What is Postpartum Depression?
Disclaimer: Blogs are a great place to get helpful information but they should never replace mental healthcare and this blog is no exception. These blog posts do not replace mental heath care and is not medical advice.
The “Baby Blues”
Many of us experience mood changes while pregnant and when postpartum but does this mean that you have postpartum depression? I attended a presentation by Dr. Helena Vissing, perinatal mental health certified psychologist of Maternal Mental Health NOW. This article explores some of the points she discussed regarding what postpartum depression is and what it isn’t, as well as what you can do if you suspect you are experiencing postpartum depression.
What is postpartum depression?
Postpartum depression is actually the same as a major depressive episode but it occurs post-birth, which is why it’s called postpartum depression. However, many women experience depression pre-birth or even a year after birth, this is still a major depressive episode but it is instead called peripartum depression. So, if you go to a mental health provider they will officially diagnose you with a major depressive disorder but they will note that the onset was pre, during, or post birth.
To take it a step further, there is a branch of mental health called perinatal mood and anxiety disorders (PMADs). PMADs includes perinatal depression/anxiety and anxiety/depression that occurs before conception or between pregnancies.
Who is at risk?
You may be at a higher risk of developing PMADs if you:
Experience a lack of support from family/important relationships
Experience domestic violence
Experience homelessness
Have a history of other mental health issues
Perceive that you are under high stress with little support
Your mother experienced PMADs
Have a trauma history (this is the biggest risk factor)
Typically have a difficult time regulating emotions
Have a high ACE score
Have a family history of anxiety and depressive disorders
Experience difficulty with menstrual pain
Have long or short time periods between pregnancies
Have a history of inflammation
Have other medical issues
Have or are undergoing fertility treatments
Financial stress
Premature delivery
Difficult delivery or pregnancy
Have a sick infant
What postpartum depression isn’t:
It’s important for us to remember that after giving brith and throughout pregnancy hormones fluctuate dramatically. Fluctuations in your mood are normal and may not be a sign of depression.
Story time:
I can remember that after giving birth to my daughter, day 3 postpartum I was bawling my eyes out. I was having difficulties with getting used to the pain of nursing and my nipples were starting to get injured. The lactation nurse visited me three times and said that my daughter was latching perfectly and I would get used it in a couple of weeks. It felt to me like she was saying my daughter was doing everything right and I was the problem, which made me feel worse.
A technician came in to check my vitals as I was bawling and I told her “not now,” a few times. (I mean honestly, does it look like the best time to get my vitals?) My husband asked her to get a nurse instead and the nurse came in to talk to me, she told me that day 3 postpartum is usually the hardest emotionally because my body was experiencing rapid changes in hormones. She also suggested I try pumping to see if the pain stops. Thank God for that nurse because I thought something was wrong with me. And pumping ended up being the way that I breastfed my daughter until she was a little over a year old.
[Me awkwardly pumping with Elvie pumps while trying to take a picture]
My “baby blues” got a lot better after switching from nursing to exclusively pumping because I was no longer in pain and my daughter was getting the nutrition she needed. And because she had a full tummy after her feedings, she was sleeping through the night by 2.5 months. Which meant I was sleeping through the night (for the most part, I still woke up once or twice to pump so I could build a freezer supply). Sleep has a major impact on our mental health. If we are not getting enough sleep we are at an increased risk of depressive symptoms, anxiety, and even psychotic symptoms.
I’m sharing that experience because it points out a couple of important things for us to consider: if your mood gets better as the postpartum period progresses or if it seems conditional (my mood got better after I switched to pumping), it may not be postpartum depression. We should be aware of what’s going on with our hormones and think through whether we are experiencing a mental health crisis or not.
Although I felt like absolute crap, I didn’t go running to a psychiatrist. It was important for me to know what was going on in my body so that I could rationally think about if I was truly experiencing a mental health crisis or if what I was experiencing was normal. I want to point out that what’s normal for me is not normal for everyone. And if you feel like you need help, you should get help.
I decided that because I was still able to function, I was still taking care of my daughter and spending plenty of time bonding with her, and because I was aware of the hormonal changes going on in my body, I didn’t need professional help.
If you feel like you can’t cope or that the stress, hormones, or depressive feelings are too much for you to deal with. I highly recommend getting professional help.
How can postpartum depression impact the baby?
If you are experiencing peripartum depression (from conception through/post birth), you may have higher cortisol levels (cortisol is a stress hormone). These cortisol levels can negatively impact the baby’s growth and can even increase the baby’s cortisol levels. Babies with higher cortisol levels can be more “colicky,” making them difficult to care for, especially if you are already experiencing a mood disorder.
If you experience depression after the birth, this may impact your bonding with the baby. Many people don’t know that the first 0-5 years of human life are probably the most important because they build the foundation for how we handle relationships, stress, and how we interpret the world around us. This is because in these first years of life the brain is developing rapidly and constantly creating neural connections that we will use through the lifespan.
Notice that in my story I noted that my bonding with my daughter was not impacted by my mood, this helped me to determine that I did not need professional help. If I noticed that because of my mood I didn’t want to hold her, spend time with her, etc. I would have gotten help.
How to get help
The following resources are recommended by Dr. Vissing for help with PMADs. These websites can point you to directories that have mental health providers who specialize in maternal mental health as well as information on support groups, helplines, and other helpful tools.
Postpartum Support International
National Perinatal Association
Maternal Mental Health Leadership Alliance
Dr. Vissing also suggests you take the following steps if you suspect you are experiencing PMADs:
Find a mental health therapist, if you can, you should find one who specializes in perinatal mental health
Find a reproductive psychiatrist
Keep your health providers informed
If necessary use
Lactation consultants
Postpartum doulas
Social workers
Pelvic floor therapy
Support groups
Helplines
Ask family/friends for help
I hope this answered some questions you had. You can also contact me to schedule a counseling session or consultation.