The purpose for writing this entry is to bring awareness to something that as a society we do not discuss yet it is such an important piece of a mother's well-being. Not only that but there is a clear discrepancy between treatment for postpartum issues for Caucasian women and women of color, namely African American and Latina women. I encourage you to do your own research, discuss this with your OBGYN, your primary care doctor or your mental health provider. I will also add some helpful articles and books at the end of this entry.
As if women didn’t have to deal with enough regarding pregnancy. We now have to worry about a depression that can be so debilitating to first-time moms or veteran moms that it carries its own diagnosis. If diagnosed and treated in a timely manner then there is nothing too worrisome about it. However, if it isn't diagnosed or treated on time it could wreak havoc on your mental health, your ability to parent, and your relationship. If you are pregnant and or recently had a child and are reading this, please know this is something that happens. Most moms will develop the ‘Baby Blues’. It can happen about 2-35 days after you give birth and can last up to 2 weeks. Symptoms could include, trouble sleeping, moodiness, feelings of sadness. If these symptoms last longer than a 2 week period then speaking with your health care provider would be advised to discuss other reasons for your feelings. If this is something that happened to you please understand it isn't something that you "do or do not do", it is a medical/mental health condition that can be treated. Postpartum Depression (also called PPD) is one of the most common problems for new moms. As mentioned above PPD are strong feelings of sadness, anxiety (worry), emptiness, and having trouble bonding or forming an emotional attachment with her baby. Most new parents have these very common feelings. You’d probably be surprised to know that
in the United States alone, approximately 70%-80% of women will experience, at minimum the ‘baby blues” of the women mentioned above, between 10%-20% of new moms are reported to move on to postpartum depression or PPD.
To understand postpartum depression, we have to discuss perinatal depression, they are not interchangeable. Perinatal depression occurs during physical pregnancy. In any normal pregnancy you will have some symptoms and signs of depression, symptoms like tiredness, maybe insomnia, weight gain, and you may experience emotional changes. Please speak to your medical professional regarding your symptoms to determine if it is the pregnancy or if the pregnancy is masking symptoms of depression. It is very important to understand that if you have a predisposition to depression symptoms may worsen or get complicated during your pregnancy or after. It is also worth mentioning that just because you have a predisposition to depression that does not mean that your symptoms will worsen or become complicated. It is important to monitor your symptoms and know your baseline. Speak with your medical and/or mental health providers prior to conception or soon after. They can continue to monitor and assess you to make sure that any complications are treated immediately.
PPD can occur up to one year after giving birth (side note: women who can most definitely be found suffering from undiagnosed PPD even up to 2 years after giving birth).
Women oftentimes do not fully disclose their symptoms due to fear of being viewed as ‘unmotherly’, brushing off the symptoms as “crazy hormones”, and not wanting to look weak or incapable. This is why discussing your plans for pregnancy (if you can) will help you, your partner, and your medical provider to better monitor your symptoms. Some women according to the National Institute of Mental Health are “at greater risk for developing PPD because they have one or more risk factors” Some of these may include, symptoms or depression after a previous pregnancy, a family history of depression, a being diagnosed with PTSD, during pregnancy or shortly after giving birth, medical complications during birth (specifically, including premature delivery, or having a baby with medical problems). Alcohol or other substance abuse problems. Although this affects women from all walks of life, it is crucial that we understand that there are significant racial-ethnic differences in depression-related mental health care after delivery. Racial and ethnic disparities in the initiation and continuation of postpartum depression care are rampant and need to be looked at for stricter clinical and policy change.
We’ve discussed baby blues, perinatal depression, and postpartum depression. Postpartum post-traumatic stress disorder (PTSD) following childbirth is typically triggered by trauma during the time leading up to during delivery or shortly afterward. It affects up to about 9% of mothers who experience this. These traumas can include:
· Prolapsed cord
· Unplanned C-section
· Baby going into NICU
· Feelings of powerlessness, poor communication and/or lack of support and reassurance during the delivery
· Women who have experienced a previous trauma such as rape or sexual abuse, are also
at a higher risk for experiencing postpartum PTSD.
The above list only mentions a few. However, there are many other traumas that could contribute to this. The last postpartum diagnosis we need to discuss is Postpartum Psychosis or puerperal psychosis, this is found in 0.1% of new moms. This is a very serious condition but is quite rare, these symptoms may include:
· Extreme confusions
· Refusal to eat
· Delusions
· Auditory hallucinations
· Hyperactivity
· Rapid or irrational speech
These reactions can occur within 3-14 days following the birth. However, everyone is different so it is also better to error on the side of caution. Seek immediate attention if something truly does not feel right with you or if someone close to you expresses concerns.
The reason I want to bring up Postpartum Psychosis is that we have all heard the headlines “mom kills newborn” “mom kills children and then commits suicide”, the cries of “that poor father, that poor husband” how could anyone do this? The confusion, sadness, and bewilderment. It is very important to realize how super small this pool of women who kill their kids or themselves due to postpartum psychosis is. Usually, their fears are brushed off, shrugged off as “jitters” for first-time moms, or being too cautious for veteran moms. It is in these small, unsuspecting moments that something can slip by us and we don’t catch it in time.
A name we are familiar with is Andrea Yates. She was told to not get pregnant again after her fourth child was born due to her attempts to commit suicide twice. She was diagnosed with postpartum psychosis.
This is a prime reason those in your support network are kept abreast of your wellbeing, your health, and your mental health. If you don’t feel heard make sure you see your medical/mental health professional AS SOON AS POSSIBLE. The fear isn’t that you will hurt yourself or the baby, but that the potential is there if your concerns are not addressed.
Helpful Books:
· Setting the Wire: A Memoir of Postpartum Psychosis. by Sarah C Townsend
· When Postpartum Packs a Punch Fighting Back and Finding Joy: by Kristina Cowan
· The Fifth Trimester: The Working Mom’s Guide to Style, Sanity, and Big Success After Baby: by Lauren Smith Brody
· Birth of a New Brain Healing from Postpartum Bipolar Disorder: by Dyane Harwood
· Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression and Anxiety: by Shoshana Bennett Ph.D. and Pec Indman EdD MFT
· Postpartum Depression and Anxiety: A Self-Help Guide for Mothers: by Pacific Postpartum Support Society.
Helpful Links:
· National Institution of Mental Health https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml#pub7
· March of Dimes
· Healthline
· MedlinePlus
· Postpartum Support International
The links above are also the references I used to write this blog. Please don't forget to check them out for more information!
Lastly, some wisdom and advice from people in my life, friends, and family I hold dear who have dealt with and overcome postpartum depression: I asked them 4 questions: How and when you were diagnosed, how many kids do you have, what was your experience like with PPD and any advice they would pass along.
I was 25 years old in 1991 when she experienced the baby blues turning into postpartum depression. I have 3 children and I only had the depression with my first. I couldn’t stop crying and thought I was losing my logical decision-making skills. It only started the 2nd week (postpartum) and only lasted 10 days. I had to move in with my in-laws. My advice would be that if someone asks if you need help, don’t be proud, take it. Stay with your support group and the ones you love . This too shall pass.
I was diagnosed by my OB when I was in the hospital the day after giving birth to my first child. I currently only have one child. The brutal honest truth It’s a weird feeling to describe. I felt like I was happy and grateful to have a child but at the same time wasn’t overly concerned when she cried for a long time. I didn’t feel the need to pick her up right away. I was more anxious than anything and scared to leave the house with her. Scared we’d get into a car accident or she would get sick. So we did stay home a lot but I still forced myself to go out when we had to. Advice for someone dealing with postpartum Give yourself grace!!!! Don’t allow the guilt to damage your perception of your parenting skills. Ask for help. Take a moment to gather your composure when needed. Two more minutes of your child crying isn’t going to hurt. It’s a serious medical diagnosis and doesn’t make you less of a mom!
I was 22 years old while on active duty in the military, I have one son. We were told to fake it till we made it. To suck it up. Depression doesn’t exist it makes you weak. I thought I was going insane, fighting an inner battle while having no support because I was afraid of what would happen if I spoke up. You cannot be a 100 perfect good parent if you do not take care of yourself! YOU come before your child because they need you at 100%. Speak up be brave you aren’t alone.
I was diagnosed about 3 months after my 2nd child was born by my OB. He is the youngest. I didn't disconnect with my kids. I did with my husband. It was one of the lowest parts of our marriage. It lasted a few years. I tried counseling, while I think it was/is a necessary tool in healing, it was not for me. I gave up after trying 2 different therapists. I ended up going the medication route. I was getting so frustrated with myself because here I was, a mother of 2 kids, blessed enough to stay home with them while he worked to put a roof over my head, etc. But yet I was still miserable. It eventually passed. The best advice I can give is to take it day by day, and remind yourself that this too shall pass.
If you or anyone you know is struggling PLEASE pass them my information. I have supports standing by to connect them with (in terms of peers). I am also accepting new clients at this time. This is such an important issue to me and thus my drive to write about it.
Till next time,
Smile & Be Well.