Understanding Postpartum Depression
Thursday, January 01, 2015
The hormonal changes that happen with pregnancy and in the postpartum period are intense. It is said that 80% of women experience the baby blues within the first 2 weeks of giving birth, and that is considered to be a fairly normal (medically speaking) part of the postpartum process. Postpartum depression is a more severe form of the baby blues, and it can be a frightening illness. Diagnosing this disease that affects between 10-20% of all women can be difficult for several reasons. First of all, because being a mom is “supposed” to feel so amazing, admitting to anyone that you don’t love or can’t handle being a mom feels intensely shameful, so women hide their symptoms. Secondly, it can be hard to recognize what is normal and what is not.
The Definition of Normal
It is very important to point out that “common” and “normal” are not the same thing. Often when women do reach out to friends or family and share their feelings of inadequacy, their frequent crying, insomnia, and constant anxiety about baby’s safety, it is dismissed because “everyone feels that way when they are a new mom.” People (including some doctors) are quick to brush these symptoms off as the baby blues. In fact the symptoms listed above are all possible signs of postpartum depression, and even though they are common, and “everyone feels that way,” they are not normal.
Baby Blues can include the following symptoms:
- Feeling let down
- Crying for no reason
- Irritability
- Restlessness
- Anxiety
- Impatience
All of these symptoms can also be present with postpartum depression, but in the case of the baby blues, they are caused by the transient but strong shift in hormones that moves your body from a pregnant state into a non-pregnant state. The hormonal aspect of the illness is enhanced by the fact that you are concurrently adjusting to life with a new baby. The thing that makes the baby blues normal is the fact that almost everyone experiences it to some degree (and to a relatively mild degree), it happens during the course of a predictable hormone shift, and most importantly, the feelings are transient lasting no more than 1-2 weeks after delivery.
Postpartum depression, on the other hand, has more severe symptoms that last for a longer period of time. Brooke Shields was one of the fist celebrities to use her status as a platform for talking about PPD. While her speaking out is credited with making people more widely aware of this disease, she suffered from a very severe case of the disease which led to the thinking that you can't have PPD unless you have extreme symptoms. So if your symptoms aren’t as extreme as being unable to eat or get out of bed, or wanting to harm yourself or your baby, the perception is that it is not PPD, you just have the baby blues, or need some sleep, or a night out. The aforementioned symptoms that Brooke had are actually more often connected to the very severe and rare postpartum psychosis (for more info on postpartum psychosis, postpartum anxiety, or postpartum OCD, check out BabyBluesConnection.org).
The following are symptoms commonly ascribed to PPD:
- Frequent sadness or crying Changes in appetite
- Insomnia or hypersomnia Intense fatigue with low mood Emotional numbness
- Feelings of helplessness and despair Irritability, surges of anger
- Feelings of inadequacy, guilt or shame Difficulty concentrating, indecisiveness Frightening feelings
- Anxiety/panic
- Repetitive fears, thoughts or images
- Overconcern for your baby
- Lack of interest in sex
- Lack of feelings for your baby
- Exaggerated high or low moods
- Dramatic changes in your feelings ranging from sadness to thoughts of suicide
This list is varied and full of symptoms that people can easily gloss over by citing how hard it is to be a mom. Complicating things further is the fact that you can get PPD after subsequent pregnancies even if you did not have it before.
There is also a fallacy that PPD begins within a couple weeks of giving birth. It is now known that it can begin any time within the first year (and maybe beyond), and it often begins coincidentally with a shift in hormones, such as the return of the menstrual cycle or the end of breastfeeding.
The Shame of Postpartum Depression
In recent years, a handful of celebrities have shared their own experiences with postpartum depression, and that has helped to lift some of the stigma that surrounds the disease. Bryce Dallas Howard wrote a particularly poignant piece for Goop, that details not only her struggles, but her denial, and the way that she hid it from friends and family. She talks about something that is so common to women who suffer from this disease, and that is the intense need they feel to hide it from everyone. There is a lot of pressure to be a perfect mother, and this should at least include the fact that you bond with and feel love for your child, right? Often an early symptom in women with postpartum depression is a feeling of numbness, of having no connection whatsoever with their baby, and no desire to form one. They know they should not feel this way, that people would think them horrible, awful creatures if they knew, and so they pretend.
It needs to be known that postpartum depression has nothing to do with loving your child — it only feels that way. It is a very real and serious disease. It is also treatable. There is an end to it. If you or someone you love may have postpartum depression, please check out the Baby Blues Connection website. They have lots of resources, support groups, a phone line, and support information for partners as well. You do not need to be ashamed. You do not need to suffer. You are not alone.
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