While the birth of the baby is bound to bring joy and delight to the mother, it can sometimes be confusing to see the opposite happen. It is normal to occasionally miss your pre-baby life or to wish that certain things about being a mother were easier. But if you are feeling sad, excessively worried, unable to enjoy life, wishing you could escape or end your life and are unable to eat or sleep for an ongoing period of time, this is not normal motherhood, and you do not need to continue to feel this way. Lasting misery usually means that Postpartum depression (PPD) is lurking. The sooner you recognize your symptoms, the sooner you can get started on feeling better, so don’t despair. Knowing the clinical facts are the first step towards wellness.
What is PPD?
Postpartum depression, also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes [1]. It may occur soon after delivery or up to a year later. Most of the time, it occurs within the first 3 months after delivery [2]. It is normal to experience exhaustion or sadness during or after pregnancy, but if it prevents you from doing your daily tasks, it could indicate postpartum depression.
Postpartum depression is not the same as the “baby blues,” a much more common condition that affects as many as 85% of new mothers. The baby blues are uncomfortable, but usually doesn’t interfere with functioning as a mother, and it almost always goes away within a few weeks.
Causes of PPD
The following factors increase the possibility of postpartum depression in new mothers [3], [4]
1. Emotional fatigue is caused due to stress from pregnancy, illness, financial constraints, social isolation, or health problems in the newborn.
2. Depression, bipolar disorder, or an anxiety disorder suffered before pregnancy, or during a past pregnancy.
3. Physical factors like inadequate diet, sleep deprivation and low thyroid hormone levels.
4. Changes in hormone levels during and after pregnancy that may affect a woman’s mood. This happens as progesterone and estrogen levels are heightened during pregnancy, and normalized after delivery.
5. Experiencing a stressful event during the pregnancy or delivery, including personal illness; death or illness of a loved one, a difficult or emergency delivery, etc.
6. History of mental illness in the family.
7. Taking alcohol, illegal substances, or smoking (these also cause serious health risks for the baby).
8. Unplanned pregnancy, or having mixed feelings about the pregnancy.
9. Having a poor relationship with your significant other or being single.
10. Physical changes in the body during pregnancy and after delivery.
11. Having less time and freedom for oneself.
12. Worry regarding the ability to be a good mother.
13. Little support from family, friends, or spouse or partner.
Signs and Symptoms of PPD [5]
Before being clinically diagnosed with PPD, your symptoms would have to persist for two weeks or more. The symptoms of PPD fall into three main areas:
(1) Physical symptoms
(2) Cognitive symptoms (symptoms that impact your thinking)
(3) Emotional symptoms
Physical Symptoms
1. Oversleeping, or sleeplessness even after being tired and exhausted.
2. Suffering from physical aches and pains, including frequent headaches, stomach problems, and
muscle pain.
3. Loss of appetite or uncontrolled eating.
Cognitive Symptoms
1. Having trouble concentrating, remembering details, and making decisions.
2. Severe anxiety accompanied by panic attacks.
3. Persistently doubting your ability to care for your baby.
4. Thinking about harming yourself or your baby.
5. Loss of interest in any work or hobbies.
Emotional Symptoms
1. Feeling sad, hopeless, empty or overwhelmed.
2. Crying more often than usual or for no apparent reason.
3. Worrying or feeling overly anxious.
4. Experiencing anger or rage.
5. Withdrawing from or avoiding friends and family.
6. Having trouble bonding or forming an emotional attachment with your baby.
7. Extreme mood swings.
8. Worrying excessively about the baby or being uninterested in caring for the baby.
The Degrees of PPD
PPD is not the same for every woman. Some women may have mild symptoms while others may be more severely affected. Each of these is a real illness that needs attention. Here is what the different degrees of PPD look like
Mild- You do not fully enjoy being a mom these days and you have some symptoms of depression, but you can still go through the things that you have to do to take care of yourself and your baby.
Moderate- You feel down all the time and have trouble being a mom and connecting with your baby. You have symptoms of depression and are not your normal self. It is really hard to get through each day.
Severe- Your mood is extremely depressed and you have most of the symptoms of depression. You are unable to look after your own needs and you just cannot attend to your baby.
Treating PPD
The key to prevention and successful treatment of PPD is early intervention. Treatment and recovery time may vary, depending on the severity of depression and individual needs. It is often treated with psychotherapy (also called talk therapy or mental health counseling), medications or both [6].
Other things that may help
1. Asking for help. Let family and friends help you with chores.
2. Talking to trusted friends and family members about the way you’re feeling.
3. Increasing your physical activity. On a physical level, exercise increases endorphins that stimulate the “feel good” center in the brain. Psychologically, being active makes you feel that you are taking charge of your life and your body at a time when they may feel out of your control [7].
4. Trying to maximize sleep and get as much rest as possible and eating healthy food.
If you are experiencing symptoms of depression, it is important to talk to your health care provider about treatment options. Your provider can refer you to mental health professionals who have experience working with women during pregnancy or after birth.
Finally, give yourself a break – after all, you just had a baby. Healing takes time, and asking for help is a courageous step.
Author: Reetu Verma
References:
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2. Falana SD, Carrington JM. Postpartum Depression: Are You Listening? Nurs Clin North Am. 2019 Dec;54(4):561-567. doi: 10.1016/j.cnur.2019.07.006. Epub 2019 Oct 10. PMID: 31703781 (https://pubmed.ncbi.nlm.nih.gov/31703781/)
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5. National Institute of Mental Health. Postpartum depression facts.
(http://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml)
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7. Carter T, Bastounis A, Guo B, Jane Morrell C. The effectiveness of exercise-based interventions for preventing or treating postpartum depression: a systematic review and meta-analysis. Arch Womens Ment Health. 2019 Feb;22(1):37-53. doi: 10.1007/s00737-018-0869-3. Epub 2018 Jun 7. PMID: 29882074 (https://pubmed.ncbi.nlm.nih.gov/29882074/)
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