You are not alone.
You are not to blame.
With help, you will get better.
All women experience pregnancy and childbirth and the adjustment to motherhood differently as each individual has different past experiences and coping skills contributing to her overall emotional and psychological state.
There are several perinatal mood disorders that can occur at this phase of motherhood.
The main types are classified as:
the baby blues
postpartum anxiety / postpartum OCD
Remember diagnoses often overlap and co-occur, and there will be different opinions from different clinicians, so a clear-cut and immediate diagnosis is not that simple and prescribing medications is not that simple either. However, professional counseling is available for perinatal mood disorders.
In addition, support regarding issues of transition to parenting and research-based support about infant sleep can also be provided.
Women need to know it is okay to ask for help.
THE RISK FACTORS FOR EXPERIENCING
A PERINATAL MOOD DISORDER
Did you know?
The risk factors for postpartum depression are biopsychosocial, which are a combination of biology, psychology & social events.
Mental Health. A personal history of a mental illness in your lifetime, such as depression, anxiety, PTSD, OCD, bi-polar disorder. This could be undiagnosed or untreated through a personal decision not to take medication or seek treatment.
Family History. A history of depression or anxiety disorders in your family. These could have gone undiagnosed.
Personal History. A personal history of premenstrual syndrome, perhaps indicating a heightened sensitivity to hormonal changes.
Significant Issues. Other areas of your life can impact you, such as:
Lack of social support
Trouble in the marriage relationship
Mental illness, such as addiction, in your partner
Poverty is a an indicator for postpartum depression. Financial difficulties, such as a general economic recession impacting an entire community
Being in an abusive relationship, even “just” verbal or emotional abuse
A past history of sexual abuse or sexual assault
Experiencing a past traumatic birth, such as a protracted labor involving multiple medical interventions, even if medically indicated. Many factors feed into a woman feeling traumatized during her childbirth experience.
Having a infant born with a disability
Having a stillborn infant
Being the mother of a premature infant
Having had extensive infertility treatments
Feelings around a personal choice to terminate a past pregnancy.
Unresolved issues from childhood regarding parenting / being parented
A previous episode of postpartum depression. A mother who has had a previous episode of PPD has a 50 to 80 percent risk of developing it again with her second baby (compared to a 10 to 20 percent chance without a prior episode).
A sensitivity to hormonal fluctuations of childbirth
If a mother's postpartum depression occurs four to six months after the birth, research shows that there is generally an additional stressor present in the woman’s life, such as substance abuse by her marriage partner, an accident, or the death of a close friend or relative. Support is available.
Support from Kathy
(An emotionally intense time typically occurring any time immediately after the baby is born until the infant is about four weeks old.)
Having a baby is naturally a time of emotional highs and lows. Research shows that about 85% of women who give birth experience feelings of sadness, fatigue, overwhelm, weepiness, anxiety, irritability and possibly some fleeting scary thoughts during the first two to three weeks postpartum. There is so much evidence to support this type of emotionality two or three weeks postpartum that it has a name, the “baby blues.”
The baby blues is considered a normal part of the human emotional experience, and will typically fade as the mother’s body, mind and spirit adjust to parenting. When these feelings continue beyond two, three, four weeks after your baby’s birth, it might be a sign that you are experiencing postpartum depression.
Support is available in this time frame to help support transitions to motherhood.
(An emotionally intense time that is more severe than Baby Blues; may extend past the time that the infant is four weeks old or older.)
Perhaps the most deceptive part about the feelings of postpartum depression is that the symptoms can appear much the same as baby blues, but are actually more long-lasting and severe. The symptoms of postpartum depression can include sadness, weepiness, anxiety, irritability, fatigue, compulsive behaviors and obsessional thinking about the baby’s safety and possibly some scary thoughts about harm to self and others. Your relationship with your partner may also suffer, as existing problems may become exacerbated. But these intense feelings are real symptoms; they are “normal” for someone who is experiencing postpartum depression. They are real in much the same way that feelings of fatigue, irritability, extreme hunger and thirst are symptomatic and “normal” for someone experiencing untreated diabetes. Likewise, the woman experiencing postpartum depression deserves professional treatment, which can help her feel better. A treatment plan for postpartum depression can consist of being evaluated for possible medication or talk therapy sessions, discussing non-pharmacological treatments for postpartum depression, getting practical help for the short-term, setting up long-term goals, and, if in a committed relationship, paying attention to improving communications.
Without blame or judgment, you can safely explore ways to protect your health.
(When the mother's anxiety has become unbearable and typically filled with scary thoughts about safety needs for the new baby.)
Anxiety is a normal response that protects and motivates us to avoid and correct threatening situations.
However, when a mother suffers from postpartum anxiety, the anxiety response has become unbearable. There can be a barrage of scary thoughts regarding the safety of the mom and the baby and it may be accompanied with the enacting of rituals that will supposedly protect her baby and herself. If a person already has a predisposition to rigidity in her thinking, is generally intolerant of uncertainty, has feelings that you can prevent things from happening by worrying, then the intense life change of having a baby can trigger postpartum anxiety. There is evidence to suggest that a new mother has a biological propensity for a heightened protective response when her infant is born. So the behavioral actions of protecting and checking the infant is biologically based. Research suggests that this response may also be heightened by a sensitivity in some women to oxytocin, the bonding hormone, which over-stimulates feelings of over-protectiveness in new mothers.
Together, we can explore
how you authentically feel about your own parenting choices and how you can manage possible conflicting opinions from family and friends.
(A psychiatric emergency. Women with cyclical mood disorders are especially vulnerable, particularly in the first thirty days after birth.)
Postpartum psychosis is a psychiatric emergency. Approximately 1 in 1000 suffer from this illness. According to the surgeon general, women are most susceptible to psychosis after birth, usually for the first thirty days after the birth. Women with previous cyclical mood disorders are vulnerable to postpartum psychosis, or if there is schizophrenia or bipolar illness in the family. This disorder can be a diagnosed or undiagnosed illness.
A psychotic state is un-nerving to observe, especially if you are seeing it for the first time, or if you are seeing it in someone you know. Signs of a psychotic state are: the woman is not sleeping for a few nights in a row; she has strange delusions; she speaks about nonsensical beings;
has thoughts about evil beings. talks about death, blood; she is mumbling;
her movements are robotic and stiff; she acts as if hears words coming from somewhere else; she is staring; she has a flat look on her face and has a flatness to her feeling states;
her speech is deadened and flat; she gives one word answers; she is fearful and paranoid.
Remember: Remain calm.
The person is not faking it. The person is ill, and needs help, not ridicule. Know that you cannot talk a person out
of delusions; instead, nod your head, listen, and GET HELP IMMEDIATELY. Do not leave her alone. Contact her husband, partner, mother, whomever is closest. Call 911 or escort her to the emergency room for a psychiatric evaluation.
For Family and Friends of Mothers Who Need Help
What can you do if a perinatal mood disorder is suspected?
Below are ways you can help protect the mental health of mothers.
Seek professional treatment.
Take the mother to see her primary care physician immediately, especially is there is a history of mental illness in her life or in her family. There are natural methods to treat symptoms of depression, but a diagnosis of a depressive episode, postpartum onset, needs to be treated with medication and therapy.
Support the need for self-care.
Increase the opportunities for self-care for the mother. Help the mother get some practical help in the way of sleeping and eating properly. It is worth it to spend the money to hire a postpartum doula to help with the night shift for a month or so.
Protect the need for sleep.
Help the mother create an opportunity to sleep. Help her look at her mothering practices and beliefs. There are many methods of raising a securely attached and emotionally health infant. If she is invested in attachment parenting, there may be a way to compromise so she can get adequate rest.
Support the need to eat well.
In many towns, a local deli or restaurant might have a special menu for people who are experiencing an illness, and you can order from this menu, or maybe organize a meal preparation chain.
Offer practical help.
Offer to hold the baby. Let the mother have time to take a shower. Organize friends & family to come over once a day every other day for a few weeks. If a medication is introduced, help support the mother's need to get past the time when the medications can start working.