Rather than
give an exact text book defintion of what postpartum depression is, what
I want to do here is talk about the subject in it's entirety. First
off, postpartum depression is not really the correct term. Postpartum depression is one type of Postpartum Mood Disorder that individuals can suffer from in the postpartum period. Others include: postpartum anxiety/panic, postpartum obsessive compulsive disorder and in extreme cases postpartum psychosis.
We can define postpartum mood disorders as mood changes that occur
following the birth of a baby. They can be anywhere form mild to severe
in nature.
Sypmtoms vary greatly and can seem to come out of nowhere. All of a sudden a woman may feel unlike herself: she may have trouble getting out of bed and performing normal daily tasks; her appetite and sleep habits may change; she may experience feelings of sadness, depression, hopelessness, worthlessness, agitation, anxiety and panic; she may have obsessive thoughts and experience abrupt changes in mood and energy level. Sometimes Moms find they feel quite irratible, have difficulty concetrating, making decisions and even suffer confusion at times. Other things are affected as well such as libido. New fears may come into play as well such as: fear of being left alone, fear of impending disaster, fear of hurting oneself or the baby. A common reaction is for a Mom to experience either a lack of interest in the baby or extreme overprotectiveness of the infant. She may have a lack of interest in activities she normally enjoys, a powerful desire to run away, or feel that her life is spinning out of control.
One
of the biggest issues with postpartum mood disorders is recognizing
them. Not only are they difficult for professionals to diagnose but they
are even more difficult for Moms to recognize. For this reason, Women
who are expecting and are aware of PPD sometimes worry they might
unknowingly develop it. Everyone is suceptable to postpartum mood
disorders but some face a higher than average risk of developing one if:
-there is a family history of mood disorders or more specifically postpartum mood disorders
-the individual has experienced depression or other mood disorders in the past
-there is a history of hormonal problems (with PMS for example)
-the individual is a first time mother and/or is quite young
-the
baby was delivered prematurely and/or by cesarean or if there were any
other complications during the pregnancy and/or delivery
-the new Mom has multiples
-the individual experienced fertility problems prior to conceiving
-the new Mom and her partner are having relationship problems
-the new Mom is experiencing financial stress
-the new Mom is not used to spending a lot of time at home or ends up spending a lot of time alone
-there is a lack of family support or community
Another
very important question is why does PPD develop? Aside from some of the
risk factors listed above, what can bring on a postpartum mood
disorder?
-Hormonal changes after delivery is probably one of
the biggest factors. It is interesting that some are susceptable to
these changes and others are not; just like some Moms experience awful
morning sickness, some just a little and others none at all - everyone
has different ranges of sensitivity.
-Sleep deprivation and exhaustion
is probably the second biggest cause. It takes awhile just to recover
from the sometimes days spent in labour and delivering. After that, it
does not matter how good the little bundle of joy is, he/she will
inevitably disrupt his Mom's sleep schedule. Plus I think a lot of Moms
do not realize how tiring it is simply looking after a little person day
in and day out. All of these factors add up to fatigue and sometimes
exhaustion.
-Depletion of nutrients can also be another
contributing factor. Maybe not enough to cause a problem on it's on but
in combination with other things, if a new Mom's nutrient stores have
run low in some areas this can have big affects on her mood.
-Feelings of overwhelment
due to new responsibilities of Motherhood. Most of us do our best to
prepare for the arrival of our new baby based on what we have read,
advice from family and friends and our own personal experiences in life.
At the same time, there is only so much preparing one can do for such
an enormous life event. I have three children myself and with each
child, no matter my experience, it was a big adjustment.
-Expectations
play a very large role in how someone will adjust to being a new Mom,
whether it is the first time or the fitth time. The unrealistic
expectations Mothers place on themselves, the sometimes outdated,
unrealistic expectations society places on Moms, the expectations Moms
place on eachother through competitiveness and how society thinks of PPD
are all factors that require change. For more information on this
subject please see my article entitled Expectations.
If
you are a new Mom or Dad and are feeling unlike yourself or displaying
any of the symptoms listed in this article it is a good idea to talk to
someone. Talk to your spouse, a friend or a relative but most
importantly book an appointment with your family doctor. Even more
importantly, remember you are the expert on yourself, if you don't get
the help you think you need from one professional or resource, get a
second opinion or try something else. Often postpartum depression
requires more than one kind of help and time, don't think that one
doctor appointment or prescription will solve the problem.
So what are
some of the options that can help with postpartum mood disorders?
-Support Groups
are an excellant resource. They may not always be easy to find but they
are a great place to start if you need some help. Often when a person
is suffering from some type of mood disorder they feel very isolated,
alone and like they are the only person going through what they are
going through. Meeting other individuals dealing with similar problems
and knowing that you are not alone makes a world of difference. For
similar reasons Moms groups are also a very good resource as
meeting other Moms and discussing similar topics of interest can really
boost ones mood as well. Of course for someone that is severely
depressed, getting out of the house alone can be difficult never mind
joining a moms group so take baby steps - you will get there!
-Nutrition and Holistic Health is a worthwhile place to do some researching. There are so many options here for a new Mom such as seeing a dietitian for nutritional changes that can be made to help mood to seeing a holistic practitioner to learn more about supplements. Acupuncture, acupressure and massage are used to help Moms during the postpartum period as well. Just looking after yourself and making sure you eat healthy, drink lots of water and rest when you can
makes a big difference. Of course I know from personal experience that
this can be much easier said than done; Especially if you are not
feeling like yourself or are depressed it seems impossible to do the
very things you need. So please reach out and get help from wherever you
can.
-Exercise is another part of looking after yourself,
especially exercise geared toward the postpartum period. Exercise is
also considered to be really good for depression partly due to the
endorphins released in the body during exercise.
-Hiring a postpartum doula is another fabulous option if you would like a little extra help at home; that extra help could be all you need!
-Making an appointment to see a Psychologist
is also a step in the right direction. Psychologists are very
resourceful and compassionate. Sometimes all a person needs is someone
to talk to. Psychologists offer not only talk therapy but have many
resources at their finger tips and can help to point individuals in the
right direction.
-Psychiatrists differ from Psychologists in
that they are more like medical doctors, but for the mind and have the
ability to presicribe medication. Generally if one sees a Psychiatrist,
it is for a shorter period of time and the goal is usually to obtain a
prescription for some type of antidepressant. Antidepressants can be
helpful when nothing else seems to help and in severe cases of
postpartum mood disorders but sometimes simply mask the problem rather
than curing it.
-Publications, Books & Websites are very
helpful as well in that they are self-help and can be used at home.
Publications from your city geared towards Moms and families are filled
with all kinds of resources that can be helpful. Books on the topics of
pregnancy, postpartum health and postpartum mood disorders are great for
those of us who like to research and get to the bottom of things.
Websites too can offer a wide variety of resources and information.
Often
a combination of the above suggestions will have a new Mom feeling like
herself again in a matter of time. Eating healthy, getting rest and
exercise, supplements, maybe a few acupressure appointments and
a visit to a Psychologist will really help. In more extreme cases
however if you are really struggling and are not feeling better over
time then please make sure you examine other options. Talk to a
Psychologist or Naturopath or book an appointment with a Psychiatrist.
I want to summarize a little bit about the different kinds of postpartum mood disorders:
1. Baby Blues
Something
I have not yet discussed in this article as most people are pretty
familiar with this concept. Baby blues are for the most part a normal
part of the adjustment period after having a baby. Just as the body
needs to heal so does all of you. Feeling a bit down or overly emotional
or exhausted is to be expected in the first couple of weeks after
childbirth. Approximately 80% of new Moms experience Baby Blues within 2
to 6 weeks after having their baby. After the 6 week period it is
generally considered to be PPD rather than baby blues.
Symptoms include: mild mood swings including tolerable/manageable anxiety and depression
2. Postpartum Mood Disorders
Depression
Symptoms
include: changes in sleep pattern, forgetfulness, changes in appetite,
crying spells, unrealistic complaints, loss of interest in favourite
activities, tendency to be withdrawn ro uncommunicative, tendency to
feel overwhelmed quickly, feeling fearful, low self-esteem, not feeling
better when reassured.
Anxiety & Panic
Symptoms
include: intense feelings of fear, heart palpitations, fear of heart
attack, hyperventalation, chest pains and indigestion, numbing or
tingling sensation in hands and feet.
Obsessive Compulsive Disorder
Symptoms
include: Obsessive worries about health of the baby and your own
health, preoccupation with cleanliness and germs, overprotectiveness of
baby, fear of being alone with the baby due to concern of hurting
him/her, repetitive/obsessive thoughts.
3. Postpartum Psychosis
Postpartum
psychosis is very rare, experienced by less than 1% of new Mothers. It
is the most extreme form of postpartum mood disorders and can begin only
days after delivery. Postpartum psychosis can display similar symptoms
to PPD as well as the following
Sypmtoms include: Hallucinations, manic episodes, disconection between actual and perceived events.
Another condition that can sometimes arise after childbirth is Postpartum Post-Traumatic Stress Disorder.
Sometimes what transpires during labour and delivery has been so
traumatic for the new Mom that she experiences post-traumatic disorder
just as a person might after any other traumatic event such asa a car
accident or war.
Symptoms include: flashbacks to event, nightmares, feelings of helplessness, feelings of fear, panic attacks.
Other
terms used to refer to postpartum mood disorders or postpartum
depresison include: Postnatal depression, perinatal depression,
postpartum adjustment, postpartum exhaustion.
So in knowing
all of this, how do we prevent postpartum mood disorders? Can we? I am
far from an expert but I don't think we can prevent them entirely,
we can however lessen their effects if they do occur. By being aware,
informed and living a healthy lifestyle I think we can stay on top of
PPD. Awareness and information is really the key so that other new Moms
and young Moms can be much more prepared for PPD should it happen.
Tascheleia Marangoni
References
How to Make a New Mother Happy
A Doctor's Guide to Solving Her Most Common Problems - Quicly and Effectively
by Uzzi Reiss, M.D., OB/GYN & Yfat M. Reiss
The Mother of All Pregnancy Books
by Ann Douglas
Internet Research.
My own personal experiences with PPD.