Spotting The Signs In Others
Postnatal depression can develop gradually and be hard to recognise. Some parents may avoid talking to family and friends about how they’re feeling because they worry they’ll be judged for not coping or not appearing happy.
Signs for partners, family and friends to look out for in new parents include:
- frequently crying for no obvious reason
- having difficulty bonding with their baby, looking after them only as a duty and not wanting to play with them
- withdrawing from contact with other people
- speaking negatively all the time and saying that they’re hopeless
- neglecting themselves, such as not washing or changing their clothes
- losing their sense of humour
- constantly worrying that something is wrong with their baby, regardless of reassurance
If you think someone you know is depressed, encourage them to talk about their feelings to you, a friend, their GP or their health visitor.
A New Study Finds Postpartum Depression Symptoms Can Linger Three Years After Childbirth Experts Say Ppd Screenings For Mothers After The First Year May Be Necessary
In recent years, more attention has thankfully been brought on postpartum depression , which up to 20 percent of moms experience. Those intense symptoms, including depressed mood and excessive crying, typically begin within the first few weeks of giving birth and can also show up later on within the first year.
For some new moms, postpartum depression can last up to three years, reveals a new study from the National Institutes of Health . The study, which appears in the journal Pediatrics, looked at 5,000 women and found about 1 in 4 had high levels of depressive symptoms at some point in the three years after giving birth. The remaining women had low levels of depression throughout the same time period.
This brings attention to the idea mothers may need longer screening for postpartum depression than the American Academy of Pediatrics already recommended one, two, four, and six months after giving birth.
Can Postpartum Depression Be Prevented
Postpartum depression isn’t entirely preventable. It helps to know warning signs of the condition and what factors increase your risk. Here are some tips that can help prevent postpartum depression:
- Be realistic about your expectations for yourself and your baby.
- Limit visitors when you first go home.
- Ask for help â let others know how they can help you.
- Sleep or rest when your baby sleeps.
- Exercise â take a walk and get out of the house for a break.
- Keep in touch with your family and friends â don’t isolate yourself.
- Foster your relationship with your partner â make time for each other.
- Expect some good days and some bad days.
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Treating Postpartum Mood Disorders
Being diagnosed with a postpartum mood disorder can put a cloud over what is supposed to be a happy time. But it doesnt have to the most important things to know about postpartum mood disorders are that they are highly treatable and not something a new mother needs to feel ashamed about. Even in the most severe cases of postpartum psychosis, one recent study showed that 98 percent of patients got better with treatment.
Treatment for postpartum depression includes antidepressant medications, which have good evidence of safety in breast-feeding. The gold-standard treatment for postpartum psychosis includes both lithium and an antipsychotic medication. With these medications, it is important for a doctor to monitor the baby to ensure that breast-feeding is safe.
How Many Women Experience Depression And Postpartum Depression
Depression is a common and serious illness. A CDC study shows that about 1 in 10 women in the United States reported symptoms that suggest they experienced an episode of major depression in the last year. Using the Pregnancy Risk Assessment Monitoring System , CDC research shows about 1 in 8 women with a recent live birth experience symptoms of postpartum depression. Estimates of the number of women affected by postpartum depression differ by age, race/ethnicity, and state. View your states prevalence of postpartum depressive symptoms using PRAMS.
The COVID-19 pandemic has affected mental health. Many people are experiencing grief and facing challenges that can be stressful and overwhelming. To find information about taking care of your mental health and coping with stress and grief, visit Stress and Coping.
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Dads Get Postpartum Depression Too
New research is finding that postpartum depression may affect up to one-quarter of dads, yet it goes unnoticed. A recent study reviewed the latest research to better explain how it affects men.
The researchers found that some men are more likely to develop postpartum depression. The risk factors include:
- A history of depression or anxiety.
- Having a partner who has a mood disorder.
- Lack of social support.
- Age older men are more likely to be affected.
Men suffer from the same symptom of postpartum depression as women. However, it may not be as obvious as men are more likely to conceal their feelings. Additionally, postpartum depression in men may also start later, often after his partner already has it.
How Can I Help Someone With Postpartum Depression
People with postpartum depression need lots of support. Here are some ways you can help:
- Know the signs of depression and anxiety and urge your friend or partner to seek medical care.
- Be a good listener. Let them know you’re there to listen and help.
- Offer to help them with daily tasks like cleaning and running errands.
- Offer to help watch their baby while they sleep or rest.
- Encourage them to seek help from a therapist or other mental health provider. Offer to set up an appointment or go with them as a support person.
A note from Cleveland Clinic
Postpartum depression is a common mood disorder that affects 1 in 7 people after giving birth. It’s not your fault, and you did nothing to cause it. It doesn’t make you a bad parent or a bad person. The biological, physical and chemical factors that cause PPD are beyond your control. Signs of postpartum depression include feeling sad or worthless, losing interest in things you once enjoyed, excessive crying and mood swings. Talk to your healthcare provider if you think you have postpartum depression. They can figure out how to best manage your symptoms. Counseling, medication or joining a support group can help.
Last reviewed by a Cleveland Clinic medical professional on 04/12/2022.
References
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Can You Get Postpartum Depression After The First Year
by Kate Kripke |
While I cant make a blanket statement about each and every woman who calls me, more times than not these womenone, two, or three years past the birth of their little onesare struggling with a form of maternal distress that dates back, in one way or another, to their pregnancy, postpartum, or even before. While these moms wouldnt technically have postpartum depression any longer, they are often struggling with what I will call here continued postpartum distress that was never adequately supported when they first noticed symptoms.
When we use the terms prenatal/antenatal and postpartum depression, we are really simply talking about an episode of depression or anxiety that occurs sometime during pregnancy or the first year postpartum. We believe that early symptoms, whether mild or severe, are caused by hormonal shifts during pregnancy or following delivery, physiological stressors like sleep deprivation and nutrient depletion, psychological strain including thought patterns that are likely to cause distress , and/or other environmental stressors such as trauma, relationship conflict, or changes in finances, employment, or residence.
However any one or more of the following are usually what we discover when we are together in my office.
How Is Postpartum Depression Treated
Postpartum depression is treated differently depending on the type and severity of your symptoms. Treatment options include anti-anxiety or antidepressant medicines, psychotherapy and support group participation.
Treatment for postpartum psychosis may include medication to treat depression, anxiety and psychosis. You may also be admitted to a treatment center for several days until you’re stable. If you don’t respond to this treatment, electroconvulsive therapy can be effective.
If you are breastfeeding , don’t assume that you can’t take medicine for depression, anxiety or even psychosis. Talk to your healthcare provider about your options.
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What Is Postpartum Obsessive
Postpartum obsessive-compulsive disorder is one of the newer disorders that is part of the postpartum mood disorders group. It is estimated that about 3-5% of postpartum women will experience some of the symptoms of PPOCD.Symptoms may include:
- Overly occupied with keeping your baby safe
- Compelled to do certain things over and over again to help relieve her anxiety and fearsThis can include counting things, ordering things, listing things, checking and rechecking actions already performed, and cleaning repeatedly. This may manifest itself in cleaning, feeding, or taking care of the baby.
- May recognize these obsessions but feels horror and shame associated with them
- Obsessions or thoughts that are persistent, are repetitive and can include mental images of the baby that are disturbing
- Fear of being alone with the baby
Women who suffer from PPOCD often know that these thoughts, actions, and feelings are not normal and do not act on them. But the obsession can get in the way of a mom taking care of her baby properly or being able to enjoy her baby. With the right treatment, women with PPOCD can experience freedom from being controlled by these obsessions and compulsions.
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How Is Ppd Treated
If you think you may have PPD, see your health care provider right away. Your provider can be:
- Your prenatal care provider. This is the provider who gave you medical care during pregnancy.
- Your primary care provider. This is your main health care provider who gives you general medical care.
- A mental health provider. This may be a psychiatrist, psychologist, social worker, counselor or a therapist.
- Your babys health care provider
To find out if you have PPD, your provider asks you questions about how youre feeling. He wants to know if your feelings are causing problems in how you care for yourself and your baby. He may ask you to fill out a form called a depression screening questionnaire. Your answers on the form can help him find out if you have PPD.
Your provider may do tests to see if you have other health problems that may lead to PPD. For example, he may check your thyroid hormones. Low levels of thyroid hormones may lead to PPD.
The sooner you see your provider about PPD, the better. You can get started on treatment so you can take good care of yourself and your baby. Treatment can include:
- Counseling, like CBT and IPT
- Support groups. These are groups of people who meet together or go online to share their feelings and experiences about certain topics. Ask your provider or counselor to help you find a PPD support group.
- Medicine. PPD often is treated with medicine.
Medicines to treat PPD include:
If youre taking medicine for PPD:
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When Should I Seek Professional Medical Treatment For Symptoms Related To Postpartum Depression
You should seek professional help when:
- Symptoms persist beyond two weeks.
- You can’t function normally or cope with everyday situations.
- You have thoughts of harming yourself or your baby.
- You feel extremely anxious, scared and panicked most of the day.
For immediate help or if you have thoughts of hurting yourself or someone else:
- Dial 911 in an emergency.
- Contact the Crisis Text Line by texting HELLO to 741741.
How Long Does Postpartum Depression Last
Postpartum depression can last until one year after your child is born. However, this doesn’t mean you should feel “cured” in one year. Talk to your healthcare provider about your symptoms and treatment. Be honest about how you feel. Think carefully about if you feel better than you did at the beginning of your diagnosis. Then, they can recommend ongoing treatment for your symptoms.
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Who Is At Risk
Any new mother can experience symptoms of peripartum depression or other mood disorder. Women are at increased risk of depression during or after pregnancy if they have previously experienced depression or other mood disorders, if they are experiencing particularly stressful life events in addition to the pregnancy, or if they do not have the support of family and friends.
Research suggests that rapid changes in sex and stress hormones and thyroid hormone levels during pregnancy and after delivery have a strong effect on moods and may contribute to peripartum depression. Other factors include physical changes related to pregnancy, changes in relationships and at work, worries about parenting and lack of sleep.
What Can I Do At Home To Feel Better While Seeing A Doctor For Postpartum Depression
Here are some ways to begin feeling better or getting more rest, in addition to talking to a health care professional:
- Rest as much as you can. Sleep when the baby is sleeping.
- Dont try to do too much or to do everything by yourself. Ask your partner, family, and friends for help.
- Make time to go out, visit friends, or spend time alone with your partner.
- Talk about your feelings with your partner, supportive family members, and friends.
- Talk with other mothers so that you can learn from their experiences.
- Join a support group. Ask your doctor or nurse about groups in your area.
- Dont make any major life changes right after giving birth. More major life changes in addition to a new baby can cause unneeded stress. Sometimes big changes cant be avoided. When that happens, try to arrange support and help in your new situation ahead of time.
It can also help to have a partner, a friend, or another caregiver who can help take care of the baby while you are depressed. If you are feeling depressed during pregnancy or after having a baby, dont suffer alone. Tell a loved one and call your doctor right away.
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What Is Postnatal Depression
Postnatal depression affects up to 15 percent of mothers after they have given birth and up to 9 percent of women during pregnancy. Depression can happen any time during pregnancy or up to a year after ppi is born. It can also occur after a miscarriage.
The symptoms of postnatal depression usually start within a first few months of the birth. You may not seem interested in your ppi or in other members of your whnau, or you may find it difficult to do everyday tasks.
Dads can also experience depression at this time, especially if their partner is depressed. Depression in new fathers is often not recognised and is not usually called postnatal depression.
The warning signs
Symptoms of postnatal depression are similar to depression at other times. They include feeling sad most of the time and losing interest in things that were once enjoyable. The symptoms might include:
- feeling worthless, hopeless, useless
- feeling so sad that eating and sleeping patterns change
- blaming yourself when things go wrong, even if its not your fault
- feeling anxious, panicky or overwhelmed especially regarding your ppi
- having thoughts of suicide that may include hurting your ppi
- not feeling close to your ppi and other whnau members.
When To Get Help For Maternal & Postpartum Depression Symptoms
While a certain amount of stress and frustration is almost synonymous with parenthood, its important to recognize when the feelings of anxiety, hopelessness, irritability, and fatigue are consistent and overwhelming.
One of the things we often say is that it is not the emotion itself that is the problem. Its the frequency, intensity, and duration of the emotion, says Kleiman. Every new mother cries. All new mothers feel overwhelmed. Every new mother is exhausted. But if she is crying all day, if she is so overwhelmed she is unable to function, or if her fatigue interferes with her ability to get through the day, thats too much distress.
But of course, when youre depressed, it can be difficult to advocate for yourself. Women need families and support networks to stay vigilant after the first few weeks of motherhood, says Kleiman.
We ask families to be alert for signs that mom is not functioning the way she would like or the way she expected to, says Kleiman. When symptoms of distress occur later in the postpartum period, families are less inclined to be looking for it and mom may be better at disguising it.
Treatment for postpartum and maternal depression is available, effective and improving. In fact, the FDA recently approved the first-ever drug specifically indicated for postpartum depression. But as always, the trick is recognizing the symptoms.
Our hope is that with greater awareness, we will encourage more women to speak out, says Kleiman.
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Getting Treatment For Ppd
But the good news is postpartum depression can be treated no matter when it hits. “Depression is treatable and most people get better with treatment,” according to the Centers for Disease Control and Prevention . “If you think you may be depressed, the first step to seeking treatment is to talk to your health care provider.”
Symptoms to look out for include feeling sad, anxious, or irritable changes to appetite, sleep, or ability to concentrate and feelings of hopelessness or worthlessness. “Parents should never hesitate to contact their doctor or healthcare provider if they have these feelings,” says Dr. Ralph.
Your doctor can connect you with a mental health specialist. The CDC also offers a database of community resources. “The most important thing for new moms to know is that they are not alone,” says Dr. Addante. “And most importantly, don’t feel afraid or embarrassed to bring up your symptoms with your healthcare provider.”
For more information on signs and treatment options, read our guide on postpartum depression.