Over the past two decades, we have seen a steady rise in media attention covering postpartum depression (PPD). This is partly because the psychiatric community officially recognized PPD as a distinct condition in the mid-90s1 and partly because of celebrities who have started to talk about their experiences with condition. And yes, you read that correctly, although there are abundant records of women talking about their experiences with maternal mental illness from the early 1800s to the present, we just started to recognize it as a distinct mental illness in the 1990s2. As you might imagine, the result is that the science, the literature and the media reporting are all a bit behind. Luckily, with organizations such as Postpartum Support International (PSI), the science is finally starting to catch up and hopefully that means the media and our social perceptions of maternal mental health will too.
So, what is postpartum depression?
It’s often used as an umbrella term for all maternal mental health conditions, but in reality, there are several maternal mental health conditions that are distinct and vary in terms of severity, duration and characterization. All of these conditions tend to get jumbled up together in the media which is confusing for those who have PPD and their loved ones. So, let’s break it down.
The technical term for postpartum depression is a Major Depressive Episode with Peripartum Onset. What that mouthful of jargon basically means is that PPD can be understood as a depressive episode that lasts a minimum of 2 weeks and is characterized by depressed mood, insomnia or hypersomnia, fatigue, feeling worthless, low interest in pleasurable activities and having thoughts of suicide3. If you read my last blog post about the Baby Blues, you might note here that PPD is very different from the Baby Blues which is a normal part of giving birth where most mothers experience a drop in mood right after giving birth. PPD not only last longer but is more severe. About 15% of new mothers experience PPD as opposed to 85% of mothers who get the Baby Blues4, 5. And while this distinction is important, keep in mind that whether you have the Baby Blues or PPD, you can absolutely get treatment, you don’t have to wait and see if it’s severe enough. Every person’s experience is different, and you deserve help. Do yourself a favour and check in with your Doctor, midwife and/or therapist to see how they can support you to feel like yourself again.
Men experience PPD too. A growing body of research has shown that roughly 5% of new fathers experience PPD6 which comes as no surprise because mothers and fathers both endure the many new stressors like lack of sleep, way more responsibilities and demands put of their plate, and feelings of failure and inadequacy often associated with bringing a baby home.
I won’t go too far into the causes of PPD here but if you ever want to talk about them, my door at Alongside You is always open.
I’ve spoken with a lot of mothers and fathers who were very confused about the way their PPD presented itself. Interestingly, PPD might look different from what we might think of as a typical episode of depression. A lot of people with PPD have reported either anger or anxiety as their primary symptoms7. Some experience periods of elevated energy and racing thoughts where they’re unable to sleep and can’t stop cleaning erratically. Many also report panic attacks8. While these responses may feel scary at the time, they are normal and can be helped with a number of different therapies that I will get into at the end of this article.
Overcoming Stigma and Getting Help
Experts agree that PPD is underdiagnosed, primarily because those who endure it often feel too ashamed to seek help. There’s a common misconception that PPD is associated with infanticide which is simply not true. Those over-reported cases of infanticide are not cases of PPD, they are cases of severe psychosis with peripartum onset. Unlike depression, psychosis is characterized by delusions and hallucinations9. And even if a parent does show signs of psychosis with peripartum onset, it is incredibly rare that these delusions will lead to infanticide10. I can’t stress enough how rare that is.
New parents are often under a lot of stress, and experience intrusive thoughts. When a person’s brain is in an anxious state, it’s common for their mind to go to the worst possible thing they could do (as if you weren’t stressed enough already…). This happens to all of us. Sometimes when I’m driving up the Sea to Sky highway, my brain imagines veering my car off the cliff. Of course, I will never do that, but my brain plays some pretty wild tricks sometimes, just like yours might when you’re under a lot of stress and your baby is still crying.
The main danger with PPD is that the stigmas that result from those sensationalized media stories keep many new parents from reaching out for help. As a result, suicide (not infanticide) is the greatest risk associated with PPD.
What can Help Postpartum Depression
As I mentioned at the start of this blog, science is catching up and we now have many treatments to choose from for PPD. Some find antidepressants helpful, like one woman said: “the me I was used to re-appeared after medication.” Other treatments include infant sleep interventions, massage therapy and relaxation, increasing Omega-3 intake (fish, nuts, seeds, healthy oils)11, spiritual practices, yoga, bright light therapy and, of course counselling (individual and couples counselling are both helpful). For most new parents, a combination of any of these above methods works best.
I’ll leave you with a simple and accurate quote from a mother I recently spoke with who had PPD: “Let people help, they want to.”
Some books that have been helpful to others:
- Motherhood May Cause Drowsiness: Mom Stories from the Trenches: A Second Edition Monkey Star Press Anthology (What Is a Mother to Do? Adventures in Motherhood and Mayhem) – by: Lisa Nolan, et al.
- When Postpartum Packs a Punch: Fighting Back and Finding Joy – by: Kristina Cowan
- Tokens of Affection: Reclaiming Your Marriage After Postpartum Depression 1st Edition – by: Karen Kleiman, Amy Wenzel
- The Birth Partner: Everything you Need to Know to Help a Woman through Childbirth – by: Penny Simkin
- American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.) VA: American Psychiatric Association
- Segre, L.S., & Davis, W.N. (2013). Postpartum Depression and Perinatal Mood Disorders in the DSM. Postpartum Support International. Retrieved from www.postpartum.net.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). VA: American Psychiatric Association
- Shapiro, G.D., Fraser, W.D., & Seguin, J.R. (2012). Emerging risk factors for postpartum depression: Serotonin transporter genotype and Omega-3 fatty acid status. CanJPsychiatry, 57(11), 704-712.
- Khajehei, M., Doherty, M., & Tilley, M. (2012). Assessment of Postnatal Depression Among Australian Lesbian Mothers During the First Year after Childbirth: A Pilot Study. International Journal of Childbirth Education, 27(4), 49-54
- Breese McCoy, S.J. (2012). Postpartum depression in men. In M. G.Rojas Castillo (Ed.) Perinatal Depression (p. 173-176.) Rijeka: InTech. Available from: : http://www.intechopen.com/books/perinatal-depression/postpartum-depression-in-men-
- APA (2013)
- APA (2013)
- Postpartum Support International (2018). Postpartum Psychosis. Retrieved from http://www.postpartum.net/learn-more/postpartum-psychosis/
- APA (2013)
- Shapiro, et al. (2013)