On the Brink & Overwhelmed? What You Need to Know About Postpartum Depression

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This article originally appeared in the May/June 2017 issue of Latina.

While the birth of a child is a joyous time for many women, being a new mom comes with an unexpected range of emotions. And it’s not all rainbows and roses.

When mom isn’t happy 

“It’s normal to experience the ‘baby blues’,” says Maria A. Oquendo, M.D., chair of the Department of Psychiatry in the Perelman School of Medicine at the University of Pennsylvania. Nearly 80 percent of new moms will go through a period of uncontrollable crying, sadness, and anxiety following a baby’s birth. Understandably so—exhaustion, lack of sleep, and hormonal surges can all take their toll. But in most cases, the symptoms go away on their own after a week or two. 

When it’s more than the just the blues

Unlike the “baby blues,” postpartum depression (PPD) — which affects approximately 13 percent of new mothers — doesn’t go away on its own and the symptoms are more severe. 

“The biggest difference is how long the symptoms last and how hard they make it for you to function,” says Patricia Harteneck, Ph.D., Seleni Institute senior psychologist. The mood swings, deep rage, and anger are more intense, and can set in a couple of weeks after childbirth and anytime within the first year. “If they last longer than two to three weeks, it’s time to talk to your health-care provider,” she advises. While rare, new moms can also develop something even more serious known as postpartum psychosis, a condition that may cause psychotic symptoms like paranoia, delusions, and hallucinations. 

Why it’s not your fault 

“Because we idealize motherhood in our society — and especially in the Latina culture — women feel it is their fault if they experience anything but bliss and good fortune. That is simply not true,” Harteneck says. 

That’s why it’s important for people to understand that PPD is a biological response. “After childbirth, your body experiences a dramatic drop in estrogen and progesterone, which leads to chemical changes in the brain that may trigger mood swings,” Oquendo explains. Sleep deprivation leaves new moms even more vulnerable. Women with a history of depression or who lack a supportive network, or face other life stressors such as financial hardship are at even greater risk. 

Why you should speak up 

PPD is very treatable. “More ob-gyns are in tune to it, screening for it, and providing treatment,” Oquendo says. The treatment is much like treatment for other types of mental health disorders—most commonly antidepressants, psychotherapy and support groups, or a combination. 

Sadly, there’s a sense of shame and stigma that keep women silent and, consequently, fewer than half don’t seek treatment and only five percent of Latinas initiate postpartum mental health care. If left untreated, it can last for months or even longer, and create a ripple effect, interfering with mother-baby bonding and putting an emotional strain on fathers and children. 

One thing is certain, says Dr. Harteneck: “It’s nothing to be ashamed of. It does not mean that you are a bad mother or that you do not want your baby. Any woman can experience it.” 

What a new mom can do 

Make healthy life choices. Try to get adequate rest, eat healthfully, and get some exercise such as taking your baby for a walk. Set realistic expectations. Don’t pressure yourself to be superwoman: Do what you can and leave the rest. Make time for yourself. Get out of your PJ’s and leave the house. Meet up with a friend for coffee, or do something else you enjoy. Avoid isolation. Talk with your partner, friends, or family about how you’re feeling, or join a mother’s support group. Lean on friends. Take people up on their offers to help you with chores, errands, or babysitting! 

How can friends and family offer support? 

Insist on helping out. Offer to babysit so mom can take a nap or a long hot shower, run her errands, or do chores around the house. Get her outside. Help make her feel human. What does she enjoy? A yoga class? Mani/pedi? Movies? Arrange to take care of the baby and book the appointment for her. Cook for her. Bring your friend something hearty and homemade like lasagna or arroz con pollo. The last thing new moms want to do is cook. Be present. Sometimes just being there and listening is the best TLC. Recommend resources. Encourage her to talk to her doctor or join a support group. Do the legwork for her and call Postpartum Support International to find a group nearby (800-944-4773). 

*Jennifer’s story 

At 39, I found myself working full- time as a lawyer and single. I had never been a baby-crazy person. Then, when my brother had his first child, something switched in me and I thought “I love this little person and she’s not even mine.” I still hadn’t met Mr. Right, but I didn’t want to miss the chance to have children simply because I wasn’t in a relationship. I decided to do IVF and froze my embryos. A year later, at 40, I did my first transfer of the embryos. That was unsuccessful. A year and a half and eight IVF attempts later, I became pregnant at 42 with twins (a boy and a girl). Full-term. Healthy. Perfect. 

I brought my babies home and initially everything was fine. I had a baby nurse to help me. But as the weeks went by, I began to feel overwhelmed. I had trouble breastfeeding. I felt disconnected. Any momentous event like the first time they rolled over, I felt nothing. I couldn’t eat, or leave my apartment. 

When they were three months old, I took them back home to meet my family. While everyone was oohing and ahhing, I kept thinking “what did I do? I’m stuck with them for at least 18 years and I can’t give them back.” At the same time, I felt guilty because I had chosen to bring them into this world and had gone to such great lengths to have them. During the visit, I went for a run and fractured my ankle. That was the last straw. 

When I returned home, for several months I was stuck in a boot up to my knee, on crutches. I was alone with no family, my baby nurse quit, and I plummeted into total despair. There were days when I couldn’t get out of bed. I lay there crying. I couldn’t hold a conversation. When I finally returned to work, I would stare blankly at my computer screen for hours unable to process the words or the tasks at hand. I was catatonic. 

When they were four months old, I finally decided to seek help from my ob-gyn and her nurse immediately recognized the signs of PPD. I began seeing a psychologist twice a week and taking antidepressants. After months of trying different medications, the veil slowly began to lift. If I felt even five minutes of joy, I considered it a milestone. I started developing a bond with my babies and finding pleasure in spending time with them. 

In part, falling into the depths of despair and getting back up has made me a more relaxed parent. Stronger. I recently moved back to my hometown. The kids are turning four in May and we’re happy. I regret that PPD took the first 9-12 months of my children’s life from me.

What it is: Baby Blues What it looks & feels like: Sadness, irritability, trouble sleeping, feeling overwhelmed, mood swings, changes in appetite, crying How to cope: Lasts a few days to a week or two after baby is born and go away on their own 

What it is: Postpartum Depression What it looks & feels like: Severe mood swings and anxiety, withdrawing, intense anger, difficulty bonding with baby, shame and guilt How to cope: Usually develops within the first few weeks, but may begin later within first year; if it lasts more than two weeks, seek help 

What it is: Postpartum Psychosis What it looks & feels like: Confusion, hallucinations and delusions, paranoia, obsessive thoughts about baby, sleep disturbances, attempts to harm self or baby How to cope: Seek immediate treatment 

How to Get Help:  Once you’ve identified the signs of PPD, these groups offer support. 

PostPartum Support InternatIonal: Offers a worldwide network of expert and peer support at postpartum.net. 

PostPartum Progress: Provides answers to FAQs, support groups, treatment facility listings, and stories of other moms, postpartumprogress.com. 

Seleni Institute: Raises awareness, provides public programs, funds research, and advocates for moms, seleni.org.