Postpartum Depression

Postpartum Depression is a very serious form of depression that affects up to 20% of new mothers. The onset usually occurs several days after giving birth. Although "Baby Blues" are even more common (around 80%) -- a mild and temporary depression characterized by weepiness, exhaustion, worry, anxiety, and mood instability -- this condition is normal and is not considered serious. Baby Blues usually goes away within a few weeks.

PPD, on the other hand, is a more severe and potentially dangerous disorder. The onset can occur anytime during the first year following birth.



Common symptoms of Postpartum Depression are:

• Exessive worry or anxiety
• Feeling overwhelmed
• Sadness, tearfulness, guilt
• Irritability or agitation
• Hopelessness/Helplessness
• Sleep problems (too much or too little)
• Feeling disconnected from the baby
• Somatization (physical aches/pains)
• Decreased concentration or forgetfulness
• Changes in appetite, weight loss or gain

Postpartum Depression in all of its forms, seems to be caused by the combination of hormonal changes and psychological factors. The rapid fall of hormones (estrogen and progesterone) on the third day after giving birth seems to play a significant role in most cases. Psychological and psychosocial factors are also major factors in the development of the disorder. The physical exhaustion of birth, the stress of being a new mother, the lack of adequate family or social support and understanding, lack of sleep, feelings of shame or inadequacy, can all contribute to the depression. Having a pre-existing illness, or history of depression, anxiety, bipolar disorder, or psychotic disorder also significantly raises the risks for new mothers.

It is very interesting to note that anthropological research finds virtually no Postpartum Depression in non-western, rural, communally oriented societies. It appears that in those societies the community recognizes and honors the fragile state that a new mother encounters after birth, and members of the community provide a great deal of supportive care to the mother and her baby, as well as assistance to the family. This greatly reduces stress on many levels and allows for the natural and healthy adjustment to the newest member of the family. The lack of recognition, support and empathy for new mothers in the United States and other western societies has left a deep void in the culture. What could be a meaningful, transformative, healing, spiritual experience for a new mother and her family can be a living nightmare for the mother with Postpartum Depression. The emotional suffering is often profound, and many women fear that nobody could possibly understand or relate to their feelings. Often women feel ashamed and confused for being sad and feeling disconnected from their baby. They feel ashamed and inadequate for not being the happy, nurturing mother that they think they should be. They may be experiencing abusiveness, or stress in their marriage and feel unsupported or misunderstood by their partner.

Joy Wilkins has an excellent website on the many benefits of natural childbirth and how to take care of yourself before during and after birth. See her Top Ten Reasons to Have a Natural Birth.

Other Types of Postpartum Depression

Less Common forms of Postpartum Depression can include:

• Psychosis (occurs in about 1 per 1000 women):
  A very serious condition, usually developing a few days after birth, in which the mother experiences confusion, de-realization, depersonalization, delusions, and sometimes hallucinations. About 4-5% of these women experience serious impulses to kill herself or her baby. This is not a state of mind that is under her conscious control, and these impulses may be completely contrary to her normal thoughts and feelings. Immediate medication, professional care and supervision are essential.
• Panic Disorder (often due to previous history, or family/genetic history)
• Post-Traumatic Stress Disorder (PTSD):
  Previous traumas, even those that were forgotten, may be triggered by the birth experience.
• Obsessive-Compulsive Disorder (OCD)
• A Manic or Hypomanic episode (Bipolar Disorder) triggered by hormonal changes and/or stress. It is not uncommon for a young mother to "uncover" a pre-existing genetic vulnerability to Bipolar Disorder after giving birth. For any of these conditions, prompt treatment by a qualified medical professional is vital, both for the safety and well-being of the mother, as well as for her baby. Without treatment, children can develop many types of problems that continue through childhood and beyond, due to the disrupted attachment with the mother. Psychotherapy, proper nutritional support, and at times medication, are often extremely helpful for a full recovery. Support groups are also a very useful resource for mothers. For more information, resources and support:
  Postpartum Support International
  
  The Online Postpartum Depression Support Group