Postpartum Depression

depression suffered by a mother following childbirth, typically arising from the combination of hormonal changes, psychological adjustment to motherhood, and fatigue.

Can we be real for a sec? Having a baby is hard. Really hard. HARD HARD HARD. Sure, it comes with some of life's highest highs, but it often comes with the lowest lows, too. Postpartum depression affects one in nine new mothers, but because the "baby blues" are common after childbirth, parents don't always get treatment as early as they should.

The "baby blues" have some elements of depression, including moodiness, sadness, anxiety, and trouble sleeping, but unlike postpartum depression, they don't last long, only a couple weeks. Postpartum depression is a longer and more severe childbirth complication that can interfere with baby bonding and even progress into an extreme mood disorder, postpartum psychosis.

Even strong, well adjusted parents are vulnerable to postpartum depression. Being overwhelmed by sleeplessness, physical fatigue, insecurity, stress, grief, body changes, and less time for self care doesn't mean you are weak. It means you are human... and having a baby is HARD.

What causes postpartum depression?

Postpartum depression, like clinical depression, doesn't have one single cause. Physical changes and emotional stress play a part, since major hormonal shifts, poor sleep, and identity changes are central to every childbirth experience. During pregnancy, estrogen and progesterone are at their highest, only to bottom out to pre-pregnancy levels in the first 24 hours after delivery. Thyroid hormones also drop after childbirth. Risk for postpartum depression is increased in those under age 20, history of depression, bipolar disorder, an infant with health problems or special needs, multiple births, relationship issues with the other parent, a weak or absent support system, breast-feeding difficulties, financial strain, or unwanted pregnancies. Men can also experience postpartum depression, especially if they have any of the risk factors mentioned.

What are the symptoms of postpartum depression?

It can be difficult to distinguish the "baby blues" from postpartum depression, but the hallmark difference is how long they last. If a couple weeks have passed and a new parent continues to experience the following symptoms, they should be evaluated for postpartum depression.

  • having a depressed mood or severe mood swings
  • struggling to bond with the baby
  • withdrawing from family and friends
  • experiencing major changes in appetite
  • having extremes in sleep, either insomnia or sleeping too much
  • feeling intense hopelessness, guilt, irritability or anger
  • finding it hard to concentrate, think clearly, or make decisions
  • having anxiety-induced panic attacks
  • thinking of harming herself or her baby

At its worst, postpartum depression can evolve into postpartum psychosis, and though it is rare, it is severe and dangerous.

How is postpartum depression treated?

Left untreated, postpartum depression can interfere with mother-child bonding and cause issues in the rest of the family. For example, children of mothers with untreated postpartum depression are more likely to have behavioral and emotional problems. Postpartum depression without treatment can last for months or more, and may evolve into chronic depression.

Fortunately, postpartum depression is treatable. Therapy helps new parents learn strategies for coping with the enormous lifestyle and identity changes that comes with having a baby, improve communication skills, manage feelings, and set realistic goals. Two evidence-based approaches to therapy for postpartum depression that have demonstrated improvement in numerous studies are cognitive behavioral therapy (CBT) and interpersonal therapy (IPT).

Antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) are also an important part of treatment, and most are considered safe to take while breastfeeding. Antidepressant medications target chemicals in the brain the control mood and take several weeks to work to their maximum effect. It is possible that some medications will work better than others, making it important for patients in treatment for postpartum depression to stay in regular contact with their provider.

The treatment plan for postpartum depression depends on the severity of the symptoms and the degree of effect they have on daily life. If therapy and medications do not work, your bonmente provider may recommend brain stimulation therapies, such as transcranial magnetic stimulation (TMS) or electroconvulsive therapy (ECT).