Speaking Out About Postpartum Depression

By Rita Brhel, managing editor and attachment parenting resource leader (API)

**Originally published in the Spring 2008 New Baby issue of The Journal of API

Postpartum DepressionSo many first-time moms are caught off-guard by their emotions after giving birth to the baby they’ve been waiting for months, even years, to join their family. It’s completely normal to feel a letdown after the big day. After all, childbirth is a life-changing experience in every way. What new moms and their partners need to do is understand how to recognize the “baby blues” and what can help until they go away…usually in a couple weeks.

If not – if the symptoms are lasting much longer, are just plain overwhelming, or are accompanied by feelings of hurting the baby or yourself – see your doctor immediately. Mothers with intensely sad or angry feelings could have postpartum depression, or the more serious postpartum psychosis. These symptoms are very serious and can even be classified as medical emergencies. But they are very treatable; it doesn’t take long until you’re feeling back to yourself again and are able to enjoy the bonding time with your new baby that both of you deserve.

I know this firsthand.

With my first child, I experienced the very common “baby blues.” My main symptom was bursting into tears at odd times and for no apparent reason that I could tell. I wasn’t prepared, no one had ever told me about the blues, but the medical team at the hospital recognized the signs right away and helped me through them. The blues only lasted a couple weeks, and one day, I woke up feeling normal again.

About the “Baby Blues”

This common mood disorder is not considered a mental illness since the majority of new mothers experience it. It occurs in about 80 percent of new mothers, coming on within the first week after the birth and lasting, at most, for three weeks.

Symptoms include: mood swings, weepiness, sadness, anxiety, inability to concentrate, and feelings of dependency.

“Baby blues” are caused by rapid hormonal changes, along with the stress of birthing; physical discomforts; an emotional letdown following the pregnancy; anxiety about the increased responsibility of caring for a newborn; fatigue; and disappointments about the birth, support from the partner, nursing, or the baby.

Beyond the Blues

With my second child, I was prepared for the “baby blues,” but what I experienced was far worse…except that I didn’t know what I was feeling. It also started during my ninth month of pregnancy. I was sad and angry, yelling at my husband, and feeling overwhelmed by the demands from my children and from the housework. At times, I felt like I couldn’t take care of the baby.

I never had thoughts of hurting myself or my children, but I did experience paranoia in relation to something else hurting my babies. I fretted over the new furnace, worried that it was leaking carbon monoxide. I obsessed about rabid bats. I stayed up all night, worried that if I went to sleep and the house started on fire or someone broke in, that I wouldn’t be able to wake up in time to save my children.

I didn’t know what was wrong with me, or rather, that anything was wrong with me. Two months postpartum, my marriage on the rocks, I sought help and was referred to a counselor who specializes in postpartum depression. It didn’t take long for the treatment to work, but it could’ve been devastating to the relationships in my family if I hadn’t.

Postpartum Depression or Postpartum Anxiety

This is more serious than the “baby blues,” but occurs less frequently, only in about 20 percent of new mothers. This illness can happen anytime during the first year.

Symptoms include: excessive worry or anxiety, sadness, hopelessness, irritability or short temper, feeling overwhelmed, having difficulty making decisions, feelings of guilt, experiencing phobias, insomnia or fatigue, discomfort around the baby or indifference toward the baby, inability to concentrate and forgetfulness, loss of interest in hobbies, decreased libido, and loss of appetite or overeating.

Risk factors include: previous postpartum depression, depression or anxiety during pregnancy, personal or family history of depression or anxiety, abrupt weaning, social isolation or poor support, history of premenstrual syndrome or premenstrual dysphoric disorder, history of mood changes while taking birth control pills or fertility medication, and thyroid dysfunction.

Postpartum is Very Real

Postpartum depression is real, and it is something that all expecting mothers, new or veteran, should know about. Not enough people tell their experiences. I didn’t know I had postpartum depression, because I had never encountered anyone who let me know that there was something wrong.

No one, not even medical professionals, could give me a specific example of thoughts and behaviors that would signal a problem. The only information I had coming home from the hospital was a bullet-point on the discharge sheet that directed me to report any unusual emotions to my doctor. But what defined “unusual”?

Other Postpartum Mood Disorders

Postpartum Obsessive-Compulsive Disorder – Up to five percent of new mothers develop this disorder. Symptoms include: intrusive, repetitive, and persistent thoughts or mental pictures often about hurting or killing the baby; sense of horror and disgust toward these thoughts; behaviors accompanying the thoughts to reduce anxiety (i.e., hiding knives); and counting, checking, cleaning, or other repetitive behaviors. Risk factors include: a personal or family history of obsessive compulsive disorder.

Postpartum Panic Disorder – This illness occurs in about ten percent of new mothers. Symptoms include: episodes of extreme anxiety, along with shortness of breath, chest pain, sensations of choking or smothering, dizziness, hot or cold flashes, trembling, palpitations, and numbness or tingling sensations; restlessness, agitation, or irritability; and excessive worries or fears. Panic attacks may wake the woman. Often, there are no identifiable triggers. And during the attack, the woman feels like she is going crazy, dying, or losing control. Risk factors include: a personal or family history of anxiety or panic disorder, and thyroid dysfunction.

Postpartum Psychosis – This illness is marked by a “break in reality” and is a medical emergency. Call 911 if the new mother shows signs of having postpartum psychosis; she is a danger to herself, her baby, and others. This disorder has a five percent suicide rate and a fourpercent infanticide rate. Postpartum psychosis is very rare, occurring in only 1 to 2 new mothers per 1,000. It usually begins two to three days postpartum. Symptoms include: visual or auditory hallucinations, delusional thinking (i.e. about infant’s death, denial of birth, or need to kill baby), and delirium or mania. Risk factors include: a personal or family history of psychosis, bipolar disorder, or schizophrenia; and a previous postpartum psychotic or bipolar episode.

Postpartum Depression Can Happen to Anybody

Furthermore, I had no history of mental illness and had always been a very stable, loving person. Before my experience, I thought postpartum depression was something that happened to people who weren’t stable in the first place.

Postpartum depression, just like the “baby blues,” happens because of a hormone imbalance and can be aggravated by the pressures of adjusting to a major life change. It is not something that happens because you are an unfit mother or because you’re weak.

If you have feelings of sorrow or anger after your child’s birth that seem to permeate your life and that you don’t feel you have control over, seek medical help. It’ll save your marriage and your relationship with your children, and you’ll feel much better being able to feel happy again and back in control of your life.

For More Information

Depression in New Mothers, Causes, Consequences, and Treatment Alternatives by Kathleen A. Kendall-Tackett

The Hidden Feelings of Motherhood by Kathleen A. Kendall-Tackett, Phyllis Klaus, and Marshall H. Klaus

This Isn’t What I Expected by Karen Kleiman and Valerie Davis Raskin

Beyond The Blues by Shoshana Bennett and Pec Indman




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