What is PostPartum Depression (PPD)?
PostPartum Depression is a depressive type of emotion felt after being pregnant (or having a baby – for men). It can happen to anyone – one in every eight women have PPD after delivery. PPD is NOT related to wheather or not you breast-feed, the sex of the baby, your level of education, mode of delivery, nor if the pregnancy was planned or not. It is an unexpected “side effect” of having a baby. Women can also develop PostPartum Psychosis – which is different than PPD. Men can also suffer of PostPartum Depression.
Signs and symptoms of PostPartum Depression (PPD)
PPD presents itself in many different ways:
- Depression changes the way you feel: depressed mood, severe anxiety (rapid heartbeat, irrational thoughts, fears, or obsessions, worrying, feeling panicky), feelings of worthlessness, hopeless, or helpless, or excessive or inappropriate guilt (blaming self when things go wrong) or suicidal, no longer finding joy in activities you liked before, irritability or anger, lack of patience, feeling being a bad mother / father
- Depression changes the way you behave: your sleep and eating patterns changes, you feel sluggish, tired, or you talk less, uncontrollable crying, having trouble with daily tasks or taking care of the baby
- Depression changes the way you think: decreased concentration or ability to make decisions or focus, recurrent thoughts of death or suicidal/homicidal ideation
- Depression changes the way you socialize: low interest or pleasure in activities
- Depression changes the way your body feels: fatigued, decrease energy, high or low appetite with weight loss, insomnia and fragmented sleep, even when the baby sleeps, physical agitation, or psychomotor slowing
- You have little, if any, interest in sex, or feel disconnected from your partner
- Not feeling attached to the baby, disturbances in mother-infant (or father-infant) relationship, inability to care for the baby, lack of interest in the baby, not feeling bonded to the baby, or feeling very anxious about the baby
- Fear of harming the baby or yourself
Men / Father’s symptoms of PPD
New fathers can also experience some symptoms of PPD, such as feeling fatigued, having changes on the way they eat (more or less) or sleep. Men are especially susceptible to PPD if they have history of depression, family history of mood disorder, or financial difficulties. PPD affects 1 in 25 new fathers.
What is the difference between “baby blues”, PostPartum Depression (PPD), and Postpartum Psychosis?
The first two share many symptoms, with the difference that in PPD, the symptoms are more SEVERE, including having suicidal thoughts or abilities to care for the new born. Symptoms for PPD are also long lasting. Postpartum psychosis is the more (RARE) and severe psychiatric disorder and only occurs 1 in 1000 new moms.
Causes of PostPartum Depression (PPD)
PPD affects 1 in 8 pregnant women and appears in the following weeks after the birth (or miscarriage), lasting anywhere between 2 to 6 months.
History of depression, family history of mood disorders (genetic contributions), stressful life events, poor relationship with the partner and weak social support are strongly correlated to developing PostPartum Depression (PPD). There are studies indicating that hormonal levels and cultural background may have a part in developing PPD.
How I treat PostPartum Depression (PPD)
I often use an integrative approach to treat anxiety. I use techniques from Cognitive Behavioral Therapy (CBT), as well as psychotherapy, Mindfulness, ACT, EFT, and other types of therapy I’ve trained on and maybe useful to the treatment. I spend a great amount of time in psychoeducation Postpartum Depression.
“Do I have to take medication for PostPartum Depression (PPD)?”
Depending on the cases, I might recommend patients to see a psychiatrist and start on medication for depression as soon as breast feeding has ended. Although, PPD can be treated without medication.
Typical outcomes of PostPartum Depression (PPD) treatment
After completing treatment, patients can expect returning to an optimal level of wellbeing with no intrusive negative thoughts. PPD can cause severe anxiety. Since anxiety is connected to the body’s flight/fight/freeze/faint system, once activated often times it cannot return to base level of zero, but to a healthy level of functioning that should not interfere with the mother or the baby’s wellbeing.
FAQ about PostPartum Depression (PPD)
How long is the PostPartum Depression (PPD) treatment?
Since there are many different levels of PPD, it is expected that the duration of treatment depends on the presenting symptoms and the intensity of the symptoms. It is usually resolved anywhere between a couple of months to a couple of years.
“Can my PostPartum Depression (PPD) come back?”
Yes. You can have PPD again in subsequent pregnancies, but it is not a certainty. You can also be more susceptible to subsequent feelings of depression. There may be situations that will trigger the depression and/or anxiety back. Understanding where the depression and/or anxiety is coming from and how it has been triggered will help subsequent treatments.
“I suspect that my partner is suffering from PPD but she/he does not want to look for help. What can I do?”
Many women and men suffer from PPD in silence. They often dismiss their struggles as a “normal baby blues” and do not look for care. Is essential for women (and men) suffering from PPD to seek for help. But if they are refusing to get help, you can be alert for the signs of PPD (see symptoms above), listen to her/him, give her/him your support, and encourage her/him to get help, if needed.
What are other disorders that are associated with pregnancy/delivery?
Anxiety is the most reported disorder among new moms. New mothers often have a sense of doom, or feel inadequate, not being sure if what they are doing is the correct way to care for a baby. Talk therapy (psychotherapy) can help with new moms’ anxious symptoms.
Peripartum Bipolar Disorder – Bipolar disorder can emerge during pregnancy or after delivery. Symptoms of depression and mania are severe sadness, feeling irritable, elevated mood, rapid speech, racing thoughts, little or no sleep, having a lot energy, behaving impulsively, making poor judgements, having delusions (grandiosity or paranoic), or having hallucinations (seeing or hearing things that are not present).
Peripartum (Puerperal) Psychosis. This is a rare, but severe psychiatric condition that begins suddenly within weeks after the baby is born. This only happens in 1 in 1000 new moms. Symptoms are: having delusions (grandiosity or paranoic), or having hallucinations (seeing or hearing things that are not present), feeling overly suicidal or homicidal.
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Dr. Rosana Marzullo-Dove