The Many Faces of Postpartum Depression

The Many Faces of Postpartum Depression


Pregnancy can be such a beautiful time: growing a life, having that ever constant companion inside your belly. You’re excited, confident, ready to throw open the doors to love beyond measure.

The birth of your baby is the grand finale of all this anticipation, and motherhood is a joyous celebration.

But what if it isn’t?

Within the year after delivery, 1 in 7 women find themselves in a deep, dark abyss of depression.

While the term “postpartum depression” often carries with it a societal stigma and calls to mind the worst in headline news, the reality manifests in many different forms on a broad spectrum.

Signs of Postpartum Depression

Although we don’t know the exact causes of postpartum depression (PPD), researchers believe it may be from a combination of changes in brain chemistry or neural circuitry and changing hormones.

Women suffering from Postpartum depression may experience

    • Restlessness and an inability to sleep
    • Lethargy and sleeping too much
    • Chronic fatigue and brain fog, difficulty making decisions, and forgetfulness
    • Eating much more or much less than usual
    • Overwhelming sadness and hopelessness, with tearful episodes coming out of nowhere
    • Lack of energy or motivation
    • Intense feelings of guilt, inadequacy, or worthlessness
    • Loss of pleasure or interest in everyday activities
    • Withdrawel from family and friends
    • Physical discomforts like indigestion, muscle aches, and headaches
    • Relentless anxiety, panic attacks, and racing, scary thoughts
    • Excessive irritability, anger, or agitation and lashing out at others
    • Fear of not being a good mother or agonizing over loss of self

Many factors may contribute to and further compound postpartum depression

    • A labor that didn’t go according to birth plan
    • Fatigue from a long, arduous labor
    • Lack of sleep from the constant demands of a newborn
    • Breastfeeding issues
    • Physical discomfort during recovery
    • Lack of family nearby to support the transition
    • Difficulty adjusting to weight gain during pregnancy
    • Changes in home and work routines
    • Perfectionism and the desire to be a “perfect” mom
    • Doubts about the ability to be a good mother

The most extreme end of the spectrum includes thoughts of abandoning the baby, hurting herself, or hurting the baby. Postpartum psychosis occurs in 1 to 4 out of every 1,000 births, with symptoms of confusion, hallucinating, and/or rapid mood swings.

Postpartum psychosis is a medical emergency. If you are experiencing thoughts of hurting yourself or your baby then go to the ER or visit your OBGYN immediately.

Baby Blues vs Postpartum Depression

You may have heard the term “baby blues” to describe the mood swings most new mothers experience. The sudden hormonal changes after delivery can cause anxiety, stress, isolation, fatigue, loss of appetite, and difficulty sleeping. About 80% of new mothers report feeling tearful and emotionally fragile for the first few weeks postpartum.

The moment my son was delivered onto my belly, I knew I would die for him. It was an intense love at first meeting, and the emotions that accompanied my postpartum period were both awesome and awful. 

Most of the time I felt fine; I was learning how to breastfeed (which was very painful for 4.5 months), I was sleeping perhaps two hours at a time, and I was engrossed in our new bundle and my new role as a mom. In those first few weeks, I found myself weeping randomly. Sometimes I was sleep deprived, other times I was overwhelmed by emotions I’d never experienced before.

My heart opened in a way I didn’t even know was possible. I felt like—simply by becoming a mother— I could love other people better, as if I could suddenly love unconditionally. I began to see strangers differently, and I was overwhelmed with the idea that everybody is someone’s baby. It was both beautiful and exhausting to feel this deeply. After about three weeks, the intensity of my emotions lessened, and I felt ready to emerge from my baby cocoon and interact with the world again.

The difference between the baby blues and PPD is the blues tend to subside after a few weeks, whereas PPD persists for months, sometimes longer if untreated. Postpartum depression often mimics normal baby blues at first with the irritability, crying jags, and incessant worrying. Healthcare professionals use the Edinburgh Postnatal Depression Scale to help assess the emotions new moms are feeling. 

What does PPD Look like?

Clinical descriptions only tell part of the story. While many moms report feeling some of the same key emotions, postpartum depression and other postpartum mood disorders will be different for every woman.

Whether from the stress of labor, a genetic predisposition, or even a perceived failure to “live up to” what you believe your motherhood journey should look like, postpartum depression can make you feel hopeless, broken, or like life will never improve. The good news? While what you’re experiencing can make you feel isolated, you’re not alone.

Jennn Fusion, Kindred Bravely's Copywriter,
learned PPD doesn’t always happen right away.

JennnI always thought of postpartum depression as something you had or didn’t have right after childbirth. So when I sailed through the first few months relatively blissfully, I thought I was one of the lucky ones.

The overwhelming despair hit me like a ton of bricks after the one-year mark, when I stopped breastfeeding. I’ve always been an optimistic go-getter, but each month, right around the time of my period, I had a week of utter hopelessness.

I was overwhelmed by basic tasks like picking up toys, meal planning, and changing diapers. I felt so fatigued and angry! I criticized my husband over the most trivial matters, thinking he was deliberately making life more difficult for me by throwing wet paper towels into the sink or by throwing his clothes next to—not inside of—the laundry basket. Mole hills became mountains. I felt like an empty husk –sucked dry from the baby, my husband, and life itself.

I lamented that I had no hobbies aside from writing, and found it difficult to look forward to anything. I felt guilty about my loss of libido and indifference toward romantic life. I stayed home most of the time and didn’t like being in ‘the mom club,’ with all the philosophies, judgments, and Pinterest pages.

After three months, I knew I hit rock bottom when I started fantasizing about how ”nice” it would be if I fell ill or became terribly injured, so I could be hospitalized and take a “holiday” from my life. Rationally, I knew it was the hormones, but I felt powerless to change the situation. I finally talked candidly to my doctor about it and decided to go back on birth control pills to help balance out my hormones.

Before I could implement the plan, I had an unusually exuberant day: full of energy, like a sudden ray of sunshine. I knew it could only be one thing: I was pregnant again! As quickly as the darkness had crept in, it went away. I had a sunny pregnancy and didn’t have anything more than a bit of baby blues the first few weeks postpartum with my second baby.

Sophia Carr, Kindred Bravely's Instagram Manager,
describes her postpartum anxiety.

SophiaIt’s planning out every possible exit each time we enter a room, just in case some terrible disaster would occur where I need to protect us.

It’s being terrified of something hurting him when I can’t do anything to help or of something happening to me so I can’t care for him anymore.

It’s only wanting to drive when the sun is shining, because I’m afraid we’ll end up in danger if I drive in the rain, snow, or sleet.

It’s willingly sitting at home and not caring about missing out on fun times with family and friends because I’m too scared of something bad happening to us while we’re there.

It takes all of my strength to get us out of the car and into the store. More often than not, I pull into the spot and sit there for a few minutes, contemplating whether we really need to be there or if we’d be fine just going home instead.

It’s panicking when we’re out and a stranger comes up to us and touches him. When my son was about seven months old, a little girl came up to him while we were at the mall and grabbed his hand. I quickly told her “no, you can’t touch him” and immediately sanitized his hand. I felt guilty after she apologized but it happened so fast. My heart was racing for hours after that.

If we’re out shopping, and someone nearby has a cough, and they either don’t cover their mouth or keep coughing and coughing, I put back all of the things I was going to buy and hustle to get us out of there as fast as we can.

This may all sound silly and ridiculous, even crazy to someone who doesn’t experience these things, but they’re real. These feelings sneak up and get you when you’re at your most vulnerable. There’s not much you can do to prepare for this, but knowing what to look for can make it a lot easier.

 

Sydney Giannell, Kindred Bravely's Outreach Coordinator,
experiences postpartum depression, anxiety, OCD, and PTSD.

SydneyIt wasn’t until I was postpartum with my second child that I began to realize something was going on. My first labor and delivery were exhausting; nothing went the way I’d planned it, and my son was eventually delivered via emergency C-section.

Nineteen months later, as I was heading towards a VBAC with my daughter, I decided to have a scheduled C-section instead. My second pregnancy had been physically and emotionally draining, and I was worried that labor would be too much for my body to handle. The night I made that decision was the best night’s sleep I’d had in months.

After my daughter was born, I felt exhausted, incapacitated, anxious, fearful… everything on every list of any postpartum mood disorder.

The hardest part for me was admitting to myself that something was off; even thinking about my anxiety triggered more anxiety. So I tried to “just get over it.” I couldn’t bear the idea that I was “weak” or a “failure.” I convinced myself that if no one noticed anything was “wrong” there couldn’t actually be anything “wrong.”

Even though I’m an introvert, I have a naturally bubbly personality, and my anxieties were easily covered up by “Smiling Depression,” which made admitting I needed help even harder.

Eventually I found the courage to admit I needed help. Once I began seeing a therapist and started taking medications, I started feeling like me again.

Now, 19 months later, I still struggle with depression and anxiety, but I’ve discovered that being honest about my diagnosis and experiences makes me feel less alone, which helps me.    

Sarah Ortmayer, Kindred Bravely's Facebook Manager,
experienced prenatal anxiety.
 

SarahIn college I was diagnosed with mild depression and anxiety; I tried taking medication, but didn’t find the right fit. I either ended up feeling numb or fake happy.

With each of my pregnancies, anxiety overwhelmed me. One moment I’d be feeling great, the next I felt consumed with worries I couldn’t control. I became obsessed with my children’s safety, constantly worrying about what could happen to them—especially if they weren’t with me.

Since medication had never worked for me, I tried to find small things to help me feel more like myself: eating healthy foods, getting a haircut, and being outside as much as possible. Fortunately for me, as soon as I give birth, the change in my hormones brings be back to my pre-pregnancy self again.

 

Many celebrity moms have been open about their postpartum experiences.

Chrissy Teigen felt mental anguish over letting others down which manifested into physical pain. Bryce Dallas Howard felt a loss of emotions, which she calls “emotional amnesia.” Gwyneth Paltrow struggled to acknowledge her depression. Marie Osmond was driven to action by intense fight-or-flight feelings. Alanis Morissette felt despondency and physical pain. Brooke Shields experienced guilt, shame, and even disinterest in her baby.

According to a study from The Cumming School of Medicine in Calgary, difficulty with breastfeeding may increase the odds of suffering postpartum depression. Mothers who sought advice and support for breastfeeding were less likely to suffer from depression.

It’s also important to note that dads can experience postpartum depression as well. While Paternal Postnatal Depression isn’t caused by the hormonal changes of pregnancy and delivery, it can be as debilitating and have as great an effect on the family as postpartum depression in women.

What Should You Do If You Think You Have Postpartum Depression?

The first step is recognizing that you aren’t feeling like yourself, and then seeking assistance to move toward feeling better. If you think you may have postpartum depression, first acknowledge that what you’re experiencing isn’t your fault. Remind yourself that you’re not imagining your feelings. PPD is a real and treatable. Remember, you are not alone.

Often, labeling the condition and just talking to someone about it can help immensely. Professional treatments for postpartum depression include various forms of psychotherapy, often combined with antidepressant medication. Through these insightful sessions, you will gain the skills you need to cope with everyday challenges and manage your feelings.

If you think you’re experiencing a medical emergency, find someone to watch your baby while someone else takes you to your OB/GYN or the ER.

How to Help a Loved One With PPD

No one wants to be told “you need help,” but you might mention that you notice she doesn’t seem quite like herself or compassionately ask, “How are you doing? Can I help with anything?” Let her know you are there for her, no matter what, and that it will get better.

Andrea Schneider, LCSW and Psychotherapist suggests the following ways to help

  • Seek competent help
  • Don’t try to diagnose her yourself
  • Educate yourself about perinatal mood/anxiety disorders (PMAD)
  • Tell her when you notice she is getting better
  • Encourage her to rest, exercise, and get good nutrition
  • Attend her appointments with her
  • Work with healing professionals to support your loved one
  • Get support for yourself
  • Remind your loved one that she is experiencing a medical condition
  • Make sure you are also getting rest

Of course, you need to look out for your own mental health, too. Even if you understand what’s causing the depression, it can be difficult not to internalize some of the struggle or question your own adequacy. Speaking with a therapist and taking some time for yourself can help you through this phase, too.

If your loved one is experiencing a psychiatric emergency, seek help from a healthcare professional immediately: call emergency services, her healthcare provider, or the hospital’s emergency department and follow their instructions.

Who to Contact

There are many places to find help. The most obvious places to start are your primary care doctor or OBGYN, who can refer you to a psychologist who is trained to help with postpartum depression. You may contact the American Psychological Association for a list of practitioners in your area at 1-800-374-2721 or at www.apa.org.

You may also contact:

Postpartum Doulas are another option to lighten the load. As Certified Doula Kym O’Malley puts it: “Postpartum doulas can help new parents who may be feeling overwhelmed or isolated by providing non-judgmental support, help with breast/bottle feeding issues, infant care and sometimes just a listening ear and extra pair of hands.”  

Be Brave. Be you. Be comfortable.

Perhaps the most damaging part of PPD is the way it leads women to believe they are “failing” due to inadequacy, or that they are chained to a lifetime of unhappiness. You may feel your resources are depleted and you’ll never be your “normal self” again, but don’t be afraid to admit what’s happening and what scares you.

I firmly believe that every mom is exactly the right parent for her child. Being open about our emotions takes incredible courage, but that bravery is the best gift you can give your children. Showing them that it’s okay to be vulnerable will help teach them to be compassionate towards others and themselves.

With the right support system, postpartum depression is treatable. Like every stage of parenthood, it won’t last forever, and it will get better.

Be you bravely,

Deeanne

 

The Many Faces of Postpartum Depression