For nine months you prepared for your baby's arrival. You picked out a crib, you took childbirth classes, you spent hours debating over names. Finally, just when it seemed like you would be pregnant forever, your beautiful baby arrived. After a few days in the hospital, you and your little one were sent home to live happily ever after.
Or so you thought.
After a few weeks with your baby, something just doesn't feel right. Not with the baby, of course. They're perfect. But you just can't shake the feeling that this isn't your happily ever after. In fact, some days, it feels like you've made a huge mistake. You're overwhelmed, fearful and everything makes you cry. You know you love your child, but you just can't bring yourself to hold and fuss over them like you'd imagined all those months earlier. In fact, you'd rather be left alone. Sometimes, late at night, you even catch yourself thinking that you're a terrible mother and maybe having a baby was a huge mistake.
Then the guilt sets in. You're overwhelmed. And tired. And angry. Something just isn't right.
What Is Postpartum Depression?
While it's easy to feel isolated and alone during this time, you may actually be one of the 10-15 percent of women who suffer from postpartum depression. Postpartum depression is typically defined as a depressive event or mood disorder that occurs after giving birth. It usually presents itself within a month of having a baby, but postpartum depression can occur anytime within the first year. While symptoms often seem to resemble depression it is different because it can have a direct impact on another individual — your baby. If left untreated, postpartum depression can have a serious impact on bonding and attachment, both in the short-term and for years to come. This can potentially lead to developmental delays for your baby.
We know this seems a bit scary, but it doesn't have to be. With the right information and the right support system, this common and treatable condition can be resolved so that you can get back to feeling like yourself again and focus on being the best mother you can be. You are not alone and feeling this way does not make you a bad mother.
Causes of Postpartum Depression
It is impossible to pinpoint one cause of postpartum depression because there are a number of emotional and physical factors that may combine to predispose a new mother to this condition. In addition, because every person is different, the symptoms can vary between women. However, several common factors are believed to contribute to the likelihood that a woman will suffer from postpartum depression.
- Hormones: When you're pregnant, the levels of estrogen and progesterone in your body rise to assist the baby with development. Once you give birth and your body no longer needs these hormones in such large quantities, they begin to drop. And they drop fast. This sudden drop in hormones can trigger mood swings and depressive feelings in new mothers. While most women experience a few days of moodiness and fatigue, some women find that this sudden drop in hormones triggers a lingering depression. This can be hard enough to deal with on its own, but when a new mother is tired from midnight feedings, depressive feelings can be magnified and quickly become overwhelming. Low levels of thyroid hormones may also contribute to postpartum depression.
- Mental Health History: Women with a family history of depression, or who have experienced bipolar disorder or depression before, are at an increased risk of postpartum depression. This includes women who experienced depression during pregnancy or postpartum depression after a previous pregnancy. Women who have problems with alcohol or drug abuse or women who had mixed or negative feelings about being pregnant in the first place are also at higher risk.
- Stress: Women who were experiencing stress prior to giving birth may be more likely to find themselves dealing with postpartum depression. Stress can come from a variety of sources, but common ones include the death of a loved one, financial stress or loss of a job. Marriage or relationship struggles can also negatively impact stress levels. This is especially true if their stress factors continue after the birth. Stress factors vary from person-to-person, but if a woman doesn't have support from a partner, is very young, didn't plan to become pregnant or has major family issues, she may be more likely to experience postpartum depression.
- Labor and Birth Complications: A premature birth, difficult delivery or hospitalization of a new baby beyond normal postnatal care can also play a role in postpartum depression. Women who had trouble getting pregnant in the first place may also be at higher risk.
- Lack of Support: This category also corresponds with stress factors, because a lack of support can be a source of significant stress for a new mother. If a new mother doesn't have a strong social network or consistent help from a partner or other family member, she may be more likely to develop postpartum depression.
- Multiple Children: Mothers of multiples — twins, triplets, etc. — may be at higher risk as well.
- Negative Thoughts: It may sound strange, but women who experience a lot of negative feelings and thoughts about being a new mother may also be at an increased risk of developing postpartum depression. For example, if a woman excessively worries about being a good or perfect mother, worries about not being the woman she was before birth, worries about the physical changes in her body or simply doesn't take time for herself, she may be more likely to become depressed following the birth of her baby.
Symptoms of Postpartum Depression
Just as the risk factors for postpartum depression can vary from woman-to-woman, so can the symptoms. While there are a number of common symptoms, each woman may experience different symptoms or a different combination of symptoms. Therefore, it's important to talk to your doctor about any new or different feelings you are experiencing, especially if you find that they are impacting your ability to care for your new baby.
But, in general, women suffering from postpartum depression report experiencing some combination of the following symptoms:
- Feelings of sadness, hopelessness, rage, anger or being overwhelmed, along with general moodiness
- Excessive worrying or increased anxiety
- Physical problems, including headaches, digestive issues and muscle aches
- Changes in appetite, either eating too much or not eating enough
- Inability to perform basic tasks, such as caring for the baby or household chores
- Unexplained or excessive crying
- Trouble bonding with the baby
- Lack of interest in hobbies and activities previously enjoyed, which may include sex
- Changes in sleep patterns, including sleeping more or being unable to sleep
- Difficulty remembering things and focusing
- Thoughts of self-harm or thoughts of harming the baby
Postpartum depression usually begins to manifest itself within the first month after delivery, but there are cases where it does not show up until later. In the beginning, you may think that you have the "baby blues," a common term for mood swings combined with feelings of fatigue and worry that may be present in the first few days after your baby arrives. These feelings, which about 80 percent of mothers experience, go away within the first two weeks after you've had your baby. Postpartum depression differs from the "baby blues" because its symptoms are more severe and they do not go away quickly.
Pay close attention to how you are feeling over the span of two or three weeks. If you feel that you are experiencing common symptoms of postpartum depression that continue for an extended period of time, it may be time to talk to your doctor. Sometimes a woman may not realize that PPD is what she is experiencing. There can be many reasons why a woman might not acknowledge the issue or ask for help, including:
- Lack of knowledge: Many new mothers don't know the signs or symptoms of postpartum depression.
- Fear: This can include fear of someone thinking she isn't a capable mother, fear of going on medication or even fear of losing her child.
- Guilt: Many feel guilty or ashamed that they are experiencing these feelings and the last thing they want to do is admit them to someone else.
- Lack of support: Some women try to tell a family member, friend or partner about how they are feeling but, for whatever reason, they have felt dismissed or judged rather than supported. They may feel that they need to just deal with things on their own.
In rare cases, some women will experience postpartum psychosis, which is a serious mental illness different from postpartum depression. Often appearing within two weeks after giving birth, postpartum psychosis symptoms include an inability to sleep, confusion, hallucinations, obsessive thoughts about the new baby, paranoia, refusal to eat and thoughts of harming yourself or your baby. This is not postpartum depression and if you are experiencing these symptoms you should seek out immediate medical assistance.
Treatment Options for Postpartum Depression
If you suspect that you may be experiencing the symptoms of postpartum depression, it's important to talk with your doctor as soon as possible. Why? Because postpartum depression isn't something you need to just "get through." It's something that can and should be treated. On average, one out of every nine women experiences postpartum depression. It doesn't mean you are a bad mother or you aren't doing things right.
It does mean that you should ask for help. Your doctor can evaluate your symptoms and they may also run tests.
If your doctor believes you are experiencing postpartum depression, they can suggest the best course of treatment to help you work through it. These are two common options:
- Talk therapy: Counseling is often an important method for overcoming postpartum depression. Talking with a therapist can help a new mother work through the feelings she is experiencing, as well as teach her coping strategies for how to overcome her feelings when they are strongest. If postpartum depression is connected with additional issues, such as relationship issues or other problems at home, a therapist can help a new mother work through those as well.
- Medication: If your doctor feels that it is necessary, medication may be prescribed. There are a number of options available, including ones that are safe to take while breastfeeding. You can work with your doctor to determine which antidepressant is the best choice for you and your situation.
In addition to consulting your doctor, there are several things you can do on your own to help manage some of your symptoms on a day-to-day basis.
- Find someone you can talk to — Having a trusted friend or family member lend a listening ear can be helpful.
- Don't be afraid to ask for help with chores, errands and even caring for your baby. This is the time to call on your support network to pitch in.
- Take time for yourself — even just 15 minutes a day — to read, take a bath, talk to a friend or do something you love.
- Be active. Take a walk, join a gym — many offer childcare while you workout — or find something else that gets you moving around.
- Eat healthily. Just like you did when you were pregnant, be intentional about the foods you're eating. Make sure you are eating a healthy, well-balanced diet including lean meats, whole grains, and plenty of fruits and veggies. Try to keep your salt and sugar intake to a minimum.
- Avoid alcohol. Many people don't realize that alcohol is a depressant. If you're taking medication, it can also interact with the medication and interrupt its impact.
- Start a journal where you can record and process your feelings.
- Try not to make big decisions or changes during this time. Unless it's unavoidable for some reason, it's not the time to change jobs, move or do something else that will increase your stress levels and intensify negative feelings.
- Set small goals each day. Celebrate when you accomplish them and give yourself grace when you don't.
- Don't be so hard on yourself. Even the best of parents become overwhelmed.
The Effects of Postpartum Depression
What many people don't realize is that the effects of untreated postpartum depression on both mothers and their children can be far-reaching. And they are not short-lived. Postpartum depression can have a long-lasting impact on both mothers and their babies throughout childhood. Without treatment, even once the depressive feelings recede, their impacts can be felt.
One of the biggest problems is that postpartum depression has been shown to negatively impact the bond between a mother and her baby during a very critical time in a child's development. The first days and weeks after having a baby are a critical bonding time for a mother and child. Interaction, touch, talk and attention are all crucial to the baby's sense of well-being, as well as solidifying the bond between mother and baby that began in the womb. When a mother suffers from postpartum depression, often her ability to bond with her baby through words, attention and physical touch can be compromised. She is less likely to play and provide the affection that her baby needs as it begins to develop. Mothers who are suffering from postpartum depression are less attentive to their children, meaning they may be slower to respond and attend to their baby's needs in a nurturing manner.
These interactions in the early months of a baby's life have a serious impact on the bond between a mother and child later on. If left untreated, the detachment in the early months can result in greater instances of psychological issues for children as they grow, leaving them with trust issues, as well as increasing their risk of experiencing anxiety and depression at a young age. And, besides that, if there was a serious detachment between the mother and her child in the early years, that detachment may continue with less-than-ideal interactions as the child grows.
Mothers experiencing postpartum depression may also experience strained relationships with their partner. When a mother is deeply entrenched in her depressive feelings, she also may not recognize that her partner is experiencing their own feelings. In fact, roughly 10 percent of new fathers have been found to experience their own version of postpartum depression or anxiety, but they don't tend to voice their feelings and may simply become withdrawn or angry. Even if a husband or partner isn't experiencing depressive symptoms, their response — or perceived response — to the new mother's feelings may prompt hurt feelings and increased distance in the relationship.
Besides placing a big strain on romantic relationships, postpartum depression can lead to conflict with family members or friends.
Seeking Help for Postpartum Depression
If you're experiencing any of the things you've read about here, you may feel nervous or scared. You are also probably feeling guilty for the thoughts and emotions tumbling through your mind. This isn't how you pictured your baby's early weeks and months. But no matter what you've heard or what someone else has said, postpartum depression isn't something to just "get over" or endure. It's a very common condition. And a very treatable one.
The first step to treating postpartum depression is always to talk with your doctor or healthcare provider. They are a great resource for information and can offer access to valuable tools and resources to help you cope. But sometimes that just isn't enough.
Located in the foothills of the Smoky Mountains, Brookhaven Retreat offers a compassionate, holistic approach for women experiencing a variety of mental health issues, including postpartum depression. By offering a women-only, residential treatment center, we are able to focus on the unique emotional and physical health needs of women experiencing postpartum depression, as well as anxiety, trauma, mood disorders and addiction. We offer customized treatment plans to meet the needs of specific individuals.
If you or a loved one are experiencing the symptoms of postpartum depression, we invite you to explore our programs and see if we can help. Contact us for more information today.