Postpartum Depression: How to Recognize the Signs
Here’s what to do if you’re struggling to adjust.
Bringing home and starting a new life with a baby is often considered one of the most amazing milestones in adulthood, so feeling any sort of sadness or dissatisfaction might make you feel ashamed or guilty.
But sadness after having a baby is more common than you might think, and many women feel some extent of postpartum blues in the year after delivery. Postpartum blues may come and go shortly in the weeks after childbirth, but postpartum depression is different. It can start any time in the first year after giving birth (it may not happen ASAP), may last months or longer, and is severe enough to prevent new moms from bonding with their babies.
“After having a baby, there are so many drastic changes to life, to your body, and life as you once knew it,” says Khadijah Watkins, MD, a psychiatrist at Weill Cornell Medicine.
The exhaustion and swirl of emotions associated with caring for a newborn can be a huge adjustment for many women, and it may affect self-esteem and stress management. Rapidly fluctuating hormone levels in the postpartum period can also make new moms more vulnerable to depression.
Symptoms of postpartum depression include the following:
Sadness
Anxiety
Despair
Irritability
Difficulty bonding with the baby
A lack of interest in things
And feeling unable to care for the baby or that nothing they do is “enough.”
Treating postpartum depression can include some combination of psychotherapy, medication, group therapy, and family therapy. Whether in a one-on-one or group setting, talk therapy may last just a few weeks or several months or longer.
“One of the challenges when you have postpartum depression is you feel like you are alone,” says New York City-based psychologist Ben Michaelis, PhD, “so having a group of other women that are experiencing similar symptoms can be quite therapeutic.”
Medications for postpartum depression are similar to those used for treating depression, but special consideration is given if the mother is breastfeeding. Certain antidepressants are safer to use while breastfeeding than others. (Learn more about the different types of antidepressants here.)
“The key thing is that there’s no one way to be a mom and there’s one way to be a new parent,” says Jennifer Hartstein, PsyD, a psychologist in New York City. “They’re going to have really great moments and really bad moments, and that’s okay, too.” If the bad moments start to outweigh the good, however, don’t hesitate to reach out for support.
Dr. Hartstein is the owner of Hartstein Psychological Services, a group psychotherapy practice in New York City.
Ben MichaelisDr. Michaelis is a clinical and media psychologist in New York City.
Khadijah WatkinsDr. Watkins is an assistant professor of psychiatry in the division of child and adolescent psychiatry at Weill Cornell Medicine and an assistant attending psychiatrist at NewYork-Presbyterian Hospital.
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For women who are struggling
with postpartum depression,
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don't be afraid to ask for help.
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If something doesn't feel right, if you
don't feel right there's no harm in that.
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Postpartum depression can present as
sad mood, really a lot of irritability,
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having a hard time bonding with their
babies, lack of interest in things.
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Really feeling like you're
doing everything you
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can to take care of yourself, to take care
of your family, take care of your baby.
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And then, feeling like it's not enough.
Women that have postpartum
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blues are usually able to function.
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Postpartum depression is usually more
severe, and it's more persistent.
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So, it can take longer, and it can really
affect their ability to bond with the baby
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and take care of the baby's needs.
After delivering a baby, women
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are particularly vulnerable to developing
depression due to the rapid and dramatic
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fluctuation of the hormone levels.
Postpartum depression doesn't happen
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right after you have your baby, I mean,
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there's that whole year period where
everbody's changing and growing.
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So, it can happen at any
point in that 12 months.
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After the birth of my daughter,
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I went through a prolonged two year
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depressive episode which may or
may not still be effecting me.
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It goes up and down.
After having a baby there are so
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many drastic changes to life, and to
your body, and life as you once knew it.
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It often is missed that this is
developing into a true depression.
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And there are lots of efforts now to
screen women for postpartum depression at
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their OBGYNs, at the pediatricians,
at the first early visits.
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Because it is not as apparent to the
person or the family members that this is
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truly a depression.
So
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postpartum depression is treated through
a combination of psychotherapy, and
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medication, and group therapy,
and sometimes family therapy.
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Postpartum depression is treated using a
class of medications that you would use to
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treat depression such as selective
serotonin reuptake inhibitors or SSRIs.
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The treatment for postpartum depression
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would depend on whether a woman
wants to breastfeed or not.
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There are a few medications within that
class that are safer in breastfeeding
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than the others.
One of the challenges when you have
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postpartum depression is
you feel like you're alone.
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So having a group of other women that
are experiencing similar symptoms can be
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quite therapeutic.
I think the key thing is,
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there's no one way to be a mom, and
there's no one way to be a new parent.
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And I think all moms
need to recognize that.
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And they're gonna have really great
moments and really bad moments, and
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that’s okay too.
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But not to hesitate to ask for help if
the bad moments are outweighing the good.
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Postpartum depression. Washington, DC: American College of Obstetricians and Gynecologists. (Accessed on January 10, 2021 at https://www.acog.org/Patients/FAQs/Postpartum-Depression.)
Postpartum depression: beyond the basics. Waltham, MA: UpToDate. (Accesed on November 29, 2017 at https://www.uptodate.com/contents/postpartum-depression-the-basics.) Postpartum depression facts. Washington, DC: National Institute of Health. (Accessed on January 10, 2021 at https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml.) Postpartum psychiatric disorders. Boston, MA: MGH Center for Women’s Mental Health. (Accessed on January 10, 2021 at https://womensmentalhealth.org/specialty-clinics/postpartum-psychiatric-disorders/?doing_wp_cron=1511919133.5311920642852783203125.) What is postpartum depression & anxiety? Washington, DC: American Psychological Association. (Accessed on January 10, 2021 at http://www.apa.org/pi/women/resources/reports/postpartum-depression.aspx.)