Postpartum Depression: Causes, Prevention, and Treatment

Although having a baby should be a joyous moment for every mother out there, sometimes, her psychological state doesn’t allow her to enjoy motherhood to the fullest. The most common reason for feeling sad, anxious, and tired for longer than two weeks after giving birth is postpartum depression.

The depressive disorder starts either while the woman is still pregnant or in the first year of motherhood, which makes PPD a sort of perinatal depression. The symptoms usually start during the first week, but it’s not uncommon for them to start later, for example, three weeks after the birth.

As far as statistics go, PPD is one of the most common post-childbirth complications. Usually, it’s the first bout of depression for most mothers — half of them haven’t been depressed before. Furthermore, the depressive disorder affects 1 in 7 women, which equals to about 15% — a staggering number for something that is a consequence of becoming a parent. On top of that, if a woman suffers from PPD after her first child, she is more likely to go through the ordeal again with another pregnancy.

Still, it’s important to remember that if you or a loved one are suffering from PPD — it is no one’s fault. Let’s see why PPD even occurs, how to prevent it, and which treatments are available to you.

What Are the Symptoms of PPD?

Unlike baby blues, PPD comes with a variety of serious symptoms that should be easy to recognize but are often disregarded.

“Baby blues” refers to sadness one feels after giving birth, and it usually lasts for two weeks at most. The onset occurs anywhere from two to 35 days post-labor.

Of course, baby blues have symptoms that are similar to PPD, including failure to get a good night’s rest, crankiness, and moodiness, as well as crying. However, your mood should get better after two weeks. If it doesn’t, you ought to talk to your doctor about it. Any of the following signs or symptoms that last for longer than two weeks could be associated with PPD:

Emotional Changes and Imbalance

  • You feel depressed most days
  • You even feel like you’ve failed at life; feel guilt, as well as shame
  • There are severe mood swings at play
  • You’re frightened and/or panicked most days

Changes in Behavior and Everyday Life

  • Your weight is fluctuating
  • You cannot focus or reach any decisions
  • Tiredness has become an everyday thing
  • You’ve lost interest in things you used to enjoy
  • Your appetite has changed — you’re overeating or starving yourself

Changes in the Mother and Baby Relationship

  • Bonding doesn’t come as easy as you thought it would
  • You’re having suicidal thoughts
  • You’re considering harming the baby or yourself

When noticed in time, there are things you can do to alleviate the symptoms and treat PPD. However, if you’re feeling lost or as if you’re going to do something terrible, such as harm the baby or yourself, call 911 immediately.

Postpartum Psychosis

Some women may suffer from postpartum psychosis, which is a rare but quite serious type of depression. According to statistics, out of 1,000 women, only one or two develop this condition after having their babies.

Just like PPD, postpartum psychosis starts within the first two weeks post-labor. However, the condition is far more likely to happen to women who already have mental health issues.

Symptoms also differ from PPD. You might hallucinate — hear or see things that no one else can testify to. Furthermore, you’re likely to feel hopeless and paranoid, as if there’s no one you can trust. Women with postpartum psychosis often think everyone is out there to get them, so they’re restless and upset most of the time, and their mood changes often.

Other symptoms include:

  • Sleeping difficulties: the woman might not be able to fall asleep even if she’s exhausted.
  • Bad thoughts: the woman may be considering harming herself, the newborn, or someone else.

The gravest symptom is always the thought of harming the baby or yourself. Thus, if you ever consider such a thing, call 911 immediately to get some urgent help.

PPD Causes

Unfortunately, doctors haven’t been able to pinpoint the exact cause of PPD yet. Right now, it seems any woman could become its next victim after giving birth. Nevertheless, here are some reasons it may occur:

  • Problems with your thyroid. The thyroid gland is responsible for the usage and storage of energy drawn from food. However, more and more women are experiencing low levels of thyroid hormones and need hormone replacement therapy.
  • Genetic issues. If someone from your family has also suffered from depression, you could carry the depression gene. We get our genes, cells that are sort of like instruction manuals for our bodies, from our parents.
  • Hormone issues. While you’re pregnant, you will experience a surge in levels of progesterone and estrogen. The levels of these hormones will stay high up until you give birth. Then, within 24 hours post-labor, they will drop down to their usual numbers. The sheer fact they’ve plummeted so fast can jumpstart PPD.

Who Is at Risk?

Certain risk factors will put you at the top of the list of women who might develop PPD. However, it’s impossible to determine them by yourself.

Because of that, your health care provider will pay close attention to your health and behavior throughout the pregnancy. They will ask questions in regard to your mood, feelings, etc., and if they find there is a certain level of risk, they will start treatment as soon as possible.

So, what are the risk factors? You could suffer from PPD if:

  • You are a drug user, smoker, or drink alcohol.
  • You’ve had depression before, it runs in your family, or you’ve been depressed for most of the pregnancy.
  • There is a history of mental health conditions in your family.
  • You’re younger than 19 years old, and this was an unplanned/unwanted pregnancy.
  • You don’t have a job or money to take care of the baby, and there’s little to no family or friend support in your life.
  • You’re a survivor of physical or emotional abuse.
  • You’re in a violent relationship (domestic violence).
  • You have diabetes (pre-existing, i.e., diabetes that was diagnosed before you got pregnant, or gestational — diabetes that developed during your pregnancy).
  • You’re under a lot of stress for a variety of reasons (death in the family, separation from your spouse, etc.).
  • The pregnancy hasn’t been smooth or has ended tragically (birth defects, pregnancy loss, complications such as premature birth, and pregnancy with multiple babies).
  • The baby is ill or was born with a specific health condition, which makes it hard for you to bond with it.
  • You’re not adjusting well to motherhood and resent it for numerous reasons (you doubt yourself, are tired and moody, etc.).

Is the Baby at Risk Because of PPD?

PPD doesn’t have a direct effect on the baby. Instead, if you don’t treat it, it can prevent you from taking care of the newborn properly. That includes:

  • Skipping postpartum checkups
  • Not following the doctor’s orders
  • Not bonding with the baby due to the depression taking over
  • Failing to breastfeed for an adequate amount of time. Babies thrive when fed breast milk, and according to research, this is the best food they can get. However, PPD makes getting on the right breastfeeding schedule difficult.

On a different note, you could risk the baby’s health by not asking for help. You may not be healthy enough to help the baby get the medical care it needs, especially if it’s ill.

Failure to do so could lead to dire consequences. For example, if you don’t get help, you might skip vaccinations, which would expose the newborn to infections. Consequently, your child could have behavioral problems, as well as development and learning difficulties later on. What’s more, no medical care means it could succumb to various mental health conditions as it grows up.

What’s Going Through the Head of a PPD Mother?

From the outside, the mother might appear as if she’s completely healthy. However, inside, she is riddled with doubts and negative thoughts.

For the most part, a PPD mother doesn’t believe she has what it takes to take good care of the baby. In fact, she’s always putting herself under a lot of pressure, trying to fit into the definition of perfection.

At the same time, her confidence is suffering. She doesn’t feel as if she’s the same person and believes having the baby has robbed her of her identity. Her body has changed and is now less attractive than it used to be. On top of that, she doesn’t have time to heal herself from within — all her free time is reserved for the baby. Thus, she’s probably moody too, as well as tired due to the lack of quality sleep (or sleep in general).

PPD Prevention: How Therapy Can Help

In order to make both the life of the mother and the baby better and easier post-birth, PPD prevention is key. Luckily, there are different types of counseling women can try to prevent the onset of perinatal depression.

By talking to a therapist, you will be able to understand why you’re feeling the way you’re feeling, as well as learn how to cope with some of the things motherhood is laying out in front of you.

However, it’s unlikely that you will be able to make yourself go to therapy. Thus, make sure to talk to your health care provider about your feelings. They may recommend two types of therapy:

CBT: cognitive behavioral therapy that helps change your thoughts and your actions. Through different exercises and techniques, you and the therapist will set certain goals. They will also help you recognize behaviors and thoughts that are bringing you down so that you may change them.

IPT: interpersonal therapy that goes deep into your feelings and helps you deal with all sorts of issues. If you’ve lost a loved one, are suffering from certain medical conditions, or have had problems at work and in relationships, IPT can help. Most often, it includes open-ended questions, role-play, and in-depth analysis of your communication and decision-making patterns.

Your health care provider will decide you should get therapy if:

  • You’re showing symptoms and signs of depression
  • You’ve been the victim of intimate partner violence
  • You are living under a lot of stress
  • You’re a single mom or a pregnant teen
  • You’ve had depression or have suffered from a mental health condition before.

Treating PPD

When left untreated, PPD can cause numerous issues, which is why, as soon as you notice any of the signs or symptoms, you ought to talk to your health care provider. That can either be your prenatal or primary care provider. You can also talk to a mental health provider, such as a therapist or psychiatrist, and even consult your baby’s doctor.

To get the right diagnosis, the provider has to ask questions. They will “poke around” to determine how you’re feeling. Additionally, they may ask you to fill in the depression screening questionnaire. That way, they’ll get more elaborate answers and make the right diagnosis as fast as possible.

Still, they ought to exclude health problems from the equation, so the provider will also do tests on you to determine if your health is in top-notch condition. As mentioned, low levels of thyroid hormones are one of the possible causes of PPD, so the provider should do tests to determine if you need hormone replacement therapy.

Types of Treatment Available

Once you’ve been diagnosed with PPD, your provider may suggest CBT or IPT counseling. In addition, they will recommend joining a support group where you may meet people who are suffering from the same condition as you are.

As a more rigorous type of treatment, the provider may decide to treat PPD with medicines. They may prescribe an antidepressant or estrogen.

When it comes to antidepressants, you have to find out more about them as some might not be safe if you’re breastfeeding. Furthermore, expect some side effects. Certain antidepressants may lead to weight gain, blurred vision, dry mouth, loss of sexual desire, etc.

As for estrogen, this is a hormone that is already a huge part of your pregnancy and overall well-being. During pregnancy, the estrogen levels surge. However, as soon as you give birth, they go down rapidly.

To offset that drop, your provider might give you an estrogen patch, which will bring back the levels of estrogen your body has lost. Still, you ought to check if the patch is safe for breastfed babies, as the hormone can pass through the milk.

Regardless of the treatment your provider decides you need, don’t take any medications for PPD without consulting them. What’s more, always follow their instructions and don’t stop taking the medication if they haven’t told you to stop.

Dealing with PPD: How to Feel Better

Apart from the prescribed treatment, there are various other things you can do to boost the quality of your life.

One of the best ways to feel better fast is to stay active. Whether that means you’ll go for a 30-minute walk each day or join a gym, it is up to you. Just remember that staying fit is crucial for your health, both physical and mental. Some fresh air could help clear your thoughts a bit. What’s more, getting stronger at the gym should boost your confidence!

In line with that, you ought to follow a healthy diet. Avoid processed food, snacks, and sweets. Aim to get enough fruits and vegetables each day. Additionally, opt for lean meats and whole-grain bread to get as many nutrients as possible from your meals.

Apart from that, remember to rest as much as you can. When the baby is sleeping, the mommy should be too.

Additional Tips for Fighting PPD

Avoid Drugs and Alcohol

Alcohol can make you even more depressed, so it’s best to avoid it altogether. It may also lower the effectiveness of your prescription medication and can even pass through breast milk.

The same goes for drugs too. Remember that drugs can damage your body from within and lead to numerous health issues as well, much like alcohol.

Lower Your Stress Levels and Don’t Be Afraid to Talk to Someone

Just because you’ve had a baby, it doesn’t mean life as you knew it has ended. Aim to do something you love each day. If it makes you feel good, do it, as that will help boost both your mood and confidence.

At the same time, don’t resort to making any huge life changes, such as moving, as, in the end, you’ll just stress yourself out. Also, if the idea of going back to work scares you, you can always talk to your boss about your options. Working from home or working fewer hours might be possible, especially given your condition.

Finally, don’t be afraid to talk to someone or to ask for help. Remember that you still have a life to live, so hiding inside your home is not an option.

If you’re not feeling well, talk to someone and ask them to help you out. Stay in touch with your friends and socialize as often as possible.

However, don’t forget to set some time aside for yourself. Ask someone to take care of the baby while you’re out by yourself or with your partner. What’s more, if you need help around the house — make the arrangements right now. There’s no shame in it!

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