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Postpartum  Depression 

By Rosalind Dorlen, Psy.D.,ABPP

     Most new mothers experience a brief episode of the baby blues and feel stressed, sad, anxious, lonely, or moody following their baby’s birth. These feelings are usually temporary and easily soothed by understanding parents, supportive partners, and devoted friends. For some mothers, however, childbirth unleashes a much more severe mood disorder. Researchers believe that fluctuating hormones cause mood-regulating brain chemicals to go awry. This condition, known as postpartum depression or postpartum mood disorder, affects one in every 8 to 10 women within one year or more after the birth of a newborn and can have a tremendous impact on well-being and her ability to bond with and care for the baby. New moms may be reluctant or ashamed to tell anyone, even their physician, how badly they are feeling. They may have had expectations of being thrilled after childbirth and find it difficult to understand their feelings and reactions to motherhood. They may feel that these feelings make them bad mothers. It is important to understand that postpartum depression is not a character flaw or sign of personal weakness. Postpartum depression can affect any woman, regardless of her culture, age, race, or economic background. 

     The importance of universal screening for postpartum depression is stressed by experts in the field. A recently enacted New Jersey law ensures that all mothers receive routine screening and education about postpartum depression during prenatal and postnatal care. Many more states are developing legislation to educate mothers and their families, create awareness about postpartum depression, and screen mothers so that they can receive the help they need for recovery.

What Are the Symptoms of Postpartum Depression?

While there is a wide range of symptoms, some of the more common are: 

• Continuous feelings of sadness and uncontrollable crying
• Severe sleep problems -  inability to sleep or sleeping too much
• Changes in appetite – eating too little or too much
• Excessive irritability, anger, worry, or agitation
• Extreme lack of energy and motivation
• Inability to get pleasure from previously enjoyed activities
• Lack of interest in the baby,  friends, and family
• Extreme feelings of guilt, worthlessness, despair, or hopelessness
• Inability to concentrate or make decisions
• Thoughts of harming the baby or yourself

Who Is At Risk?

Despite the wonderful joy that a newborn can bring, the year following childbirth is actually the most vulnerable time for a woman to experience a mental health disorder such as postpartum depression. Many factors may play a role, such as: 

• Previous depression or  postpartum depression
• First-time mothers
• A family history of mental illness
• A substance abuse history
• Complications at delivery
• Extreme sleep deprivation
• A very difficult or health-challenged baby
• Not enough support from family and friends
• High levels of stress

What to do if you have Postpartum Depression: 

• Talk openly about your feelings with your spouse, family, friends, and healthcare professionals
• Ask for help with baby care from friends and family
• Eat a healthy, nutritious diet and exercise for more energy. Walking, which is a mild exercise, may be a good choice
• Join a postpartum depression support group, such as
  • Postpartum Support International www.postpartum.net
  •  National women’s Health Information Center www.4woman.gov
  • Online PPD Support Group www.ppdsupportpage.com.  
• Seek mental health treatment

What Treatments are Available for Postpartum Depression? 

     Early detection and treatment are crucial for full recovery. The good news is that postpartum depression is readily treated with counseling and antidepressant medication. The following treatments, usually combined, can offer the most help for mothers struggling with postpartum depression:

      Psychotherapy Treatment - Psychotherapy is another word for talk therapy or counseling. Women meet with a psychologist or other qualified mental health professional and talk about their fears and problems. Psychologists teach patients how to develop skills to manage feelings and cope with problems. Psychologists spend an average of seven years in doctoral education, training, and research before receiving a doctoral degree (either Ph.D. or Psy.D.) in psychology.  In addition, they spend one pre-doctoral and one post-doctoral year in a clinical internship in a hospital or organized healthcare setting and a year of postdoctoral experience before being licensed to provide services to the public. Psychologists practicing in your geographic area can be easily located 24/7 through the Web site www.findapsychologist.org which will put you in touch with a credentialed psychologist who can help you move toward recovery.             Since psychotherapy is a process that occurs between a psychologist and you, it is essential that you feel comfortable with that person in order to develop an open and trusting relationship, which is needed to facilitate growth and progress. Be sure to discuss fees, insurance, and emergency care. It is important to remember that mental health is an important investment in yourself, your baby’s, and your family’s future. When you have located a supportive and knowledgeable mental health professional, you have taken an important step in the journey back to finding yourself and enjoying your life again.

     Medication Treatment – There are a range of antidepressant medications that are prescribed to treat varying degrees of postpartum depression. Coordination of care between your psychologist and the prescribing medical doctor can be most helpful to your recovery. You will need to talk to your physician to determine a safe medication if you are a nursing mother.  

     Education and Support Groups - Support groups provide guidance, compassion, and assistance for women suffering from postpartum depression. They offer an opportunity for women to understand their depression and benefit from the experiences of other women and helps them to realize that they are not unique.