I saw a center in la treating one leg of the tripod with a magnetic field. they show a video on their fb page if you like it. sounds like it causes electric changes between cells that help them communicate better. you should include that sort of non drug related treatment in the article

  • K.Morgan

    K.Morgan

    March 6th, 2012 at 8:23 PM

    Easy to say its not in my control and watch thi ve go down. But let’s take it up let’s try to change and turn things around. That should be the attitude and this article explains that really well.

  • Nippiechick

    Nippiechick

    March 7th, 2012 at 2:35 PM

    It must be very easy if you have never experienced this kind of depression to say that you don’t believe that it is real, that you should be able to shake it off and enjoy life with baby. But you have not been there and I have. It is not so simple. There are so many emotions that you have no control over at all, and you wonder why you are feeling this way and when will it go away and you know something is wrong but are too afraid to say it out loud for fear of what others are going to think about you. It is even hard to tell your doctors because you are afraid he will tell you it’s all in your head.

  • rick harris

    rick harris

    March 7th, 2012 at 4:54 PM

    Depression is very real and a serious problem, especially for people who have advanced depression and can’t take drugs due to side effects or who are still breast-feeding. There are new options available though.

  • Helena

    Helena

    March 8th, 2012 at 2:06 PM

    I was on Prozac when I found out I was pregnant and had to go off of that medication.

    It was fine, the worst of the depression was long gone and I was nothing but happy over the arrival of my child.

    But what if I had needed to go back on it while breastfeeding. Would that have been safe for the baby? I would like to know the medical consensus about that.

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