Finding out you are pregnant brings with it a long list of things to do. There’s getting the nursery ready, scheduling monthly checkups and exams, buying baby clothes and stocking up on diapers, making sure you are getting enough rest and eating right, picking out a name and so much more.
Having a baby should be one of the most exciting and magical times in a woman’s life. However, even so, for some women, having a baby not only brings a lot of changes physically, but also mentally.
Nearly 80{b4bb8ddb70249670c85c66def16f765bd40a90ddaa69bcee7e340d9a7e1b07a9} of women who give birth will experience what doctors call “baby blues.”
“Baby blues” can include feeling sad, constant crying, having trouble sleeping, eating or making decisions; feeling worried or nervous, especially about being a good mother; and feeling overwhelmed or trapped.
“Baby blues” typically occur within the first three days after giving birth when the levels of estrogen and progesterone in a woman’s body dramatically plummet. The symptoms usually last for about two weeks before going away on their own.
For some women, the depression, anxiety, worry, sleeplessness and other symptoms turn into something more serious called postpartum depression.
Angela Holmar Wood from Evans gave birth to her son Elijah in April during the early height of the COVID-19 pandemic.
“I would say that was probably what caused most of it other than hormones,” she explained. “I always suffered from anxiety and have been on anxiety medications but I think with everything going on, being a new mother, my mother is deceased so not having support from a biological family member didn’t help.”
Holmar Wood had feelings of “just driving away” and that she was a “detriment” to her family.
“Is my mental health, is my negativity going to harm my son and make him feel bad?” she asked herself. “Would I want him to be around that? And I said ‘no’. So, why would I want to put him through that, so just walk away.
Walking away wasn’t a solution, Holmar Wood said. That’s when she knew things were more than just “baby blues,” anxiety, hormones or worrying about COVID-19, and she needed to seek professional help.
“I went straight to a therapist and got medication management,” Holmar Wood said. “I have a really supportive therapist. Talking with a therapist is the way to go to being able to not just manage postpartum but also life in general.”
When depression is more than “baby blues”
Postpartum depression, PPD, occurs in about one out of every 10 women and is more severe and longer lasting than “baby blues.” PPD is considered a form of major depression that can begin at different times during or after a pregnancy.
“It’s interesting because it can happen during pregnancy, it can happen following delivery and it can happen, according to most sources, up to a year after delivery,” Dr. Natalie Rochester, an obstetrics and gynecology specialist with UCHealth said. “Postpartum depression can be mildly symptomatic or it can be severely symptomatic.”
Learn more about postpartum depression through this video https://www.youtube.com/watch?v=zbUl2hZNlKY&feature=youtu.be
There are a number of factors that can contribute to a woman having postpartum depression. Some of the factors include:
- A history of depression prior to becoming pregnant.
- Age at time of pregnancy — the younger the woman is, the higher the chances of experiencing PPD.
- Ambivalence about the pregnancy.
- The number of children you have — the more children you have the more likely you are to become depressed.
- Limited social support
- Marital conflict
Women can experience PPD with their first child or subsequent children. Data shows that women who have had PPD with one child have a higher chance of having PPD with another child.
While PPD and the “baby blues” have similar symptoms — sadness, anxiety, irritability, etc. — the difference between the two is how these symptoms affect a woman’s daily activities and how long they last.
PPD often keeps women from doing daily activities such as getting out of bed, showering, eating, connecting with family and more.
“Asking what you are doing for fun, what are you doing for self-care or what is something you are looking forward to are questions that I ask my patients,” Rochester said. “If people can’t think of anything they are looking forward to or what they do for fun, that is really concerning to me and makes me ask more questions.”
Physicians addressing PPD early
More healthcare providers like Rochester are addressing PPD the instant a patient calls into the office saying they are or may be pregnant.
“We give them a packet of information of signs and symptoms that we want to know about. So we give these moms information upfront that says it’s normal to be nervous about having a baby, its normal to be nervous about being a mom for the first time, but we want you to know these are signs and symptoms we would be concerned about,” Rochester explained. “And then we talk about it during pregnancy; it’s part of their care and is part of their visits.”
The exact causes behind PPD are still being researched, Rochester said, but medical professionals do believe that the changes in hormone levels and life stressors contribute to the chances of a woman developing PPD.
“For a lot of people, that shift in hormones really rocks their world and changes how they feel physically and how they feel emotionally,” she said. “We think there is an interplay in how those hormone level shift and postpartum depression. We all respond differently to hormone changes.”
Like many mental health disorders, PPD treatment is based on the severity of a woman’s symptoms.
Some of the treatment options for PPD include participating in talk therapy, exercising Cognitive Behavioral Therapy or CBT, joining support groups and taking medication. Women who breastfeed can often take medication for PPD and should discuss their options with their doctor.
Organizations like Postpartum Support International, PSI, which works to increase awareness between the public and healthcare professionals about the changes women experience during pregnancy and postpartum, provides support for women, men, LGBTQ couples and more.
PSI offers in-person and virtual support groups, connects people with mental health providers in their areas, offers medication resources and educates women, families and healthcare professionals about pregnancy, PPD and other mental health disorders as well as support for mothers who have given babies up for adoption or have babies in the Neonatal Intensive Care Unit.
“Perinatal Mood and Anxiety Disorders, like PPD, are time limited. You get better and you get well and you move on if you get the treatment you need for your particular situation,” Chris Raines, PSI Board chairperson said. “PSI really has its finger on the pulse of what’s going on and provides a variety of resources.”
One of the myths that surround PPD is that it isn’t just depression, PPD is a combination of symptoms like anxiety and/or insomnia along with depression, Raines said.
“People think of it as postpartum ‘depression’ and a lot of women don’t come in because they think ‘I was just really anxious and I couldn’t sleep’,” Raines explained.
Another myth is that if a woman admits to having PPD, their child will be taken away or that having PPD makes them a “bad mom” and there must be something wrong with them.
“There’s a lot of fear and anxiety around PPD. Especially now with COVID, pregnant women are very vulnerable,” Raines explained. “From March when COVID started, we have more than 16 online support groups to help negotiate isolation in your house and about the virus.”
More severe cases of PPD or postpartum psychosis, a severe mental illness that can cause delusions, visual or auditory hallucinations, insomnia and restlessness, may call for hospitalization.
“In our community there’s been a couple of patients who have had hospitalizations and even a couple of suicides postpartum,” Rochester said. “In our country, the number one cause of maternal death is maternal suicide in the first year after delivery.
“That is a hard pill to swallow because our society sells that having a baby should be happy and wonderful and glorious. But it’s also really hard and really bad for a lot of people.”
Women who experience severe PPD or postpartum psychosis usually have an underlying mental health condition or have been previously diagnosed with a mental health condition and treated, Rochester said.
PPD doesn’t just affect women, Raines said. Men can also experience PPD after the birth of a child.
“Research shows that up to 10{b4bb8ddb70249670c85c66def16f765bd40a90ddaa69bcee7e340d9a7e1b07a9} of men have a mood disorder after delivery, “Raines said. “If their partner has PPD, then their risk increases up to 50{b4bb8ddb70249670c85c66def16f765bd40a90ddaa69bcee7e340d9a7e1b07a9}. It looks a little bit differently with partners, but it can be devastating. Men tend to just check out and go out and work on a car or something; that’s how they deal with it. So, communication can be difficult.”
Sharing PPD experiences
After a hard labor and delivery and her daughter having to be in the NICU, Regina Haugland-True didn’t feel the joy and excitement that she thought she should be feeling after having a baby.
“I was crying a lot and felt totally overwhelmed. I was angry about how everything had gone with her birth, I was even a little traumatized by it,” Haugland-True said. “There would be times in the middle of the night I would be frantically Googling if she was going to die from dehydration because I’m not producing enough breast milk.”
There were times she even contemplated if things would be better if she wasn’t here, she explained.
“Then I would think ‘no, that’s ridiculous’,” Haugland-True said. “It would be way, way worse on my husband if I wasn’t around. But it was just so hard.”
After about two months, Haugland-True decided that she needed to talk to someone about her feelings and reached out to a therapist for help.
“I also figured out that I needed to get out of the house once a day. I couldn’t be home all day with her; I was getting exhausted with that,” Haugland-True said. “I started to ask my husband to help with more things. It was a slow process.”
Haugland-True’s experience with PPD inspired her to help other mothers.
“After calling around and realizing that there weren’t many people that specialize in this or not being able to get in fairly quickly, I knew there had to be more resources for other women,” she said. “A lot of my friends talked about how they didn’t know where to turn for help. So that really inspired me to be another resource in my community when I opened my own private practice.”
Through her practice Seeds Counseling, Haughland-True helps guide women and their families through the PPD process through talking about their struggles, challenges and feelings.
“Finding other moms who have been there and knowing that you are not this awful monster because you are having these disturbing thoughts at times or you’re crying all the time — having somebody else who gets that is so important,” Haugland-True commented.
One thing Rochester stresses for women who may be experiencing PPD is that having the disorder doesn’t mean you are “crazy and you’re going to hurt yourself and your baby.”
“That’s what we hear about in the news and that’s what people put a stigma on,” she said. “I think that there’s a lot of things that make it hard to be a mom. Having a baby does change you and it changes you forever. But you shouldn’t feel like your world is out of control.”
Postpartum Online Resources
Postpartum Support International
National Alliance on Mental Illness