Pregnancy and bringing a new life into the world is a powerful feeling that cannot be taken lightly. This is a wonderful experience full of constant cuddles and beautiful little smiles with a toothless grin. But things aren’t always so exciting for some moms.
According to Centers for Disease Control and Prevention (CDC), 1 in 9 women (other studies say 1 in every 7) is at the risk of experiencing feelings of severe sadness, hopelessness, anxiety, self-harm, and a disconnection from the newborn.
This condition is called postpartum depression (PPD) and can last for weeks, months, or even more. It not only deprives the mother and child the golden early moments that are vital for bonding, but it could also have life-long impacts on the quality of mother-child relationship as well as adolescence and adulthood outcomes.
This article is not a substitute for medical advice.
What Is Postpartum Depression?
This is a type of mental disorder that moms experience during pregnancy and after childbirth. This condition is often characterized by feeling down in the dumps, low energy, irritability, anxiety, and changes in both eating and sleeping patterns.
To the family members, friends, and colleagues who don’t have a clue of this disorder, the mother’s unexplained lack of affection towards the newborn may seem like a character flaw or general weakness in parenting.
In reality, though, the affected mother doesn’t understand that she has developed PPD. This is made worse by the fact that she can’t describe to other people what she feels. Sometimes, the mom may harbor thoughts of harming the baby, self-harming, or even committing suicide.
Drawing The Line Between Baby Blues & Postpartum Depression
The majority of all new moms (approximately 70-80%) experience some sort of mood swings after delivery – and it’s perfectly normal.
These short-term dips in mood are called Baby Blues and are thought to be caused by the dramatic hormonal changes that take place in the first few days after delivery.
In most instances, the effects of postpartum Baby Blues kick in anywhere after 3 to 10 days and the mother may feel teary, irritable, and anxious. The teary feeling may be compounded by difficult labor, feelings of disappointment (planning for vaginal birth but ending up with a C-section), and round-the-clock demands of the infant.
The symptoms of Baby Blues aren’t severe, though. More often than not, they will fade away on their own by the time your newborn turns 1 or 2 weeks. You also don’t need any specialized treatment besides constant support from your spouse, family, or friends.
However, if these symptoms last longer than 2 weeks and the feelings of sadness and being overwhelmed worsen instead of getting better, then you could be experiencing a more serious condition probably PPD which is a severe form of Baby Blues.
Baby Blues and Postpartum Depression share a lot of symptoms including insomnia, crying jags, irritability and mood swings.
The major difference is that the symptoms of postpartum depression are longer lasting (could last several months or more). In addition, the symptoms of postpartum depression are severe and are often accompanied by suicidal thoughts and a serious lack of affection for the newborn. This lack of connectivity leads to an inability to take care of the baby.
Symptoms Of Postpartum Depression
At first, postpartum depression is often confused for Baby Blues since the 2 have a lot of similarities. However, how and when it unfolds is quite unpredictable. The symptoms usually develop within the first weeks after delivery but they may also begin earlier- during pregnancy- or even later- up to 1 year after giving birth.
This is the main reason why most women don’t realize that they could be suffering from PPD or their feelings could be serious or life-threatening.
The CDC states that the signs and symptoms of postpartum depression are similar to those of depression only that there are additional symptoms. It also notes that how often the symptoms occur, their level of intensity, and how long they last could vary from one person to the other.
List Of Signs & Symptoms
- A feeling of disconnection from the baby
- Crying a lot (more than usual)
- Sadness that lasts for over 2 weeks
- A feeling of being rejected
- A sensation of guilt
- Suicidal thoughts or attempts
- Feeling overwhelmed, trapped, and hopeless
- Low concentration levels
- Frequent irritability and restlessness
- Persistent fatigue
- Problems recalling details and making decisions
- Lacking interest in oneself
- Withdrawing from friends and relatives
- Feelings of anger
- Overeating or losing appetite
- Reduced motivation
- Loss of libido
- Headaches, blurred vision, and stomachaches
- Feelings of inadequacy
Diagnosis
After giving birth, a new mother and those close to her should be on the lookout and be able to pick up any signs and symptoms of PPD.
When diagnosing postpartum depression, the healthcare provider will first require you to answer a few depression-screening questions to distinguish between short-term baby blues and severe postpartum depression.
The doctor may also recommend carrying out a test on the patient’s thyroid levels as hypothyroidism may cause similar symptoms to PPD.
For the evaluation, the doctor may ask if you have:
- Problems with self-confidence
- Difficulties concentrating and making decision
- Changes in appetite
- Suicidal thoughts
- Feelings of guilt
Causes Of Postpartum Depression
Unfortunately, the exact causes of postpartum depression are not known yet. But experts hypothesize that the major culprit here is the abrupt swing in hormone levels. Throughout the pregnancy period, estrogen and progesterone hormones are usually at their highest levels. Within the first 24 hours after delivery, these levels drop fast to normal- this acute drop has been associated with depression.
Thyroiditis- an uncommon condition where a normal-functioning thyroid starts producing low levels of the thyroid hormone after giving birth- could also cause symptoms similar to those of PPD.
In fact, a research report cited in this study found out that thyroid dysfunction during delivery increases the risk of postpartum depression by 2-3 times. If hypothyroidism is suspected, your doctor may recommend a blood test for verification and prescribe thyroid medicine if it’s found to be the cause.
Importantly, mothers who have suffered PPD before have been found to have a higher risk of developing it again in their subsequent births.
Risk Factors – Who Can Develop Postpartum Depression?
The heightened media awareness of postpartum depression has got most people wondering whether particular individuals are affected by this debilitating mental conditions.
Contrary to the common myth, this condition is not for brand new moms only. All women are vulnerable to developing PPD regardless of their age, marital status, socioeconomic status, mode of childbirth, and condition of the newborn.
However, some mothers seem to be more predisposed to developing PPD than others. A 2001 meta-analysis of Predictors of Postpartum Depression reveals 13 variables that increase the risk of having postpartum depression:
- Prenatal depression – mothers who experienced depression during their pregnancy are at the highest risk of developing PPD
- Maternity blues – severe baby blues may lead to PPD
- History of previous depression
- Inadequate social support
- Low self-esteem
- Poor marital status – in most instances, mothers who are diagnosed with postpartum depression also report marital dissatisfaction
- Recent stressful life events
- Prenatal anxiety
- Childcare stress
- Difficult infant temperament
The 3 additional factors below were found to pose a slightly lower risk. However, they have also been consistently linked to PPD especially if the mother has one or more of the factors above;
- Single parenthood
- Unplanned/unwanted pregnancy
- Lower socioeconomic status
Another Canadian study also notes that postpartum depression is much more prevalent in urban areas. This study found out that women who live in urban areas have a 10% higher risk of developing PPD compared to rural dwellers.
Effects Of Postpartum Depression On Mother-Baby Interaction
Poor relationship and communication
Mother-infant attachment and bonding are incredibly important factors for the development of the baby. This attachment starts right at the beginning of the infant’s life particularly in the first 3 months of life.
Unfortunately, mothers ailing from postpartum depression exhibit an emotional disconnection with the baby thereby leading to detachment between the two.
This detachment leads to fewer-than-optimal mother-baby touches and positive engagements for instance in reading books, telling stories, singing songs, and playing games.
Also, mothers suffering from postpartum depression have been found to respond to the baby’s needs in a less attentive and nurturing manner.
This withdrawn parenting behavior slowly leads to a lack of interest in a child’s activities and poor communication between the mother and child.
Lack of physical touch
Postpartum depression also leads to inadequate physical touch. As studies on the positive effects of physical contact after birth show, motherly touch, especially during early life, is paramount for the child’s development and stress management.
In non-depressed mothers, the baby develops its self-regulation skills from the warm and nurturing interactions offered by the mother.
Since these positive interactions are barely available if the mother is affected by postpartum depression, the baby resorts to self-soothing. While this offers a degree of relief to the mother, it only perpetuates the disconnection.
Ultimately, this avoidant relationship inhibits the child’s development of self-regulation skills (controlling one’s emotions, thoughts, and behaviors) as well as the overall mother-child loving relationship.
Impacts Of Postpartum Depression On Baby Development
The symptoms of postpartum depression are a clear indication that it’s not only bad for the mother but the child as well. Since these symptoms mostly kick in during the early life of the baby- when it’s developing both physically and cognitively (mentally) – it’s not surprising that some of the impacts last for years and could be felt through adolescence and adulthood.
Short Term Effects
Stressed mom, stressed newborn
Postpartum depression is often accompanied by elevated stress hormone levels (cortisol) and decreased levels of biogenic amines dopamine and serotonin (responsible for regulating mood, anxiety, and happiness).
Because these chemicals cross the placenta into the fetus, newborns of depressed mothers often exhibit the chemical patterns of the mothers. That’s to say that they also feel somewhat sad and depressed- poor things.
Impaired Start Into Life
Infants who are exposed to depression before birth have also been found to start life with a degree of physiologic disturbances. These impairments are believed to be as a result of abnormal patterns in the brain and include negative affectivity, decreased newborn alertness, and disorganized sleep patterns.
Less Response To Stimuli
For infants who experience the effects of PPD after birth, the impacts are mainly as a result of the unconducive interaction with the mother. Such kids have a lower interest in exploring their environment compared to babies of non-depressed moms. They also display lower response to stimuli.
Long Term Effects
Increased Behavioral Problems
There is enough evidence to associate postpartum depression with behavioral problems. In an analysis of data from a study titled Children’s Behavioral Problems tied to Postpartum Depression, Dr. Netsi of the University of Oxford (Department of Psychiatry) and her team found that PPD caused a two-fourfold higher risk of behavioral problems at 3.5 years.
Poor Academic Performance
In the analysis above, the researchers also learned that children born to depressed mothers also showed difficulties with mathematic grades especially at around 16 years. Precisely, the study showed a 2.65-fold increase in the odds of the child scoring grade D or below in mathematics.
Higher Likelihood Of Dropping Out Of School
A longitudinal research cited in this study involved following children born of depressed and non-depressed mothers from 6th grade to 12th grade. The researchers found out that offspring of depressed mothers had a higher likelihood of dropping out.
Coping With Stress
Another troubling finding from the study above is that children born of depressed mothers are more likely to be more reactive cognitively (thinking pessimistically) in situations that don’t favor them.
Particularly, the researchers found that prolonged parent-child stress as a result of parental withdrawal caused higher levels of cognitive reactions to stress in children. For instance, these children may have high levels of emotional and physiological arousal, rumination (thinking deeply about something), and intrusive thoughts (unwelcome involuntary thoughts).
Cognitive Vulnerability To Depression
Cognitive vulnerability refers to a pattern of thoughts that predisposes someone to a psychological disorder.
A lot of studies have been conducted around it especially when studying the children born to depressed mothers. Not surprisingly, most of these studies that have shown that children of depressed mothers show early signs of vulnerability to depression even before hitting 5 years. These signs include pessimism, hopelessness, attributing negative outcomes to themselves (self-blame), and negative attributional styles.
Postpartum Depression – Treatment
The good news is that postpartum depression is treatable. Years of research have also provided helpful tips for dealing with PPD.
When the signs are picked up early enough and adequate support is offered to the mother, PPD will sometimes fade away on its own by the third month after delivery.
If it persists, though, or if the symptoms of Baby Blues are severe and interferes with normal functioning, it’s important to seek treatment as early as possible.
After a positive diagnosis, the psychiatrist may prescribe antidepressants (mostly Selective Serotonin Reuptake Inhibitors antidepressants also called SSRIs) to balance the hormones and neurotransmitters that are associated with mood.
While the effects may take a few weeks to kick in, these antidepressants may help to deal with anxiety, hopelessness, lack of concentration and most importantly, bonding with the baby.
Keep in mind that medication will not solve everything. Psychotherapy is an important part of treatment and new mom’s way to feeling better.
For people with depression, one of the most recommended types of psychotherapy is Cognitive-Behavioral Therapy (CBT). It’s an evidence-based type of psychotherapy and currently considered as the golden standard of treatment for PPD and depression in general (as well as other mental health disorders).
CBT involves teaching the mother how to manage her thoughts better by challenging them. During this type of psychological therapy people learn new coping mechanisms that will help them to change their old thoughts patterns and behaviors.
To fight depression, psychological therapies should be combined with medication. Several results show this combination works best most of the times.
IMPORTANT UPDATE (2023):
What’s noteworthy, currently we all have even better access to medical treatment, thanks to online services. There are a few good online psychiatrist platforms that can provide a convenient way to access mental health services without leaving the home (which gives the sense of security and comfort).
Online psychiatrist platforms may provide an invaluable resource for moms who may not have access to traditional mental health care, as well as women who are simply hesitating about visiting a psychiatrist in person or even feel scared about seeing a doctor and talking about her problems in person.
Mothers who have symptoms of postpartum depression may benefit from the ability to access these services quickly, without even leaving home. It eliminates the need for time-consuming travel, which can be a significant obstacle for new moms who are taking care of a newborn baby.
Thanks to these platforms new moms have access to a wider array of services than in-person visits. This way they can find the best online psychiatrist and get the support they need.
Online psychiatrist platforms offers full anonymity and privacy, which can be especially helpful and reassuring for those who may be concerned about sharing personal information during in-person visits.
In case the thoughts of harming the baby cross your mind, call your spouse, a family member, or a friend immediately. You could also get instant help from the following helplines 1-800-PPD-MOMS (1-800-773-6667), 1-800-SUICIDE (1-800-784-2433), or 1-800-273-TALK (1-800-273-8255).
Bibliography:
Beck, Cheryl Tatano. “Predictors of postpartum depression: an update.” Nursing research 50.5 (2001): 275-285.
Ghaedrahmati, Maryam et al. “Postpartum depression risk factors: A narrative review.” Journal of education and health promotion 6.60. (2017).
Grace, Sherry L., Alexandra Evindar, and D. E. Stewart. “The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature.” Archives of women’s mental health 6.4 (2003): 263-274.
England, Mary Jane, Leslie J. Sim, and National Research Council. “Associations Between Depression in Parents and Parenting, Child Health, and Child Psychological Functioning.” Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. National Academies Press (US), 2009.
Paulson, James F., and Sharnail D. Bazemore. “Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis.” JAMA 303.19 (2010): 1961-1969.
Wisner, Katherine L., et al. “Onset timing, thoughts of self-harm, and diagnoses in postpartum women with screen-positive depression findings.” JAMA psychiatry 70.5 (2013): 490-498.
Please keep in mind that this article IS NOT a medical advice. The purpose of this article is informative. It is an overview of recent studies on the subject of postpartum depression and a summary of the latest research results. It’s not a substitute for consultation with a doctor. Always consult your health concerns and decisions with your doctor. The author of this article does not accept any responsibility for any liability, loss or risk, personal or otherwise, incurred as a consequence, directly or indirectly, from any information or advice contained here.
Hello Moms! I am Zooey. I am a wife and a mother of three amazing kids: almost 5-year-old Haley and 2-year-old twins Jesse and Matthew. I am a jogger, cooker and blogger.If you have a question or a comment, do not hesitate to write to me! 🙂