No one wants to hear the words “postpartum depression.”
But it does exist, it is real and the more we talk about it, the better things go for everyone. “The Baby Blues” is the normal period of sadness that impacts around 80% of women for up to two weeks postpartum. These symptoms will naturally subside. However, about 14-20% of women experience more severe symptoms of postpartum depression, anxiety, OCD, PTSD, or psychosis.
Experiencing postpartum depression or any of these other symptoms will significantly disrupt a mom’s well-being and ability to function. She will require more support, resources, and coping skills to manage the symptoms. Postpartum depression can happen to anyone, but a woman with certain predispositions have increased risk. These particulars and careful risk assessment is important to consider before birth, so she can take the steps to create a safety net of support and awareness.
Historically, it was believed that postpartum depression symptoms only began “postpartum,” or after the delivery of the baby. We’ve since learned that these depression symptoms can actually begin “perinatal,” or during pregnancy. Many women don’t experience pregnancy bliss and joy, but instead have negative feelings of depression in pregnancy. The onset of these symptoms can be confusing and even alarming.
Moms often take personal responsibility for these symptoms and may feel hopeless, worthless, or like a failure as a result. Comparisons to other moms are endless, and the guilt feels incurable. The disappointment they feel can be so heavy that it silences a mom from sharing her pain with anyone, including her husband, family, friends, and doctor. What these women need to know is that they are not alone. Their feelings are valid and they deserve a safe place to share them.
Signs of Postpartum Depression
- Mood: anger, anxiety, guilt, hopelessness, loss of interest or pleasure in activities, mood swings, panic attacks, feeling shutdown
- Behavioral: crying, irritability, restlessness, uninterested in caring for baby, detached from bonding
- Psychological: depression, fear, repeatedly going over thoughts
- Whole body: fatigue, loss of appetite, insomnia
- Cognitive: lack of concentration, unwanted thoughts, thinking your baby would be better without you
How Does Postpartum Depression Happen?
There are so many changes, transitions, and expectations that occur all at once to a new mom! Her entire world turns upside down the minute after birth. Birth and postpartum can be physically exhausting, but we don’t pay much attention to the mental health of a new mom. This is even more important and their physical health!
A mom’s mental health is so critically impacted during the time of bringing a baby into the world. It is impacted by the intersection and collision of family beliefs and values, hormonal fluctuations, identity transitions, career changes, financial obligations, personal dreams and fantasies, social and cultural expectations, sleep deprivation, urgency of caring for a new life, pressures of creating a secure attachment to the baby, and with potentially minimal family support. Phew, do you see why motherhood can be overwhelming and why mental health could be a challenge?!?
Will Postpartum Depression Happen to Me?
There are predispositions that increase a woman’s likelihood to experience perinatal or postpartum distress.
- Are you more sensitive to hormonal changes during your period or premenstrual syndrome (PMS)?
- Is there a family history of perinatal distress or postpartum depression?
- Do you have a personal history of depression, anxiety, OCD, bipolar disorder, psychosis, abuse, or trauma?
- Are you a perfectionist?
- Do you have a tendency to worry, obsess, or ruminate?
- Do you have limited family or friends who will support you?
- Is your marriage or relationship already strained?
- Was your pregnancy difficult, unexpected, or undesired?
- Are there other big stressors like a job change, recent move, financial stress, major loss, or illness?
4 Things to Do If Your Risks are Higher for Postpartum Depression
1. Plan for a postpartum doula
Having a baby, bringing it home, and becoming a mother is just hard. But the great thing is, you don’t have to do it alone. A Postpartum doula helps lighten the load, bring confidence to all the firsts, give you time to rest on your own, shower, clean up the kitchen so you have more calm, be a listening ear to your joys, concerns and of often, the tears.
Having a postpartum doula has been shown to decrease postpartum depression risks as the mother doesn’t feel so isolated. A postpartum doula makes sure her emotional, mental and physical needs are being met which absolutely impacts her mental health in the best way! We all need this! If you have a predisposition signs for postpartum depression, schedule your postpartum doula in pregnancy,so you have this built in support system from the start!
A Postpartum Doula is not a luxery or an extra. It can be a critical part of the support team surrounding the parents so they get the sleep they need to function and be healthy. Ask for family to pitch in for gift cards or a baby shower donation so you can have built in support before the baby even comes home. Knowing you have someone in your corner can make world of difference in reducing postpartum depression. Learn 52 ways a Postpartum Doula can bring support to you and your family!
2. Create your postpartum plan in pregnancy for support
Don’t wait for crisis to happen. Make a postpartum plan in pregnancy. Delegate chores to family and friends before birth (laundry, garbage, dog walking, etc). Create a meal plan so you have ready to go meals after baby comes home. Freezer meals, meal train, Uber Eats, helpful mother-in-law, you name it, have a plan for regular meals.
If you are wanting to breastfeed, take a comprehensive class BEFORE birth. Better yet, schedule a prenatal in-home consult with a Certified Lactation Specialist. So much stress can come with breastfeeding. Having education, empowerment, and a built in support system can reduce this stress ten-fold.
3. Find a Mother Circle/Meet-up
The feelings of motherhood are so often silenced and shamed. Especially when we are inundated with Instagram-worthy moments that are far from reality. Mother Circles are intended to be a safe place to share, but also to hear others’ stories and help you realize that you aren’t alone.
Occassionally, Mom Groups make you smile and show that everything is fantastic. We are suggesting you find a MOTHER CIRCLE — one where the focus is authenticity, vulnerability, strength, and camaraderie. The world is full of judgement. A Moms Group needs to be a place for you to come in your yoga pants, unshowered hair to just be with other moms. To remind you that you aren’t alone.
It has been an extra challenge to find supportive groups during COVID-19. Here are a few trusted resources that meet online in the Portland, Oregon & Vancouver, WA areas.
- Group Peer Support – offers evidence and trauma informed support with virtual Pregnancy & Postpartum Groups nationwide
- Brave Birth – offers virtual groups for New Parents, Queer Parents & Cesarean Support in Portland, OR
- Legacy Hospital – offers virtual weekly groups for all parents in the Vancouver, WA & Portland, OR areas
- Seven Starling – provides small group support that guide you through your entire pregnancy and postpartum
4. Talk with your partner and have a plan in place.
If you find that you have predispositions for postpartum depression, talk to your partner and trusted support system. Let them know your feelings and thoughts. Together, make a plan in event they start to see signs of postpartum depression. How would you like them to talk to you about it? If we don’t talke about it, postpartum depression can be the elephant in the room. Talking about it beforehand and making a plan reduces this elephant and gives you awareness and empowerment to deal with it head on.
Priscilla Gilbert is a Licensed Mental Health Counselor in Camas, WA and is the owner of Lacamas Counseling Professional Offices. As a counselor she specializes in supporting people through perinatal and postpartum distress, grief, anxiety and depression, life transitions, and identity enrichment. Priscilla also seeks to increase community awareness through writing blogs and articles, community presentations, advocating, and training other professionals. You can email Priscilla or visit her website to learn more.
Additional Postpartum Depression Resources and Reading Recommendations
- “This Isn’t What I Expected”, (2013) Karen Kleiman – Overcoming postpartum depression
- “Dropping the Baby and Other Scary Thoughts” (2010), Karen Kleiman – Addressing anxious and scary thoughts affecting mothers
- “The Postpartum Husband” (2000), Karen Kleiman – Practical solutions for living with postpartum depression
- “What Am I Thinking” (2005), Karen Kleiman – Having another baby after postpartum depression
- Katherine Stone Blog dedicated to maternal mental health
- Baby Blues Connection, a national and local resources, referrals, and information