The conversations surrounding postpartum mood disorders are some of the most important ones we can have when we talk about the fourth trimester.
I’m going to start this conversation by telling my own experience with a postpartum mood disorder. I try to tell my story as frequently as possible. We have to break the stigma around postpartum depression & mood disorders and we do that by sharing our stories.
My postpartum experiences with my first two children were normal. Nothing to report there. However, my pregnancy and postpartum with my third child was substantially different. Unlike my first two pregnancies, my third was difficult. I had hyperemesis gravidum (HG), which meant I threw up every day my entire pregnancy.
Imagine nine months of the worst hangover of your life. Because of the HG, I lost my job, and my social life. My husband worked out of town for a lot of my pregnancy and we were planning to move an hour away immediately after the baby was born. It was a perfect storm.
It took about six months after the baby being born for my mental health to begin to affect my life. When I had been told about postpartum depression, I was told about a sadness, an inability to bond with your baby, laying in bed for days. I had none of those issues. My postpartum mood disorder presented in the form of anxiety. I lived in a constant state of panic. The fear and anxiety began to affect my friendships, my ability to leave my house, and eventually my relationship with my husband. An eating disorder that I thought was old history reared it’s ugly head. They were dark times. In the midst of what I call “the fog” I had a moment of clarity. I realized I was sick. I reached out to the people around me and found out I was surrounded by women who had similar experiences and most of them had suffered silently just like me.
This is why I share my story.
Now, my journey to recovery involved both immense support from my friends and a short period of medication. For some women herbs, therapy, or other treatments are the answer. It doesn’t matter what it takes to help you get better. What matters is that you are healthy and happy.
Current research shows us:
1 in 7 american women will experience some form of a postpartum mood disorder.
Low income mothers have rates of 1 in 4.
Young mothers experience postpartum mood disorders at the rate of 1 in 3.
Recent studies tell us that after giving birth, 40% of young American women of color suffer from a postpartum mood disorder at some point.
These numbers are too high.
A woman’s environment during her pregnancy and postpartum plays a huge role in her postpartum mental health. So, let’s talk about some risk factors that can increase the odds of a woman experiencing a postpartum mood disorder.
There are a few we would expect such as a personal or family history of depression, anxiety, OCD, eating disorders or manic episodes.
Other hormonal issues from before your pregnancy such as infertility, thyroid issues, diabetes, or PMDD.
Hormonal issues that arise after your pregnancy such as an early onset of your period or irregular postpartum periods can also affect your postpartum mental health.
Recent studies show us that women who receive the drug Pitocin increased a woman’s risk of postpartum depression by 32%.
However, like I said before, some of the largest contributing factors that play into a woman’s postpartum mental health are those in the environment around her.
Those factors being:
Inadequate support in caring for the baby.
What do I mean by that? I mean that if the care of the baby is falling mostly on the shoulders of the mother. You just gave birth, so your main priorities should be healing, bonding, and if you choose to breastfeed, nursing the baby. You can see why this factor affects low income, younger, and single mothers more dramatically.
Other environmental stressors include:
Complications in a woman’s primary relationships
Difficulties surrounding the birth or breastfeeding
A major recent life event: a death in the family, moving, losing your job, getting married, really any large life changing event.
Mothers of multiples are more likely to suffer from a PPMD
Mothers whose infants are in the NICU
So, what are postpartum mood disorders?
We have all heard of postpartum depression.
Signs of PPD include:
A loss of pleasure or interest in things you used to enjoy, including sex
Eating much more, or much less, than you usually do
Sadness, crying frequently or for long periods of time
Sleeping too much or not enough
Thoughts of hurting yourself or the baby
Frequently lumped in with Postpartum depression is postpartum anxiety. Because the symptoms of PPA are different than PPD, a lot of women suffering from postpartum anxiety go undiagnosed.
Symptoms of Postpartum anxiety include:
Hyper vigilant concerns about the baby
Sudden changes in mood
Difficulties eating or sleeping
Distractablity or inablity to concentrate
Postpartum anxiety symptoms can sometimes take a year or more to manifest and it is common for women to suffer from both PPD and PPA.
If postpartum depression and/or postpartum anxiety goes untreated it can spiral into more serious postpartum mood disorders such as postpartum panic disorder, postpartum OCD, postpartum GAD, and the very rare postpartum psychosis.
A traumatic pregnancy, birth experience, or postpartum recovery can also trigger the onset of postpartum PTSD in which the mother experiences intrusive thoughts, nightmares, and flashbacks.
So, I know all of that feels like very heavy stuff but take heart in knowing that even those of us who have found ourselves in the midst of the dark days have found our way through it. If you suspect that you may be dealing with some type of postpartum mood disorder or prenatal depression, reach out to your partner, your care provider, your best friend, a family member, anyone. Let them know you’re struggling.
I have heard women speak of the damaging myths of motherhood. Unrealistic expectations of being “the perfect mother” or the “perfect wife”. Really, a perfect ANYTHING is an unrealistic expectation. The idea that the months postpartum are supposed to be the happiest in your life, and the crushing realization that you must be failing as a mother if they are not.
Well let me tell you something, right now.
There is no such thing as the perfect mother.
There is no such thing as the perfect ANYTHING.
All we can do is the best we can. If we make a mistake, we learn from it and move forward. I always quote Maya Angelou for my mothering mantra, "when you know better you do better". So, do your research, use your B-R-A-I-N when making decisions about your pregnancy, birth, and baby and remember that no one is perfect.
I am a working mother. The level of guilt I carried because I left my baby at home with a bottle of someone else’s breast milk because I don’t respond well to a breast pump and needed the help of a milk donor was a daily reminder of my inability to measure up to the absolutely unrealistic expectation of motherhood I had built for myself. So let go of all of baloney images of perfectly dressed babies and well pulled together moms and be ready for reality. I just ask that you remember the most important piece of advice I can give you here.
SELF CARE IS NOT SELFISH.
I am going to repeat myself. SELF CARE IS NOT SELFISH IT IS SELF PRESERVATION.
Things like basic hygiene. Showers, brushing your teeth, brushing your hair those are the very basics when I talk about self care.
What I mean when I say that a new mother needs to ensure she is able to focus on her self care, I mean she deserves the time to be a human being and not a meat binkey. A massage, lunch with your friends, time to read a book, anything that you like to do is essential in the postpartum period. We have been brainwashed into thinking that a good mother gives up everything about herself to devote herself entirely to her children and that is the only way for them to be happy. But this isn’t true. There is a reason why you are supposed to secure your own oxygen mask before helping your children on an airplane. This is because it is essential for the adults to be conscious to help the children. The same goes for postpartum self care. You cannot pour from an empty cup. So be sure that you are getting what you need to feel like a person.
Having a supportive group of women around you can also be a huge factor in stable postpartum mental health so contact your midwife or care provider to find out if they have a postpartum support group in your area.
Here are some tips from The Canadian Mental Health Association on supporting a loved one who experiences a postpartum mood disorder:
Make sure your own expectations of your loved one’s experiences and day-to-day abilities are realistic.
Remember that every parent and child is unique and it’s not useful to compare two people or two families.
Understand that people who experience postpartum depression may want to spend a lot of time alone. This can hurt, but try to remember that it isn’t about you. They are simply trying to cope with an illness.
Offer help with daily responsibilities. It’s hard enough at the best of times to find time for daily chores when there’s a new baby. Often, offers of help from friends and neighbors are strong in the first month or two, but may be needed just as much, or more, in later months.
Help with child care (including overnight help for feedings), or help finding a child care provider. A short break or a chance to get back into interests can make a big difference in anyone’s well-being. It can also create more opportunities for sleep.
Managing postpartum depression can take a lot of hard work. Recognize a loved one’s efforts regardless of the outcome.
Talk to your doctor or public health nurse, or accompany your loved one on appointments, if you’re concerned.
Seek support for yourself, if needed. Support groups for loved ones can be a great resource and a great way to connect with others.
You can find more information on postpartum mood disorders linked below. If you need support but don’t have it at home you can call the Postpartum Support International warmline at (800) 944-4PPD
The PSI Warmline is a toll-free telephone number anyone can call to get basic information, support, and resources.
If you are having thoughts of harming yourself call the National Suicide Prevention Hotline at 1-800-273-8255 or 911.
And remember, if you find yourself struggling with a postpartum mood disorder, you are not alone. There are resources in place to help you.