Susan Dowd Stone, MSW, LCSW
President, Postpartum Support International
There is a difference between what’s referred to as the “baby blues” and postpartum depression. The “baby blues” is a very common condition that affects up to 70% of women. Symptoms include tearfulness, escalation of anxiety, mood swings. The baby blues normally resolves itself on its own within 2 to 4 weeks after delivery.
Postpartum depression shares some of the same symptoms as the baby blues, but the difference is the severity of those symptoms and the length of time they persist. We estimate that 15-20% of women suffer from postpartum depression. But this figure may even be higher because this doesn’t include women who suffer from miscarriages, stillbirths, or women who never get help.
Postpartum depression interferes with a woman’s ability to function. Women may find that they’re sleeping too much, or not enough; they can’t settle down or think straight; they can experience a lack of concentration and even thoughts of harming herself or the baby. Postpartum depression interferes with all the tasks that come with caring for a new baby.
A more extreme postpartum condition is what’s called postpartum psychosis. Only about 1-2% of all women suffer from this. This is a different condition from postpartum depression. Postpartum depression doesn’t necessarily lead to psychosis. Symptoms for this condition include hallucinations that command a woman to harm herself or the baby. Many times the hallucinations have religious overtones. These illnesses are easily treatable with diagnosis. Women will get well with the right help.
Women who are developing postpartum depression can start developing the symptoms up to 24 hours after birth. The blues will worsen and it will become difficult for her to function. The feelings of anxiety increase, feelings of anger may begin to develop, and she may start to have thoughts along the lines of, “I don’t want this child,” “I’m a bad mother,” “There’s something wrong with me.” They may even start to isolate themselves further from their family and friends.
There can be different contributing factors to postpartum depression, and they’re broken down into psychosocial factors and biological factors. Psychosocial factors are stressors that can include financial difficulties, marital difficulty, ambiguity about having a baby in the first place, having twins, cultural differences/ pressures, etc. Biological factors can include a history of mood disorders, hormonal changes, a history of severe PMS, etc.
Postpartum depression can affect any mother – not just first-time moms. You can have had one child without experiencing postpartum depression, and then experience it with the second child. However, if you have experienced postpartum depression after your first pregnancy, there’s a higher risk that you might experience it again with your second pregnancy. Women who delivered by C-section are also at a higher risk of experiencing postpartum depression because of all the ramifications of having that kind of major surgery.
We can prevent postpartum depression from escalating if we start screening women during pregnancy. If a woman’s doctor screens her throughout the pregnancy, we can many times see the signs of postpartum depression. Many women actually become depressed during the pregnancy and carry it through delivery. So if we can catch it early, we can prevent moms from having to go through so much.
The “baby blues” usually go away by themselves and don’t require any other treatment. There are a few different treatments for postpartum depression, and they can be combined and/or done individually.
There are pharmacological, or medical, treatments. There are medications that are safe to be taken during pregnancy. We always consider the level of depression to determine if that’s the most appropriate route. There are also non-pharmacological treatments, which include psychotherapy, group therapy, and skills-based treatments where we try to get women to think of things in a more practical way and teach them self-soothing techniques.
Women who receive treatment often say they can’t believe they suffered for so long, or that their doctor never told them that postpartum depression was a possibility. They often say they wish they had known because just having the knowledge could have prevented so much unnecessary suffering.
If not treated, postpartum depression can last indefinitely. There are negative consequences for both mothers and children. For mothers, untreated postpartum depression can result in marital difficulties, isolation and the overall negative emotional state of depression. There are also serious ramifications for the children of mothers with untreated postpartum depression. For example, because babies try to do everything they can to engage the adults in their lives, they will eventually stop responding to their mothers because the mothers aren’t engaged. The baby can then become depressed, because your whole life as a baby depends on engaging your caregiver. Children of mothers with untreated postpartum depression can have learning disabilities, behavioral issues, and are more likely to be abused.
Licensed child care provider for two years
I think that having a really good support system is crucial. I had a great support system, and I don’t know what I would’ve done without it. It’s also important for a new mom to hear someone say, “I’m here for you”. They need that comfort and support. So I can at least offer mothers that much, having gone through similar feelings myself. It may provide a great deal of comfort for mothers to know that their child care provider understands and can relate.