Postpartum Depression

One in five women in the US suffers from depression, anxiety, or both while pregnant or after giving birth, negatively impacting the mother and the child. Despite this high prevalence of mental health issues, few women receive treatment.

Perinatal mood and anxiety disorders are the most common medical complication affecting women during pregnancy and after childbirth. They include prenatal and postpartum depression and/or anxiety, and, in extreme cases, postpartum psychosis. According to the Maternal and Infant Health Assessment (MIHA) 21% of pregnant and postpartum women in the United States are affected. The prevalence is estimated to be even higher in some populations. For example, one in four African American and Latina mothers in the state reports depressive symptoms, and so do as many as half of all mothers living in poverty.

Left undetected and untreated, these conditions can lead to negative health outcomes for the mother and can negatively affect the mother-child bond and the child’s long-term physical, emotional, and developmental health. Additionally, the financial cost of untreated maternal mental health conditions can be significant (for example, more use of emergency care services, higher rates of absenteeism at work).

Generally, after childbirth or a miscarriage your doctor will ask with you about your feelings, thoughts and mental health to distinguish between a short-term case of postpartum baby blues and a more severe form of depression. There is no reason to feel ashamed or embarrassed. Postpartum depression is common as well as depression from a stillbirth or a miscarriage. It is important that you share your symptoms with your doctor so that a useful treatment plan can be created for you.

As part of your evaluation, your doctor may:

Do a depression screening that may include having you fill out a questionnaire
Order blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms
Order other tests, if warranted, to rule out other causes for your symptoms

Postpartum Depression Treatment:

Treatment and recovery time vary, depending on the severity of your depression and your individual needs. If you have an underactive thyroid or an underlying illness, your doctor may treat those conditions or refer you to the appropriate specialist. Your doctor may also refer you to a mental health professional.

The Baby Blues vs. Postpartum Depression

On average, 80% of new moms get the baby blues while 20% experience a postpartum mood disorder (PPMD) (depression, anxiety, OCD). Some women after giving birth experience one type of disorder while others experience a combination of them both. Everyone woman’s chemistry is different.

The baby blues are often referred to as the time right after a child is born. Mother not only has had the physical exhaustion of giving birth, but she also has had a hormone release in her system. The baby blues usually fade on their own within a few days to one to two weeks – sometimes up to four weeks. During the first two weeks:

Get as much rest as you can.
Accept help from family and friends.
Connect with other new moms.
Create time to take care of yourself.
Avoid alcohol and recreational drugs, which can make mood swings worse.

If though the blues do not leave after two weeks, it is important to speak to a medical professional. Depressive symptoms that extend past the first two weeks after giving birth can include:

Your baby blues don’t leave after 2 weeks
Sadness or guilt consume you
You lose interest in things you use to like
You have trouble making decisions
You worry you won’t be a good mother
You have had big stressful changes in your life
You think about harming yourself or your baby

Postpartum Support

One of the very first steps to identifying postpartum depression is speaking with your OBGYN. They will have tests to rule out any medical issues and help identify treatment options. Individual and couple’s counseling can be very helpful. In addition, group support organizations such as the La Leche League and birth support centers have resources. Postpartum Support International has many groups online and locally to help new mothers and parents with postpartum mental health after the birth of a child. Postpartum mood disorders can be successfully treated with psychotherapy (also called talk therapy or mental health counseling), medication, or both. Finding a therapist specializing in perinatal mood disorders is often key to finding relief from symptoms.

It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional. Through therapy, you can find better ways to cope with your feelings, solve problems, set realistic goals and respond to situations in a positive way. Sometimes family or relationship therapy also helps.
Your doctor may recommend an antidepressant. If you’re breast-feeding, any medication you take will enter your breast milk. However, most antidepressants can be used during breast-feeding with little risk of side effects for your baby. Work with your doctor to weigh the potential risks and benefits of specific antidepressants. It is important also to work with a prescribing maternal mental health professional to help you decide on what course of action to take in treatment planning.
Group Therapy Look online for support groups to help normalize your experience. Because of the recent pandemic, access to groups internationally are a feasible option. This can be very helpful for new mothers whose routine is off due to infant’s feeding schedules.

With appropriate treatment, postpartum depression symptoms usually improve. In some cases, postpartum depression can continue, becoming chronic depression. It is important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse.