If you’ve experienced postpartum depression you’ll know that it’s a really intense time, for many reasons. Someone going through postpartum will notice hormonal changes, body changes, pain, adjustment to a new family member, a new dynamic with their partner or family, sleep deprivation, along with other brain changes all happen at the same time. This is really, really, really hard.
A lot of new parents will feel an immense amount of guilt for not being thrilled postpartum. Not everyone feels the attachment and intense love that everyone talks about. If you have felt this way, you are NOT alone. It’s totally normal and we as a society just don’t talk about it enough.
Transitioning into a new role is hard, whether that means you are transitioning to be a first time parent, a second time parent or an eighth time parent. Postpartum depression will not spare you. It doesn’t matter if you’ve never had depression, or if you have had seven children before and never experienced postpartum depression. You can still be at risk.
It doesn’t make you a bad parent if you’re having bad thoughts or if you’re not feeling absolutely over the moon with this new baby. This is a normal experience that professionals are equipped to help with.
A documentary I would beg you all to watch is called When the Bough Breaks which reviews the significant impact of untreated postpartum mood disorders. You can find it on Amazon Prime. In the meantime, let’s address some signs and facts of postpartum depression.
What is postpartum depression and the baby blues? And when can it begin? The baby blues are a very normal occurrence expected for the initial first two weeks after a person gives birth. With hormones shifting and physiological changes happening as you start to regulate back to your pre-pregnant body, a lot of emotions can occur.
The baby blues can come on as quickly as the day you give birth, but should resolve in two weeks.
If you are having symptoms beyond two weeks, you need to start considering that this has morphed into a postpartum depression.
Another thing that a lot of people do not know about is D-MER. D-MER is also known as Dysphoric Milk Ejection Reflex. It is an intense sadness that comes only when milk is being let down during breastfeeding. If you are feeling fine mood-wise, but notice during breastfeeding you feel overwhelmed, sad, tearful, irritable, or restless - please let your provider know. This is not the same as disliking breastfeeding, or being in pain because of breastfeeding. This is an uncontrollable, physiological response causing intense emotions during breastfeeding that cannot be rationalized. It can be scary and confusing for moms. Learn more here.
What are the signs?
Inability to sleep while baby is sleeping
Irritability
Sadness
Anger
Appetite changes
Anxiety
Restlessness
Inability to get out of bed
Lack of attachment/care for the baby
Guilt
Shame
Hopelessness
Inability to find joy in things
Thoughts of being better off dead
Thoughts of potentially harming your baby
These symptoms last beyond the initial 2 weeks following the birth.
There are also other possible developments such as postpartum OCD or postpartum psychosis. Postpartum OCD may include frequent checking on the baby to alleviate anxiety or prevent a negative consequence. Postpartum depression can include intrusive images. Some may have horrible thoughts about killing their baby, dropping their baby, hurting their baby, someone else hurting the baby and so on. In most cases, these are just thoughts with no real intent.
Postpartum psychosis is something that a partner or family member would need to monitor for. This includes a very drastic change in personality and mood, and is typically found in patients who have an underlying bipolar disorder. There may be paranoia, suspiciousness, delusions (that cannot be challenged - the person really believes it and does not see their belief as irrational), hallucinations, an inability to sleep for days, strong irritability and strong mood swings. Sudden religious talk for a non-religious person may also be a sign. Postpartum psychosis is a medical emergency which requires urgent treatment and occurs in 1 out of every 1,000 births.
Who has a higher chance of getting postpartum depression? There are a lot of risk factors that play into postpartum depression. If you have a personal or family history of depression or anxiety, you are at higher risk. If you have poor support from your relationship/friends/family or a lot of financial stress, you may be at higher risk. Having a baby in the NICU can be traumatic, and also predispose people to postpartum depression. Medical conditions that may predispose you to postpartum depression include diabetes, severe PMS or thyroid imbalances. Traumatic births, struggles with breastfeeding or throughout pregnancy, and recent losses/traumas are also huge risk factors.
Does it go away on its own? Sometimes. It could fade out within 3-6 months. Sometimes it can be years. Sometimes it never goes away without treatment. I’ve had patients who are 10 years postpartum, started struggling with depression after birth and never found relief until seeing me a decade later.
I would strongly encourage you to reach out to a therapist, your doula or your birth provider to talk about your symptoms and your options.
What are the best ways to treat it?
There are a lot of options. Therapy is DEFINITELY recommended, and there’s evidence to provide that it reduces postpartum mood disorders. Your therapist will be able to help you navigate through the emotions, and to develop proper coping skills to heal. There are also support groups available both virtually and in-person.
Ensuring you have proper self-care is also vital to getting better. This includes reaching out to your personal support system, asking for help and allowing others to help with baby or perhaps allowing others to help you meal prep nutritious food. Diet and exercise can be beneficial. Ensure you have time to relax and spend time with your partner or social support group.
If you feel very irritable or overwhelmed that your baby is crying, remember that crying doesn’t kill babies! Just walk away, hide in the bathroom, cry if you need to and take a break. Also if you have a baby who won’t stop crying, ask for help. A pediatrician, chiropractor, lactation-specialist, midwife or other professional may be able to help you.
Sometimes medications can be amazing and life-changing too if you are open to that option. I specialize in the perinatal/postpartum population -- we could talk about options and how they affect breastfeeding, your baby and you.
For very severe cases of postpartum psychosis, medication may be necessary for the safety of yourself or your baby.
Helpline for PPD: 1-800-944-4773
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