Kelly Hill, M.A.  Psychotherapist - 303-834-0394        lifeempowermentcenter1@gmail.com.com
Postpartum Depression

Everyone thinks that having a baby is supposed to be the happiest time of your life, and in many ways, it is.  But what many people don't realize is how incredibly stressful having a baby is is on a woman's body and psyche.

Childbirth alone creates physical changes that are more rapid and dramatic than any other transformation a woman's body can go through. Within hours, there are unparalleled changes in hormone levels, changes in blood volume, blood pressure, metabolism and immune system functioning just to mention a few. 

Then there is the emotional stress of abruptly becoming a mother... someone who is responsible for the life and safety of another human being.... and having little knowledge about this new and sometimes intimidating role.  There can be extreme fatigue from the lack of sleep a woman experiences when caring for and feeding an infant, and if a woman in nursing, there are hormonal changes (both through nursing and through weaning) and an incredible physical demand on her body. 

BABY BLUES

There is a somewhat fuzzy distinction between "baby blues" and postpartum depression.  Eighty percent of women experience some form of baby blues during the first two weeks postpartum, usually related to the hormonal changes she is experiencing.  Symptoms can include extreme fatigue, crying spells, irritability and anxiety about caring for a new infant.  What distinguishes postpartum depression from baby blues is time. If a woman experiences symptoms that last more than two weeks postpartum, she could be developing postpartum depression, and should seek help immediately so that she can receive treatment before the problem worsens.  

Seeking help takes courage and may be difficult for a new mom because of the expectations others place on her to be in a state of happiness. It is sometimes taboo for a woman to be unhappy during this time in her life when she to expected to be joyous. People may dismiss the mother's feelings by telling her that she just needs more sleep, or the mother may try to hide her true feelings in front of friends and family who come to visit bearing gifts. They may neglect to ask the mother how she is doing because of all the attention on the new baby.

CONTRIBUTING FACTORS

Most childbirth classes and even doctors don't adequately address the issue of postpartum depression, so when it does happen, mothers may feel shameful and keep it to themselves instead of seeking the help they need.

New mothers often have unrealistic expectations of what early motherhood will be like.  Our society paints a picture of the happy, well rested, energetic new mom taking baby for walks or to various activities. And although having a new baby is joyous and wonderful, reality can sometimes be a bit different.

New mothers can be tired.  Sometimes they have difficulties with nursing and bonding.  Although joyous, they are often unprepared for the incredible emotional and physical demand it takes to care for a new infant.  They are often isolated having left a career to start a new role as a parent. New mothers may lack experience in caring for a baby, and may therefore feel inadequate or anxious. In addition, all the attention that was given to the pregnant mother-to-be is now being given to the new baby, and the mother may feel left out of the picture. There may even be feelings of disappointment because childbirth may not have gone the way mom had planned or hoped for it to go. ALL OF THIS IS NORMAL.  


SYMPTOMS OF POSTPARTUM DEPRESSION

While eight out of ten women will experience some level of baby blues, only one in ten women will experience postpartum depression.  Postpartum depression becomes evident more than two weeks after childbirth, and can begin up to a year or more postpartum. It can also surface when a woman is weaning due to the drop in prolactin levels (the nursing hormone).  Symptoms of postpartum depression are similar to those of clinical depression and may include:


  • depressed mood
  • excessive fatigue
  • inability to sleep when the baby sleeps
  • inability to get out of bed
  • excessive worrying /anxiety
  • feeling inadequate or hopeless
  • tearfulness/crying spells
  • irritability
  • guilt or shame
  • mood swings
  • thoughts of suicide


IMPORTANT: If you have thoughts of harming yourself or your baby seek help immediately! Tell someone! Call 911 or go to your nearest emergency room!

ARE YOU AT HIGHER RISK?

While only ten percent of mothers develop postpartum depression there are a few things that may put you at higher risk. If you have a previous diagnosis of depression or anxiety disorder this is the biggest predictor of your chances of developing postpartum depression. If a close family member has a history with any type of mood disorder your chances are greater. If you have experienced postpartum depression with a previous birth, you are more likely to experience it again.  If you experienced depression during your pregnancy you may be at greater risk.  Or if you have had severe premenstrual  depression, you may be at greater risk. Other predictors are a major stressor during your pregnancy (such as a death, a move or a divorce), problems during delivery, your own history with child abuse or trauma, or the quality of your relationship with your partner.

PREVENTION

Here are some things that you can do to prevent the onset of postpartum depression.  Remember that your baby needs you to be healthy and at your best:

  • Exercise regularly. It will improve both mood and sleep.
  • Get plenty of rest - sleep when the baby sleeps
  • Limit visitors to "helpers" and ask them to help with specific tasks
  • Have friends and family cook and clean for you or watch the baby while you sleep
  • Eat healthy foods and drink plenty of water
  • Get outside regularly. Sunlight improves mood!
  • Five or ten minutes of mindfulness meditation can be rejuvenating
  • Take a shower. It will energize you and make you feel human!
  • Allow yourself to enjoy little things that make you feel good, feeling pleasure is important
  • Ask someone to give you a massage for 15 minutes every day, it circulates your blood and feels great
  • Have realistic expectations about what you can and cannot do right now, don't over-schedule yourself; set limits without guilt
  • If you are at high risk, start seeing a therapist during your pregnancy.
  • Remember that you are new at new at motherhood and you are going to make mistakes


TREATMENT

If you do develop postpartum depression, IT DOES NOT MEAN YOU HAVE FAILED IN ANY WAY.  It DOES mean that you need to reach out to someone and get help. IF LEFT UNTREATED POSTPARTUM DEPRESSION CAN LEAD TO CHRONIC LIFELONG PROBLEMS WITH THE ILLNESS. The most reliable help for postpartum depression is a combination of therapy (counseling) and medication. 

When looking for a therapist, it is important to find someone with whom you feel comfortable and able to be truthful about your thoughts and feelings. Therapy is not an easy process. It is good to choose a therapist whom you feel respects your individuality, opinions, and self. You must be able to trust your therapist 100% and if you cannot and feel like you have to lie to your therapist or withhold important information, you are not going to get any real help.

You should find someone who is knowledgeable about postpartum depression and issues related to pregnancy, parenting and spousal relationships. (Depression can put strain on a relationship and couples counseling may be a consideration as well).  You can expect to meet with your therapist on a weekly basis for at least three to six months. Health insurance may limit the number of visits allowed, so you may want to consider seeing someone with whom you can choose the amount of time that is right for you. 

Only a medical doctor can prescribe medication. In this case, a psychiatrist would be the best choice of doctors because they are more knowledgeable about issues related to depression. Ask your therapist to recommend two or three psychiatrists that they have worked with and feel good about so you have options from which to choose. Educate yourself about medications for depression. When you see the doctor, ask questions about breast feeding, side effects and success rates.  There are some medications that are more highly recommended while you are nursing and some that are not recommended.  It is important that your doctor knows these differences.

If you are uncomfortable with the idea of taking an anti-depressant medication even after you have gathered accurate information, you may want to consider a holistic physician who may have knowledge of natural ways to treat depression. However, do not start taking ANY over the counter medications or natural herbs without consulting your doctor first, 
and NEVER stop taking an anti-depressant medication abruptly or without consulting your doctor. Postpartum depression can have a serious effect on your baby's development.  So keep in mind that the negative effects your depression has on your baby may far outweigh the side effects of an anti-depressant medication. Feel free to contact me for further information or a free depression screening.

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