Licensed Clinical Social Worker
May 23, 2022
What is Postpartum Depression?
“Is this just the ‘baby blues,’ or am I really depressed?” As a therapist who specializes in maternal mental health, I’m continually asked this question from clients trying to adapt to the surge of hormones, sleep deprivation, and huge adjustment that comes from caring for (and giving birth to) an infant.
Postpartum depression (PPD)—depression or anxiety that develops immediately or soon after childbirth—has gained visibility over the years, due to recent laws passed requiring healthcare providers who serve pregnant clients to screen for perinatal mood and anxiety disorders (PMADs), as well as celebrities like Chrissy Teigen and Brooke Shields opening up about their own struggles with this illness. But that hazy period after giving birth is extremely overwhelming, and many of my clients—whether they’re on the path to getting pregnant, currently pregnant, or in the thick of postpartum—often want to know why they are feeling the way they do.
Since May is Maternal Mental Health Awareness Month it’s a good time to identify some key aspects of PPD, as well as some solutions to help new mothers take better care of themselves and reduce the risk of this illness. Here are the top five questions my clients have about PPD:
How do I know if this is just the “baby blues” or if it’s postpartum depression?
About 80 percent of women experience the “baby blues” after they deliver. It generally starts when your baby is 2-3 days old and dissipates after about two weeks. The fact that the baby blues resolves on its own is one of the primary differences between it and PPD. Baby blues, like PPD, do cause tearfulness and irritability, but these emotions, while intense at times, are transient. They should come and go throughout the day. When you sleep, your energy is restored. And your self-esteem remains intact, so overall you feel like yourself. The symptoms of PPD are lasting, present for most of the day every day and require treatment in the form of either therapy and/or medication.
What are ways I can reduce my risk of postpartum depression?
The first way is to educate yourself about what postpartum depression looks like and the symptoms. Symptoms generally resemble those of depression with sadness, frequent tears, low mood, feelings of guilt and worthlessness, and not wanting to be around others. Despite its name including depression, it can also equally look like anxiety—you may feel worried, fearful, and overwhelmed. You can also feel irritable, angry, or even experience rage. It can affect your appetite and very commonly your sleep. You can feel disconnected from your baby. At its most severe you can also have thoughts of not wanting to live anymore or harming yourself or someone else. Should this occur it’s essential to talk to either your doctor or your therapist immediately.
Ways to reduce your risk primarily involve good self-care. This includes getting as much sleep as you can, whenever you can. Eat regular, nutritious foods to promote healing and increase your energy. It can be helpful to prep snacks that are easily grabbed from the fridge or pantry like baggies of fruit, nuts, crackers, and cheese. Exercise—once you are cleared by your doctor—can also help boost your mood. This does not need to be a 60-minute bootcamp! Just getting outside for a short walk, feeling the fresh air on your face, and getting a change of scenery will do wonders. Allow others to help: they can make some meals, tidy up your kitchen, run errands, take out the trash, or do loads of laundry so you can focus on your baby and your care. They can also tend to your older children if necessary, handling pick-ups, drop-offs, and trips to the playground. Finally, connecting with others can help you feel less isolated and alone. Make a goal to see a friend one time a week or join a local parent group. Finding support from others going through these intense newborn days can be extremely helpful—practically and emotionally. Postpartum Support International has a wide variety of online groups at www.postpartum.net.
How do I decide whether to take medications to treat my postpartum depression?
Whenever you are considering treatment, it’s important to consider the risks and benefits. When people consider medication, they often focus on the risks to taking it, as well as the risks to their baby. A great resource for reviewing the risks of medications is www.mothertobaby.org. However, there are also risks to untreated PPD that should be considered as well.
It’s important to have a full discussion of these risks with your prescribing doctor. I always recommend to my clients that they not only seek the help of a psychiatrist but a perinatal psychiatrist. These psychiatrists have chosen to specialize in treating women who are either planning to get pregnant, are pregnant, or who are postpartum. They have the most up-to-date information on the variety of medications available to use in this phase of life and can help you make the most informed decision. People often hesitate at the idea of seeing a psychiatrist, but it’s no different from seeing any other specialist. Just as you would see a cardiologist for a cardiac condition, I recommend seeing a psychiatrist for a mental health condition.
Medications in the perinatal phase are not going to take away your lack of sleep, solve your problems, or make your baby stop crying. But they will help to make all of this feel more manageable. They will also help you better use the coping tools at your disposal. They give you a boost during a vulnerable time in your life and are worth considering.
How can therapy help me?
Unfortunately, many women with PPD experience feelings of shame, guilt, or fears about why they are feeling this way. Therapy is a chance to talk about those feelings in a non-judgmental space. It’s a place to explore why you feel this way and perhaps what might be contributing to those feelings. It’s a place to get reassurance that a lot of this is common. It is time to focus on your own mental health, your own care for yourself—which may be in particularly short supply at this vulnerable and demanding time in your life. And it’s a place to feel heard and supported.
Why didn’t anyone tell me it would be like this?
Unfortunately our society paints a very rosy, unrealistic picture of what getting pregnant, being pregnant, and having a baby are truly like for most women. Social media contributes to this as well—your screen may be littered with a multitude of pregnancy announcements, gender reveals, images of glowing pregnant women, and happy mothers strolling with their newborn. I think with growing awareness we are slowly dispelling these myths. But it takes all of us sharing our stories and collectively being open about the true nature of what life is like when you embark on having a baby.
Motherhood brings a seismic shift in life. There’s no way to know exactly what it will bring your way, but if you’re armed with information and the tools available to take care of yourself, you’ll be better equipped to handle its surprises.
Christine Bennetts is a licensed clinical social worker who is certified in perinatal mental health. She works with women experiencing infertility, pregnancy and infant loss and postpartum depression. Christine is seeing clients throughout the state of California via telehealth and starting in August, 2022 will be available to see clients in-person in her office in Davis. To connect, send an email to firstname.lastname@example.org or call 530-219-2438.