May is Mental Health Awareness Month as well as a the month we celebrate Mothers. One of my greatest passions is maternal mental health, especially new mamas who are adjusting to all the aspects of what it means to care for a new life. I work with moms to figure out how they can be nurtured emotionally, physically, and mentally so they thrive and not just manage to get by.
One aspect of my work is helping moms with Postpartum Depression / Anxiety (PPDA). With all the books out there about what to expect after having a baby, we still have no idea what it will be like until our own baby arrives, whether it’s through our own womb, a surrogate, or through adoption.
I know for myself, I wasn’t prepared for what it would actually feel like to nurse around the clock while only getting a couple hours of sleep at a time. I was in love with my baby boy but completely depleted and exhausted most of the time. I was also parenting most of the day alone. Even though I had worked with many depressed clients, it wasn’t until I became a mom that I could really imagine what it would be like to struggle with postpartum depression or anxiety while caring for a baby. It was a good day if I got a shower and three meals in and I didn’t experience postpartum depression. It seemed daunting.
I thought often of my sister who had struggled some years earlier with severe postpartum depression. She later told me that she had sat on her kitchen floor deciding whether to live or die. Thank God she chose to live. She got help, got better, and is an amazing mom to two teenagers. My sister's experience inspired me to help other moms who have some form of postpartum depression and anxiety and that became part of my specialty in my private practice.
I remember being shocked to learn that postpartum depression / anxiety is the number one complication of childbirth. It occurs in about 1 in 6 women. Unfortunately, it isn’t something women are routinely screened for after giving birth. If women aren’t asked, it can easily go undetected and untreated. There is still a lot of guilt and shame around postpartum depression / anxiety so many times women don’t bring it up.
Here is what you should know:
Anyone can be susceptible to PPDA. It doesn’t discriminate. However, there are risk factors that put certain women at greater risk:
• Prior history of depression or anxiety
• Family history of mental illness
• Difficulties with partner
• Lack of social support
• Past trauma
• Complications in pregnancy, birth or breastfeeding
• Medical complication with newborn and / or with mother
• Women who have undergone infertility treatment
• Financial stress
• Mothers of multiples
• Women who are sensitive to hormonal changes
PPDA can occur anytime during the first year after giving birth. Symptoms can be different for everyone and can come and go.
Signs and Symptoms
• Crying and sadness
• Anger or irritability
• Feelings of guilt, shame, overwhelm, hopelessness
• Lack of interest in baby
• Fatigue or lack of energy
• Loss of interest or pleasure in things you used to enjoy
• Constant worry or feeling like something bad is going to happen
• Racing thoughts
• Difficulties sleeping and changes in appetite
• Physical symptoms such as nausea, dizziness, or hot flashes
• Thoughts of harming yourself or your baby
If you find that you are experiencing some of these symptoms more often than you’re not, it is likely that you have some form of postpartum depression or anxiety. There is help and this is treatable.
I will repeat: There is help and Postpartum Depression and Anxiety are treatable.
A simple screening tool is the Edinburgh Postnatal Depression Scale (EPDS). You can find it here on my website. If you score 10 or higher, there is a possibility of PPDA. If you answer yes to question 10, please call for help immediately.
Where to find help:
See your doctor! Let them know what you are feeling and asked to have your thyroid checked (thyroid dysfunction can look like PPDA). They may also have local resources.
Postpartum Support International is an amazing organization with many resources and service providers.