What is postpartum depression, also referred to as PPD? Postpartum is the period after giving birth. The postpartum baby blues is a reference to the experience of sadness or emptiness after giving birth, most likely due to hormones, body changes, and/or genetic factors. When these symptoms last for more than three to five days there may be a more serious development of depression. Learn how to help someone with postpartum depression.
Postpartum depression is a serious disorder. It lasts longer than two weeks after giving birth with worsening symptoms of sadness, hopelessness, feeling empty, difficulties connecting with your baby, and lethargy, it impacts your behavior and physical health (1). PPD is being discussed more as it has been found to be more common than previously thought.
Postpartum Depression affects around one in seven women, it occurs most commonly within the first six weeks, and it is most common in adolescent females, mothers delivering prematurely, and women living in urban areas. In 2006 Beck referenced that half of PPD in new mothers go undiagnosed due to reported reasons of not wanting others including family members to know (2).
How to Identify Symptoms
You or your new mother loved one may have PPD if five or more signs or symptoms last longer than two weeks: (3)
Changes in your feelings
- Feeling depressed most of the day, daily
- Feelings of shame, guilt, or failure
- Feeling panicked or scared most of the time
- Experiencing severe mood swings
Changes in everyday life
- Having little to no interest in usually enjoyable things or activities
- Feeling tired most or all the time
- Change in eating habits
- Gaining or losing weight
- Difficulties with sleep, too much or too little
- Difficulties concentrating or making decisions
Changes in how you think about yourself or your baby
- Difficulties bonding with your baby
- Thoughts of harming yourself or your baby
- Thoughts of suicide
Causes, Contributing Factors, Risk
There are a lot of hormone changes that occur during and postpartum. The female hormones are the highest they can get, estrogen and progesterone, then they quickly drop 24 hours postpartum. Researchers suggest the sudden drop contributes to depression. Thyroid hormones also drop postpartum, low levels of this hormone cause depressive symptoms as well.
Other common life-issue contributing can be tiresome or strained labor and delivery, lack of sleep from pregnancy or delivery, being overwhelmed with a new baby, doubts of being a good mother, stress from disrupted daily routine, unrealistic expectations, the grief of losing self-pre-baby, feeling less attractive, and lack of free time. (1)
Having a previous mental health history or family history of mental health issues can increase the risk of PPD though doesn’t mean for sure PPD will occur. A trauma history that includes physical or sexual abuse, including problems with your partner or domestic violence can impede on coping ability and increase risk.
Other environmental factors can be a high level of stress in your life in the areas of occupation, finances, family, lack of support, loss, or even pregnancy being unplanned, or being younger than 20 years old. Health and medical risk factors include diabetes, vitamin B6 deficiency, complications during pregnancy or birth defects or a baby with special needs if you smoke or drink, or use drugs, and/or difficulties with breastfeeding. (2)(3)
Helping Someone with PPD
There are many ways to be helpful, but it can often feel so powerless and helpless to watch a loved one go through such emotional pain and suffering. Reassurance goes a long way and great way to start. Reassure them they are not alone, it’s not their fault, that they are loved and will get better. Encourage self-care and taking breaks to rest.
Offer simple affection and be patient with what they are up for. Manage your expectations and be realistic and help with tasks around the house. Schedule time away for them or a romantic date by getting a babysitter. Encourage them to reach out to friends or clinical professionals and treatment if symptoms become unmanageable (4).
Communication is going to be a big factor in dealing with anger and irritability symptoms. Provide opportunities to listen and ask how you can help and refrain from being suggestive or too solution-focused. Share how you feel and include the distance you are experiencing from them. Ask for a break if the expression of anger becomes too much. Lack of sleep and nutrition can also cause irritability and anger, helping provide opportunities for rest and adequate meals (4).
Psychotherapies and Medications are common treatments for PPD.
In participating in psychotherapy, you can share your feelings, and your experiences, problem-solve, set realistic goals, and respond to barriers you experience in more positive ways. Two common psychotherapy modalities (5):
- Cognitive behavior therapy (CBT) – This therapy helps to identify negative thoughts/self-talk by setting achievable goals to counteract these thoughts, think differently and act and react differently to the environment. (3)(5)
- Interpersonal Therapy (IPT) – IPT looks closely at communication and decision-making. It’s a relational therapy to help improve personal life problem areas. (3)(5)
Antidepressants are used to treat any kind of depression. Most are found to have little to no effect on the baby – breastmilk. Work with your medical provider to find the right antidepressant for you with little to no side effects.
Hormone therapy may be another route your medical provider takes. Estrogen plays an important role and drops rapidly postpartum and increasing estrogen can help with depressive symptoms.
Finding a support group can be another helpful resource. It helps to not feel alone, and it can add hope.
There is not a one size fits all treatment, but there are a lot of resources if you’re looking for help for yourself or your loved one.