Everything You Need to Know About Postpartum Depression

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It's important for all parents to know everything about postpartum depression.

Many parents who are welcoming a new baby are thrilled, and at the same time expect that a new baby will bring a challenging season of life. However, mothers and parents diagnosed with postpartum depression (now known as peripartum depression) go through a particularly trying time during the first year of a new baby.

A new baby fills us with warmth, love, and excitement because we’re anticipating our future with them.

However, sometimes situations don’t go as planned and instead, we’re overcome with despair.

Expecting parents often overlook the significant changes that can happen when bringing home a baby.

I know I did. I expected it would be easy to put a baby down for a nap so I could carry out my day-to-day schedule! Who was I kidding?

New schedules, physical and mental exhaustion, adjusting to breastfeeding and bouts of crying, are just a few changes that happen after having a baby, all of which lead to stress.

In this article, I’m going to talk about what postpartum depression (PPD) is, along with its symptoms, risk factors, prevalence, and consequences.

I’ll also go over what you can do to prevent and treat PPD and highlight how it’s different from the “baby blues.”

I want to note that this article uses Postpartum Depression in its title because people know the illness by that name, but the actual illness is now called Peripartum Depression, in recognition that the illness can occur both before and after giving birth, not just post-birth.

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What is Postpartum Depression?

PPD is a type of mental illness under the umbrella of Depressive Disorders.

Mothers are at the highest risk of PPD, (some studies suggest that women are more likely to inherit depression), but fathers can have it as well.

The illness can last for a couple of months or longer. When left untreated, PPD can continue into a depressive disorder.

Physicians can diagnose PPD in mothers using the same criteria as Major Depressive Disorder (MDD) in the Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition. The difference is that PPD is a subtype of MDD and is diagnosed during pregnancy or the period after pregnancy.

PPD Symptoms

So, what does PPD look like exactly?

You can be diagnosed with PPD if you have several of the following symptoms during pregnancy or within the first four weeks after having a baby:

1. A depressed mood almost every day.
2. Disinterest in activities that would typically give you pleasure.
3. Extreme weight loss that’s not a result of intentional exercise and dieting.
4. Loss of appetite.
5. Too much or too little sleep.
6. Repetitive movements that serve no purpose, giving the appearance of restlessness (as noted by others).
7. Tiredness and lack of energy almost every day.
8. Feeling guilty and unworthy.
9. Difficulties with decision-making, concentration, and thinking.
10. Regular thoughts of suicide, or suicide attempts.
11. Showing no bond with or interest in your baby.
12. Thinking you’re a bad mother.
13. Thoughts of harming yourself or the baby.

PPD Prevalence

About 13% of mothers experience PPD (depending on the country, diagnostic tools, and definition of PPD), with most diagnoses occurring after giving birth.

Out of all the developed countries, the prevalence of PPD is the highest in the United States but rates are higher in developing countries overall.

Needless to say, such a high prevalence means PPD isn’t going anywhere and should still receive the widespread attention of healthcare providers and the masses.

PPD Risk Factors and Potential Causes

Though PPD can be unexpected, there are some warning signs to watch out for during pregnancy planning.

For instance, family history of depression and mental illness can put women, in particular, at risk of PPD and other depressive disorders.

Being a single mom, poverty, financial trouble, lack of social support from friends and family, and previous mental illnesses before pregnancy are just some of the risk factors for PPD.

It’s important to remember that there isn’t a single cause for PPD.

Typically, a combination of factors puts mothers, and fathers, at risk. The same is true for major depression (after all, PPD is a subtype of major depression).

Almost all mental illnesses come from a combination of biological, psychological, and social factors

Consider the below example:

Libby, a 25-year-old woman, just had a baby. She is a single mom. Both of her parents have had depression since their 20s and have since been taking medication. Libby has shown some signs of low mood in the past, but she’s never been diagnosed with a mental illness.

After Libby graduated high school, she decided to move to British Columbia for university, away from Ontario where her parents live. She knows nobody at the school and she had to take out student loans since her parents can’t afford to pay her tuition.

She met a man at the university and they were together for two years. During Libby’s pregnancy, she and her ex-boyfriend started to argue a lot and couldn’t settle their differences. They decided to split up.

Libby felt utterly alone throughout her pregnancy and now she is having trouble adjusting to motherhood due to her increasing financial troubles and lack of social support. She is feeling extremely depressed and doesn’t know how much longer she can take care of her baby.

Libby decided to see her doctor and was diagnosed with PPD.

I only made this story up, so it may seem extreme to some of you. What I’m trying to do is illustrate all the factors at play that can contribute to PPD.

We can see that not only does Libby have a biological vulnerability to depression, but she also went through numerous stressors (having a baby is a stressor in itself) and lacked social support because she didn’t have any friends and her family lived far away.

So, there isn’t a single cause for PPD, but if some of these red flags were brought to Libby’s doctor from the get-go, she would've likely been noted as high risk.

How are the Baby Blues Different from PPD?

It’s completely normal to be…emotional after having a baby, to say the least.

From mood swings to crying profusely during the first week after having a baby, you may start to worry that you’ve got depression.

These big emotions may be a symptom of depression, but most of the time they are just the baby blues.

The difference with the baby blues is that the symptoms are temporary and usually dissipate after a week or so.

If you’re still excessively crying for two weeks postpartum, that’s a sign you should reach out to your doctor.

What are the Consequences of PPD?

Unfortunately, PPD is not an illness that can be ignored and it’ll certainly not go away on its own.

There are many negative consequences of untreated PPD for you, your baby, and your relationship with your baby.

PPD Consequences for You

• Worse quality of life.
• Poor physical and mental health.
• Poor relationships with others.
• Higher chance of dangerous behaviours (including substance use and suicidal ideation).

PPD Consequences for Your Baby

• Struggles with weight gain and stunting (primarily in low-income populations).
• Increased chance of low birth weight or prematurity, when PPD occurs during pregnancy.
• Impaired cognitive, language, emotional, behavioural, and social development.
• Lower sleep quality.
• Poor physical health.

PPD Consequences for the Relationship With Your Baby

• Lack of bond and emotional attachment.
• Troubles with breastfeeding.

Based on these consequences, it’s clear that PPD should be treated immediately.

What Should You Do if You Think You Have PPD?

First Things First: Prevention

Before jumping into solutions and treatments for PPD, I want to focus on prevention for a moment.

Many clinics provide questionnaires when they take a pregnant woman in their care. Luckily, these questionnaires usually screen for PPD risk so that proper interventions can take place before there’s a diagnosis to begin with.

If your doctor is a good one and flags you as a risk for developing PPD, they’ll refer you to a counsellor or psychologist.

Now, social desirability can get the best of us, so some of us may not answer these screeners truthfully. With this, your doctor won’t know that you’re at risk and prevention won’t take place.

So, please just answer these questions honestly. You won't be harshly judged! You need to be honest for your own sake and your baby's.

Treatment

If you have any of the symptoms described above for more than two weeks straight while you’re pregnant or after delivering, it’s time to tell your doctor.

You may be tempted to chalk up your symptoms as normal or “just your hormones taking over,” but unless what you’re experiencing is the baby blues, then you’re not going through something that will pass.

There’s no need to feel ashamed. PPD can happen to anyone who’s with a baby. Would you rather enjoy your first year with your baby or suffer in silence in the hopes it will disappear on its own?

Some mental illness treatment approaches include lifestyle changes, therapy, and medication.

Treatment for PPD looks a lot like treatment for other depressive disorders.

Often, PPD treatment includes talk therapy (such as cognitive-behavioural therapy, emotion focused therapy, and interpersonal psychotherapy). Sometimes, when therapy isn’t enough, women can take medication prescribed by a physician (in moderate to severe cases).

Be sure to ask your doctor about the negative side effects of different medications. Though the benefits of antidepressants often outweigh the risks, it's important for you to stay informed in your decision to take medication or not.

My Experience with the Baby Blues

My baby is almost 5-months-old and fortunately, I haven’t had a PPD diagnosis so far.

I did experience some sadness, dread, and regret in the beginning though - just as many other mothers before me had.

The last time I held a baby was fifteen years ago when my sister was born. My baby was so small and I didn't know how to hold him!

The latching was difficult, so on the second night after we brought him home, I felt like a failure because I couldn’t breastfeed him properly. My nipples were also too sore to pump.

Ultimately, my partner went to the store to buy some formula so our little one could eat and I could rest.

Things definitely got better after that but I felt pretty lonely and isolated for a couple of weeks, especially after my partner had to go back to work.

I coped by watching some Modern Family and cuddling with my baby.

Eventually, I moved on to healthier habits like meditation and exercise.

I finally was able to match my baby’s rhythm and through teamwork, we figured out how to breastfeed.

You see, what I went through wasn’t PPD.

I was definitely sad and had my doubts that I’d be a good mother, but it went away after a week or so.

The baby blues don’t warrant treatment, but there are ways to cope…

How to Cope with the Baby Blues and PPD

I stayed sane during the newborn stage by making use of coping strategies.

You can use the following strategies to help you cope with your mood whether you have the baby blues or PPD. To be clear, these are not treatment methods, but rather can work in conjunction with treatment.

• Exercise whenever you can. A walk with your baby and this 7-minute daily workout are great options for sneaking some activity.
  • TIP: Exercise while you feel good and when your baby is awake. They’ll love watching you!
• Stay connected with people you care about. Spending time with people is a protective factor against depression. Have visitors over once a week when you’re ready.
  • TIP: Make notes after you spend time with particular people. By noting down your experiences with someone, you’ll figure out who you enjoy spending time with.
• Journal and practice gratitude. Having a conversation on paper and expressing gratitude can improve your mental health.
  • TIP: Time yourself for just 5 minutes when you’re ready to journal. You might find that you don’t want to stop.
• Meditate daily. Meditating doesn’t have to be hard. Many people are skeptical of meditation because they think they'll never be able to stay still to do it “correctly.” In reality, even if your mind is spinning, all you need to do is notice this and then go back to your breath.
  • TIP: You can combine meditation and walking - you don’t have to be sitting to meditate. I call that a time saver!
• Remember activities that you enjoy. Enjoyment is a tall thing to feel if you have PPD, but try to do the things you love anyway.
  • TIP: Start by just showing up. If you enjoy painting, get those paintbrushes out. Even if you don’t end up painting, you're one step closer.

Conclusion

Having PPD can feel devastating and like the world is going to end.

As moms, we tend to think about everyone else around us and are quick to dismiss what’s going on within our minds and bodies. This dismissal is only to our detriment, so it’s crucial to take action the moment we recognize our sadness during the peripartum period is not going away.

As mentioned in my previous blog post, we take action based on our thoughts and feelings.

Fortunately, there are treatments that work and simple lifestyle choices can alleviate the pain of PPD and the baby blues.

Feel free to send me a message on social media or send me an email at info@carewithserena.com. You can also leave a comment about your experience with PPD or the baby blues if you feel comfortable

If you or a loved one are thinking about suicide, call Crisis Services Canada at 1-833-456-4566.