6 Questions About Postpartum Depression, Answered
Written By: Melissa Fiorenza
As you probably already know, there’s an exorbitant amount of misinformation out there when it comes to pretty much anything in the health and sciences realm. So as someone who’s known to Google for answers until her fingers ache from typing, I love when an editor asks me to interview practitioners and get real, direct answers that are rooted in facts and experience. Especially when it comes to something I’ve experienced firsthand, like postpartum depression.
Here are six questions I asked a couple of experts about PPD specifically in relation to new moms (but fyi, dads can get PPD too), along with their honest, professional answers. It doesn’t matter if you’re about to be a mother, a father, a loved one, a friend, a parent of three kids, there’s surely something for you in here. Take a look.
1. How can someone tell when what they're experiencing is PPD and not just the typical "baby blues?" Are there common signs to look for?
Baby blues is extraordinarily common and happens within the first few weeks after having a baby, typically starting several days postpartum and lasting up to two weeks, explains Shana Averbach, LMFT, a psychotherapist in San Francisco who focuses on maternal mental health. “It may include sadness, irritability, and mood swings that come and go throughout the day. If it’s been more than two weeks and a woman is noticing more intense depressive symptoms, such as excessive crying, loss of pleasure, under or over sleeping, intense anger/agitation/irritability, and hopelessness—to name a few—those are more indicative of PPD.”
Other red flags worthy of noticing, she adds, include having difficulty bonding with the baby (or babies in the case of multiples), and/or feeling hooked or overwhelmed by thoughts like “my baby would be better off without me,” or “I’m not cut out for this.” It could very well be someone else who notices these things, she says, since depression tends to disguise itself as the “truth.” “What I mean by that is a mom in the depths of depression might really think she is hopeless and a terrible mother, whereas her partner may observe that she’s doing everything she can and is being extraordinarily hard on herself, or is really not like herself at all.”
2. What's the first step someone should take (or perhaps, their loved one should take for them), when they're feeling depressed after the birth of their baby?
“What’s great is there are multiple good options for steps to take if feeling depressed after having a baby,” says Averbach. “If I were in charge, the very first step would be to tell yourself you’re a good mom having a depression experience. But more practically speaking, many moms start by calling their OB/GYN, since it’s a relationship that has been active throughout pregnancy and birth.” (Key to remember here: you don’t need to wait until the 6 week appointment!) An OB/GYN can directly prescribe medication if appropriate, she says, or can make a referral to a psychiatrist. Your OB/GYN can also make referrals for psychotherapy.
“Postpartum moms can also directly reach out to a therapist and/or psychiatrist. If the search is too daunting, an excellent resource to help is Postpartum Support International, which has local coordinators around the globe who can make referrals to therapists trained in perinatal mental health.” Next step? Keep your appointment, she says. “The truth is, it’s kind of the last thing a new mom wants to be doing, since she’s busy with so many other things, but it’s worth the effort.”
3. Do we know what causes it? Is there any way to "prevent" it from happening?
PPD is likely a result of a great number of factors: changes in hormones, little sleep, physical results of childbirth, feelings about the birth, isolation, the stress of taking care of a new baby, and shifts in personal identity, explains Saba Harouni Lurie, LMFT, ATR-BC, owner and founder of Take Root Therapy. While there’s no way to “prevent” PPD, says Harouni Lurie, it can help to have plans to access support even before the baby arrives. It also helps to be kind to yourself and to give yourself permission to experience and feel whatever is real for you, she says. “When we see photos of new moms, both momma and baby often look blissfully happy. That’s not the reality most moms experience, however, and that’s okay.”
4. What options are there for treatment?
“I think of treatment options on a wide spectrum,” says Averbach. “Some moms—if the depression is mild—might benefit from self-help actions, such as making sure to get proper nutrition, fresh air, exercise (if medically cleared to do so), sleep (this involves figuring out night time parenting), connecting with friends/loved ones, and education about PPD.” Another option, she says, is joining support groups, facilitated by a professional who is aware of common new mom and baby experiences. Psychotherapy is another choice and it is often effective in treating mild to moderate PPD, she adds.
“Medication is another great option and should especially be considered if the PPD is severe. Medication and psychotherapy are often used in conjunction. Another option is doing an intensive outpatient program, which essentially combines all of these components together. She would have group and individual therapy, and would meet with a psychiatrist.”
Finally, if mom or baby are in acute danger due to the severity of PPD (i.e., if mom is at risk of hurting herself or baby), this is an emergency and needs to be treated as such, advises Averbach. “Mom would need to get to an emergency room, or have her OB/GYN or mental health provider make an immediate referral to an appropriate inpatient facility.”
5. What are some common misconceptions about PPD?
Averbach says that, to her, the biggest misconception is that someone can tell when it’s happening. “Many moms who are experiencing PPD look very well put together and might even say they are doing great. That’s why we really need to be honest about the not-so-great parts of postpartum life, which gives permission for others to do so too.” Another misconception, she adds, that actually happens for the person experiencing it, versus those looking on, is that having PPD makes you bad mom. “Many depression moms are actually doing a great job meeting babies’ basic needs, and great moms experience hard times.”
6. For those reading this who know someone experiencing or has experienced PPD, what are some things they should avoid saying to that person?
People should avoid telling someone who has or had PPD, “It’s worse for others,” says Harouni Lurie. Other inappropriate comments: “But just be grateful for your baby,” or, “Look at that beautiful baby... what is there really to be sad about?” It’s also unhelpful, she adds, to be told anything that starts with “It’s only.” Like, “It’s only because you haven’t slept,” or “It’s only going to be a couple weeks.” When one is experiencing PPD, she explains, they’re often already invalidating and minimizing their own experience and often feel guilty for having feelings of sadness. So other people should definitely avoid saying anything to invalidate or minimize the experience of the individual with PPD.
For more information and resources regarding PPD, check out Postpartum Support International.