Postpartum Depression - it's not just your mother's blues anymore

It's common today to hear about women experiencing some form of Postpartum Depression (PPD) -  why?

What it is

PPD, also commonly known as Postpartum Perinatal Mood Disorders (PPMD), is the most common complication of childbirth today. Approximately 9-16 % of postpartum women will experience some form of PPD/PPMD—and this number doesn’t include those who suffer in silence. PPD/PPMD is not a failure to be a good mother, or a way to seek attention, or get out of caring for your baby. It is an illness, affecting many aspects of your psychological and physical wellbeing. Sometimes PPD/PPMD can be very frightening for the new mother, causing her to fear coming forward with her symptoms.

PPD/PPMD Today

New mothers today are more isolated than they were years ago.  In the past, many young women had babies at relatively the same time as their friends, which provided greater peer support. Grandparents and other family members were more readily available to step in and offer help.

Grandparents may not be available to help out as easily today with more and more households requiring two incomes.  Women are also now able to focus on their career, and have their babies at different stages in their lives, without that same built-in support network. Many new mothers are also focused on returning to work, and worry about childcare and getting things in order.

We know a lot more about PPD/PPMD than we did years ago.  Women did suffer back then, but for most, it was swept under the carpet and ignored.  We simply didn’t understand what it was, or how to treat it.

PPD/PPMD is an umbrella term that describes a cluster of symptoms and can be broken down further into five categories:

  • Postpartum depression and/or anxiety.
  • Postpartum obsessive-compulsive disorder.
  • Postpartum panic disorder.
  • Postpartum post-traumatic stress disorder.
  • Postpartum psychosis.

The “blues” are considered part of normal postpartum adjustment and are not part of these disorders.

Baby Blues, or postpartum blues, are usually seen within the first week or two postpartum and symptoms can last up to six weeks, including:

  • Mood instability
  • Weepiness
  • Sadness
  • Anxiety
  • Inability to concentrate
  • Overly sensitive
  • Emotionally labile
  • Mild depression
  • Restlessness
  • Fatigue
  • Insomnia
  • Overwhelmed
  • Anxious

We've put together some facts about postpartum depression to help you understand the signs and symptoms and get help as soon as possible.

PPD/PPMD and/or anxiety

  • Can occur at any time within the first year and beyond
  • Can be triggered by a hormonal change, such as beginning of the menstrual cycle, or cessation of breastfeeding
  • Can begin during pregnancy

 

Signs and Symptoms

  • Excessive worry or anxiety
  • Irritability or short temper
  • Feelings of being overwhelmed
  • Feeling sad, guilty or phobic
  • Feelings of hopelessness
  • Major sleep disturbances; insomnia, or fatigue
  • Loss of appetite, or craving carbohydrates and sugar

Physical symptoms

  • Uncontrollable crying, irritability
  • Nervousness, anxiety, panic
  • Poor concentration, confusion, memory loss
  • Feelings of guilt, inadequacy, worthlessness
  • Overly concerned or lack of concern for the baby
  • Fear of harming the baby or self

Postpartum Obsessive Compulsive Disorder (POCD)

  • Intrusive, repetitive, and persistent thoughts or mental pictures
  • Thoughts often are about harming the baby or self
  • Can include excessive counting or checking, or other repetitive behaviors
  • Fear or shock in herself for having these thoughts
  • Sometimes exhibiting strange behaviors to reduce the anxiety of these thoughts

Postpartum Panic Disorder

  • Episodes of extreme anxiety
  • Shortness of breath, chest pain, sensations of choking or smothering, dizziness
  • Hot or cold flashes, trembling, palpitations, numbness or tingling sensation
  • Possible restlessness, agitation or irritability
  • During the attack: fear of going crazy, dying, or losing control
  • Panic attack may wake you from sleep
  • Sometimes there is no identifiable trigger
  • Excessive worry or fears, usually worry about more panic attacks

Postpartum Post-Traumatic Stress Disorder (PPTSD)

  • Repetitive flashbacks and images of an event (often of the birth experience or of prior sexual abuse)
  • Nightmares and “Daymares”
  • Hypervigilance (always on alert)
  • Increased arousal (startles easily)
  • Depressive symptoms and anxiety tend to co-occur
  • Conditioned insomnia

Postpartum Psychosis (PPP)

  • Extremely rare and occurs in one to three per thousand new mothers
  • Onset typically is three days postpartum
  • Visual or auditory hallucinations
  • Delusional thinking
  • Delirium or mania

Getting Help

If you are experiencing any of the above symptoms, please seek treatment and remember that PPD/PPMD is curable, and you will get well.

The following organizations have many valuable resources:

Please don't hesitate to contact my office in Garden City, New York if I can be of assistance.

Cheryl Zauderer, PhD, CNM, NPP, IBCLChas been a registered nurse since 1985. She is a nurse-midwife, a lactation consultant and a psychiatric nurse practitioner specializing in perinatal mood disorders and other women’s health issues. Dr. Zauderer has authored her first book entitled Maternity Leave: A New Mothers Guide to the First Six Weeks Postpartum, Praeclarus Press. It is a self-help book for new mothers focusing on the first six weeks postpartum. You can follow her with her blog and on her website at: postpartumcare1.com, on twitter, and on facebook.  Dr. Zauderer has also served as a board member for PSI (Postpartum Support International) and has been the Nassau/Suffolk coordinator for PSI since 2009.