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Postpartum Depression

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Dear Debi,
I'm a new mom of a 1-month-old baby & I've been feeling really down lately. How do I know if this is just the baby blues, or something more serious?
Danielle Mercado-Paschall
Debi's Tips
Debi Gutierrez
Debi Gutierrez
Host
  • Experiencing some form of depression is common
  • Baby blues usually fade on their own
  • Postpartum depression interferes with your ability to function
  • If you’re depressed, seek prompt treatment
Expert Advice
Susan Dowd Stone, MSW, LCSW
Susan Dowd Stone, MSW, LCSW
President, Postpartum Support International
Baby Blues
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
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.

Postpartum Psychosis
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.

Symptoms
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.

Contributing Factors
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.

Prevention
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.

Treatment
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.
Caregiver Comments
Claudia Hartman
Claudia Hartman
I felt a physical change in my body right after my daughter was born. I thought it was just the baby blues. I have never experienced depression before, but I knew that something was wrong. As the weeks went on I just couldn’t shake it. I just felt really sad, depressed, had low energy and I was afraid all the time. I was afraid to be left alone. I felt like I had made a big mistake having my child. I didn’t want my child at all. It was very overwhelming for me. I never thought of harming my child – just myself. I just wanted to disappear. I felt like I didn’t deserve her.

At about 7 weeks I had a really bad panic attack. I was shaking, hyper-ventilating and I couldn’t breath. I went to the doctor and he put me on medication which actually made me feel much worse. We tried another and two weeks later I started to feel better. It took 14 weeks for me to feel better about myself.

My husband was working and we needed help so we contacted a local postpartum doula agency. Nicole stepped in as my postpartum doula. She saved my life. She was only with us for one month because we could not afford to have her longer, but that was enough to help. Now I am having a love fest and I look forward to the birth of our second child.
Roy Wood
Roy Wood
Claudia got a referral to a postpartum support group and she started on prescribed medicine. It took several weeks for the medicine to take effect, but she slowly started coming out of it. She would have good days and bad days. We didn’t really know that it was a real clinical depression. Her family has a history of chemical imbalances, but we never knew this was something we should watch out for. Claudia is doing well now. I truly believe that the more people you have to help the better. Her support groups really help.
Tondra Gardner
Tondra Gardner
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.

Self-Soothing Techniques Featured Activity:
Self-Soothing Techniques
Postpartum Depression Featured Video:
Postpartum Depression
Topic: Health & Safety
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