By: Jean Johnson for Fibroids1
“I’m a nurse, and we learned all about postpartum depression when we were in school,” said Suzanne Everhart of Alta Loma, Calif. “I guess I thought that knowledge would protect me, but it sure didn’t. My hormones plummeted after I had my daughter just like the next woman’s, and there I was with a new infant to care for. The baby blues weren’t fun.”
1 in 10 New Mothers Need Help – No Shame; No Fear
As Neill Epperson, M.D. of the Yale University School of Medicine in New Haven, Conn. observes in an American Family Physician article, major postpartum depression strikes 1 in 10 women and is a “considerably undiagnosed” condition. Part of the problem is that because women expect things to change after they deliver, they often do not realize that feeling sad, blue, unhappy, miserable or just plain down in the dumps is cause for a visit to their physician.
| Major life changes are unsettling. The wise among us know that keeping expectations moderate and taking small, consistent steps on a daily basis is a prudent path that can help ease dark moods and feelings of hopelessness. |
The following tips adapted and expanded from the American Academy of Family Physicians (familydoctor.org) and the National Mental Health Association (nmha.org) are best approached by choosing one and then adding in others as you are able.
Stay active. Make time for a 10 to 20 minute walk, put on some music and dance, or get some vacuuming done. All steps are equal in the larger scheme of things, so however your day unfolds just make sure you take every chance you can to move. (Even shelving the remote control and getting up to change the TV channel can pay dividends.)
Play. Balance the 10 to 20 minutes of activity with an equal amount of time devoted to nothing but fun. It’s your choice entirely here. The idea is to get a bit of a smile going, or at the very least stir up some rejuvenating creativity. If you’re at a loss, try making a collage from images torn from magazines and newspapers. A little paper; some glue. The message you send to yourself just might be illuminating.
Find a pal. Even if you don’t wish to share your troubles, it can help to spend time with someone you enjoy – someone with whom you share some interests.
Reduce stress. Once again, just 10 to 20 minutes can help. Lie down and go through your whole body tightening and relaxing the muscles – toes, legs, hips, up through the torso, hands, arms, shoulders, face, forehead. Breathe in vitality. Breathe out tension. Soften. Let go.
Eat well. Keep an especially careful eye on getting dark green leafy veggies. Consider warm or cold salads your friends and dress them with care: Good olive oil, interesting vinegar, and all manner of nice additions like crisp radishes or cucumbers, almonds, fruits in season, home-toasted, garlicky croutons, and a grate of cheese that comes from a dairy farm in your vicinity. (You’ll get the added benefit of knowing you’re strengthening your own community with purchasing power.)
“When [major postpartum depression] onset is abrupt and symptoms are severe, women are more likely to seek help early in the illness,” Epperson writes. “In cases with an insidious onset, treatment is often delayed, if it is ever sought.”
In Everhart’s case, she says that knowing what to expect allowed her to address the problem before it interfered with her bonding with her daughter. “My depression wasn’t that severe so I imagine that if I wasn’t a nurse I might have just tried to pass it off,” she said. “But I’m glad I went in – I just went to our family’s regular doc even though I used an ob-gyn for the pregnancy – because it’s a time when you want to give your baby your best. After all, with any luck at all, my daughter’s going to grow up to be my best friend.”
Everhart paused for a moment before continuing. “You know, when I think back on all that, what really impressed me was how I went from feeling really, terribly bad to being just fine once I got some help. That’s the best message I guess I have to share. That even if it seems so very hopeless and awful, and you think there’s no way for you to manage, give it a chance and get into the docs. Moods are like night and day, and can change so that a person will look back and wonder how she could have possibly been so unpleasant or mean-spirited.”
Epperson supports proactive approaches like the one Everhart took. Indeed, the physician points out that many women worry about being branded “a bad mother” or fear that someone will take their baby away. Also, he writes that since women expect a period of adjustment after having a baby, particularly “first-time mothers may not recognize that what they are experiencing is not within the norm.”
The Science Behind Postpartum Depression
According to the National Women’s Health Center at WomansHealth.gov, the female hormones estrogen and progesterone increase significantly during pregnancy only to drop abruptly back to normal levels in the first 24 hours after childbirth.
“Researchers think the fast change in hormone levels may lead to depression, just as smaller changes in hormones can affect a woman’s moods before she gets her menstrual period,” states WomansHealth.gov. “Occasionally, levels of thyroid hormones may also drop after giving birth…. Low levels of thyroid can cause symptoms of depression.”
WomansHealth.gov also points out that situations during pregnancy can be red flags to trouble afterward. Mothers-to-be that have a history of depression or substance abuse as well as those with a family history of mental illness are well served to be on the look out for postpartum depression. Also women who have little support from family and friends or are experiencing marital or financial difficulties are at higher risk. Finally those who have had problems with previous pregnancies or births, or who for any number of reasons are particularly anxious about the fetus they are carrying need to be vigilant for volatile emotions after delivery.
Symptoms of Major Postpartum Depression
Our list of symptoms probably won’t come as a surprise, but the trick, writes Yale’s Epperson, is to separate out differences between the “normal sequelae [aftermath] of childbirth” and abnormal occurrences.
Things like sleeping too little or too much, weight loss, loss of energy and diminished concentration or indecisiveness, he notes, are all symptoms that could simply be the natural outcome of giving birth and taking care of a highly dependent brand new human being. Then again they could be signs that something is wrong.
On the other hand, Epperson lists the following as relatively clear indications that postpartum depression is occurring: Depressed mood, lack of pleasure or interest, agitation, feelings of worthlessness or inappropriate guilt, and even frequent thoughts of death or suicide. Of course, if a woman has elements from both lists, she should take action and get professional advice.
Better Safe than Sorry – Postpartum Depression can Have Long-term Effects on Mother-Child Relationships
Epperson puts it bluntly: “Postpartum depression is a traumatic event that can have lasting effects on a woman’s confidence in herself as a mother and on her infant’s social, emotional and cognitive development. Infants as young as three months of age are able to detect the affective quality displayed by their own mothers and modify their own affective displays in response to it. Cognitive skills, expressive language development, and attention have been adversely affected by maternal depression.”
The physician’s comment, of course, is not designed to add yet another layer of guilt to what new mother’s experiencing depression already often feel. Rather the idea is to “emphasize the importance of early detection and treatment.”
Like any other disease, depression can worsen when it is not addressed. So the message is better safe than sorry. If you suspect a problem, take the time to give yourself the care you deserve and make that appointment.
Talk therapy and medications are available for this problem that can be as much a biochemical one as an emotional one. Lack of energy. Trouble concentrating. Irritability. The inability to meet a baby’s need for love and affection. No mother wants to be this way or face the problem alone. There is help, and it’s smart to go get it just like Suzanne Everhart did.