Depression

Dealing with Postpartum Depression

November 18, 2019

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One in seven new mothers will suffer from postpartum depression—but for a condition that’s so common, not nearly enough people are talking about it. Instead, mothering newborns is often misleadingly rose-colored. Sure, most new parents will admit  feeling tired and overwhelmed, but at what point do these emotions exceed what’s to be expected? 

If you’ve recently had a baby or are currently pregnant, postpartum depression might not be at the top of your list to worry about (which is understandable, of course) but it is something that you should keep in mind—for your sake as well as the sake of your baby. Keep reading to learn more about postpartum depression, including:

  • More about postpartum depression as a mental health condition
  • Warning signs and risk factors
  • Treatment options for postpartum depression

Postpartum Depression: Beyond “The Baby Blues”

You’ve probably heard of “the baby blues,” a term that’s used to describe the exhaustion and dejectedness that can accompany adjusting to life with a newborn. While these feelings are undoubtedly both challenging and taxing, they are, to a certain extent, normal. Postpartum depression (PPD) and the baby blues might be similar in concept, but they aren’t the same: PPD is more severe, lasts longer, and jeopardizes the safety of both you and your baby. 

Differences between the baby blues and postpartum depression.
Suicide is a leading cause of maternal death, and thoughts of suicide are a common symptom of PPD. This is a major difference from the baby blues, which does not entail suicidal thoughts or ideation. Image courtesy of American Family Physician

It can be easy to mistake PPD for the baby blues, especially if you’ve never experienced depression before. Longevity is a key determinant when it comes to differentiating the two, as the baby blues shouldn’t last more than two weeks, at most. Additionally, as noted above, suicidal thoughts, ideation, and tendencies are a dominant symptom of PPD, and if you find yourself struggling with feelings of suicide, it’s absolutely crucial that you seek help immediately


Researchers at the University of California found that 60 percent of women with PPD “have obsessive thoughts focusing on aggression toward the infant.” Comparable to the intrusive, repetitive thoughts that are associated with obsessive-compulsive disorder, these types of thoughts are involuntary, recurrent, and potentially very dangerous. However, because of the shame and guilt that come with having thoughts of hurting their baby, many parents are reluctant to tell anyone that they are struggling with this aspect of PPD. 

It’s important to remember that you are not a bad mother for having these PPD-induced thoughts and, likewise, that these thoughts are a result of a mental health condition, not a moral flaw or even a genuine desire to harm your infant. If you can’t bring yourself to voice this specific symptom of PPD, a good place to start is seeking help for PPD in general. 

The most common types of depressive disorders.
PPD is among the most common types of depression, and like any other form of depression, it is a mood disorder that requires treatment. However, as many as 60 percent of those with PPD go untreated. Image courtesy of VeryWell

Men and PPD 

PPD is most commonly found in women, but it can also affect men: An estimated one in four men will experience PPD following the birth of a new baby. Because PPD is predominantly associated with women, it is even less likely to be recognized in men, both by men themselves and those around them. 

Men are more likely to experience PPD if their partner has it as well—in fact, a man’s risk of developing PPD could be increased by as much as 50 percent if his partner is struggling with the condition. 

Types of risk factors relating to paternal postpartum depression.
There are both internal and external factors that can contribute to a man’s likelihood of developing PPD, including biological risk factors and environmental or ecological risk factors. Image courtesy of Get Holistic Health

PPD: Warning Signs and Risk Factors 

Symptoms

Symptoms of PPD can start as early as within the first four months of the postpartum period up until a year after delivery. For the most part, symptoms of PPD are the same as those found in major depressive disorder. These include:

  • Depressed mood
  • Decreased interest or pleasure in previously enjoyed activities
  • Changes in sleep patterns (getting too much sleep or too little) 
  • Weight loss or weight gain
  • Feelings of guilt and/or worthlessness
  • Suicide thoughts, active or passive 
Symptoms of postpartum depression.
Again, these symptoms differ from the baby blues in that they last more than two weeks and make you feel hopeless rather than sad, angry rather than frustrated, and anxious rather than worried. Image courtesy of Hempure

How These Symptoms Can Affect Your Baby

PPD might make it difficult for you to care for your baby, therefore jeopardizing your baby’s health. Not only can this affect your baby in immediate ways—such as preventing them from forming a secure attachment to you—but it can also affect the way that they develop, leading to emotional and behavioral complications later on. 

Babies who do not bond properly with their mothers, a phenomenon that is also known as an insecure attachment, might have trouble interacting with people, causing them to become withdrawn. Furthermore, this can result in developmental delays and impairments, especially those involving social skills. 

Risk Factors 

While it is true that any parent can experience PPD, certain factors can put you at a higher risk of developing the condition. Psychiatric history, pregnancy complications, biological factors, and environmental factors can all contribute to the likelihood that a person will find themselves battling with PPD. 

Risk factors for postpartum depression
Knowing the risk factors of PPD can help prepare you for what to expect after you give birth. Image courtesy of EQW News

Psychiatric History

A prior history of anxiety and depression heightens the risk of experiencing PPD. This includes depression during pregnancy (antepartum depression), as well as non-pregnancy related depression. Similarly, if you’ve struggled with PPD after past pregnancies, you are more likely to have it again. 

Pregnancy Complications

Women who experience complications during their pregnancies have been found to be at a higher risk of developing PPD. Additionally, complications during birth, such as undergoing an emergency cesarean section, also create a higher risk of PPD. 

Biological Factors

As with the majority of health conditions, biology plays a role in how likely you are to develop PPD. 

  • Age — Maternal age is thought to influence PPD, and mothers between the ages of 13 and 19 have the highest rates of PPD, while mothers between the ages of 31 and 35 have the lowest.
  • Glucose Metabolism — Having a glucose metabolism disorder during pregnancy, such as diabetes, can contribute to your risk of developing PPD
  • Hormone Levels — The fluctuation of hormone levels can also make a person more susceptible to PPD. After giving birth, hormone levels drop, which can put you at a higher risk of depression.  

Environmental Factors

Environmental factors might not “create” PPD, but they can make you more likely to develop the condition. These factors include a lack of emotional support, financial instability, domestic violence, familial relationships, and the death of a loved one. 

Treating PPD

Finding treatment for any type of depression can be difficult simply because of the nature of the condition. Depression makes you feel hopeless and can lead you to believe that things will never get better. It’s important to remember that no matter how visceral these notions might be, there are treatment options out there that can help you to manage your depression and make your way toward recovery. 

Psychotherapy

Psychotherapy (informally known as counseling or therapy) is typically the first step that is taken when treating depression. If you know ahead of time that you are at a higher risk of developing PPD, it might be beneficial to start seeing a therapist—if you’re not already—from the very beginning of your pregnancy. That being said, it’s never too late to try therapy, and there are even therapists who specialize in treating PPD. If you’re not sure how to find one, ask your obstetrician, midwife, or general practitioner if they have any recommendations. 

Psychotherapeutic approaches to treating postpartum depression.
There are different types of therapy, and most therapists will use a combination of approaches to best suit the patient’s needs. Image courtesy of Semantic Scholar

Medication 

In cases where therapy is not sufficient, antidepressants are usually the next treatment recommendation that a patient will receive. Selective-serotonin reuptake inhibitors, a class of antidepressants, are most commonly prescribed to treat PPD. Some antidepressants are considered safe for breastfeeding, while others are not. Your doctor will be able to advise you about the best medication for you and whether or not you can breastfeed on it. 

Using medication to treat postpartum depression.
Research concerning medications and breastfeeding are continuously underway, and you should discuss the most up-to-date research with your doctor before making a decision. Image courtesy of Semantic Scholar

Non-Pharmacological Treatment Options

If you’re looking for treatment options beyond antidepressants, there are several types of non-pharmacological (not involving medication) treatments that exist. 

Electroconvulsive Therapy 

Electroconvulsive therapy (ECT) uses electric currents to induce brief seizures in the brain. During an ECT procedure, the patient is under anesthesia while a medical team conducts the procedure. It is most commonly used to treat treatment-resistant depression and bipolar disorder. ECT is thought to be effective in treating PPD, but it is not usually a first-line treatment. 

Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) uses magnetic pulses to penetrate the skull and stimulate the brain. Unlike ECT, TMS is non-invasive and does not require anesthesia. During a TMS treatment, the patient is fully conscious while a technician applies the therapy using an electromagnetic coil. TMS is generally considered to be safer and a less intense experience than ECT. Typically used to treat major depressive disorder, TMS has been shown to be a viable treatment method for PPD

Keep in Mind That Treatment Is a Process

Unfortunately, it might take some time to find the treatment method that works best for you. This can be disheartening for patients with treatment-resistant depression, but keep in mind that when it comes to treatment, there’s always another route to take and more options out there. 

Finding Help Means a Better Life for You and Your Child

Many new parents mistakenly dismiss symptoms of PPD as a “normal” part of having a baby. However, overlooking PPD isn’t just detrimental to your own health—it can also be detrimental to your baby’s. Taking care of a newborn can make life chaotic, but you should be careful not to disregard your personal well-being in the process. 

If you think that you might be experiencing PPD, make an appointment to talk to your doctor as soon as possible. Being depressed doesn’t mean that you’re not a good parent or that you don’t love your child, but it might delude you into believing those things. Remember that you deserve to enjoy parenthood and that finding help doesn’t just mean a better life for you—it also means a better life for your child. 


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