Postpartum Depression

Jill Kane, Psy.D.

Although new moms are expected to shed some tears after delivery, many women are shocked to find that those are tears of misery rather than tears of joy.  Having a new baby is difficult. Dealing with a newborn while depressed makes it nearly impossible. The birth of a baby is supposed to be a joyful and exciting event, yet many moms find themselves confused about how badly they feel. A mom may wonder: What’s wrong with me? Why am I feeling this way?  Did I make a mistake? Shouldn’t babies be fun? Thoughts and questions like these may be symptomatic of a very treatable illness called postpartum depression.

Although many women suffer from postpartum depression, until recently the condition has been largely ignored and under diagnosed.  Often women are too ashamed to discuss their feelings with their doctors and families and remain silent about their struggle.  They feel embarrassed, ashamed, bewildered, lonely and too depressed to do much about it.

Most new moms are tired, overwhelmed, and moody.  If you just had a baby and feel depressed, you are not alone. Postpartum depression affects up to 15% of all new mothers. Approximately 80% struggle with the “baby blues,” which is a nice term for a not very nice short-term depression. The baby blues generally abates by the second week postpartum, but if it lasts longer you probably are dealing with a clinical postpartum depression. If you are concerned about yourself, ask the following questions:

• Do I feel sad?

• Do I cry a lot?
• Do I have trouble getting out of bed?
• Do I no longer enjoy activities that I used to like?
• Do I dread social visits?
• Do I feel hopeless, apathetic, or intensely irritable?
• Do I have insomnia?
• Do I have trouble bonding with my baby?
• Do I have negative feelings towards him/her?

If you answer yes to any of these questions AND your feelings last more than a couple of weeks, you are probably struggling with postpartum depression.

If you are thinking about hurting yourself or your child get help immediately.

It is important to understand that depression is not your fault. Nobody chooses to be depressed and generally women want to have a healthy and happy baby and family life. No one knows exactly why some women suffer from postpartum depression and other women don’t.  Interestingly, some women get postpartum depression after their first baby and not their second, or they get depressed after the birth of their third with no previous history of it at all.  There is not necessarily a pattern and it can happen to any mother.

It is generally believed that hormones play a large role in the process. As most women can already tell you, moods are greatly affected by hormones. After childbirth, there is a dramatic drop in estrogen, progesterone, and sometimes even the thyroid hormones. These hormonal changes can lead to fatigue and mood swings, especially when accompanied by blood loss from delivery and changes in blood pressure.

Other factors that can contribute to postpartum depression are sleep deprivation, anxiety over how to care for your child, feelings about changing your identity and feeling a loss of control over your life.  If your baby is demanding, if you are a single parent or feel a lack of support from your partner and/or family, if breastfeeding is difficult, if the birth was challenging, and if you are having financial problems or experiencing other life stressors you may be more prone to postpartum depression.

Postpartum depression is serious. Depression can interfere with parent-infant bonding, which hurts the baby psychologically, and also leaves mom feeling even more guilty and hopeless. If left untreated, it can lead to a more chronic depressive illness.

Thankfully, postpartum and other types of depression are very, very treatable.  Talk therapy, often in combination with medication, are the most common and effective treatments.  Of course, many women object to taking medication while breastfeeding.  The general consensus from physicians, however, is that while antidepressant medications do end up in breast milk, some end up there more than others.  Zoloft (a common medication prescribed for depression) seems to be the best medication for breastfeeding moms because less of it ends up in the breast milk. Prozac (another common anti-depressant) appears in larger amounts in the breast milk than Zoloft. Regardless, infants do not seem to be harmed by the anti depressant medication that their mother’s take.

Before taking any medication, weigh all the pros and cons. If your depression is severe and is impacting your ability to bond with your baby, it is probably better for you to take medication and for your baby to have formula if you are worried about the medication’s effects on your child. Leaving depression untreated is worse for both you and your baby than the medication itself. Remember, many moms have taken antidepressants while pregnant and breastfeeding and experienced no ill effects. Please talk with your doctor for more information.

Although talk therapy (generally in combination with medication) is a proven method to treat depression, if for whatever reason you don’t want treatment, here are some things you can do at home to make life a little easier.  Take a short walk as often as possible, nap when your baby naps, eat small amounts of healthy food frequently throughout the day, make arrangements for child care so you can have some time alone and some time alone with your partner or a friend.  Ask for help from family or friends, try an activity you used to enjoy, write in a journal, and utilize the mother’s club – talk to other moms – you might be surprised how much that helps!

One last note: Depression is the most common but not the only postpartum mood disorder women experience. Some women get anxiety symptoms postpartum.  Panic attacks feel like your heart is racing, you can’t catch your breath, and there may be chest pain and dizziness. Women can also get specific phobias about caring for their newborn.  For example, a mom with a postpartum phobia may avoid giving her baby a bath for fear of hurting him or her.  Postpartum OCD, can also occur. Symptoms include scary and intrusive thoughts and images about hurting the baby. Women who have postpartum OCD are terrified and even though they are good mothers, they have intense fears about their ability to care for their child. Women with postpartum psychosis hear voices in their head or have other sensory hallucinations. If you feel like any of these things are happening, either for you or someone you know please get help.  Postpartum depression, postpartum anxiety and postpartum psychosis are all treatable.  You don’t need to suffer. If you feel like you want to hurt yourself or hurt your baby, call for help immediately.

Having a new baby is hard for everybody. It’s a great challenge but also a great joy. If you are feeling all the stress and none of the joy, know that these feelings are common and there is help available. Don’t be afraid to ask.  You’ll be glad you did.

For more information and other resources, check out the website www.postpartum.net and the book Postpartum Depressions for Dummies by Shoshana Bennett,  Ph.D.

Jill Kane, Psy.D. is a Psychologist in Petaluma and San Rafael, CA

You can visit her website and www.drjillkane.com