Understanding Peripartum and Postpartum Depression

A new addition to the family brings with it lots of changes, and a myriad of emotions may be experienced in the first weeks of your new infant’s life. While a birth is anticipated over a long period, most believe it will be a joyful and uplifting experience, but it also can create some shifts that are not anticipated.  New parents expect to be sleep deprived and to have some challenges with breastfeeding, schedules, and trying to figure out their baby needs, but they also expect to have a happy blissful feeling about the birth of their new baby. However, depression is often an unanticipated occurrence.

Although this may be the case for a majority of families, a sizeable minority of new moms have a different response.  Peripartum Depression is the term which is used to include depression in pregnancy and postpartum (after the birth) depression.  The percentage of depression is 18.4% during pregnancy and 19.2% postpartum (Dtsch Arztebl Int. 2012 Jun;109(24):419-24.).

Many new moms may feel weird or different because of their responses or feelings about pregnancy and/or after the birth.  They may not realize how common Peripartum Depression is for parents of newborns, and thus, feel alienated and hesitant to speak up about it.  This can intensify the new mother’s depressive symptoms, negative self-talk and sense of isolation.

New dads may want to help and support , but telling her to “snap out of it,” “it’s not that hard”,  they do not understand why she is feeling down, and/or she should be fine are very common responses. These responses can unintentionally further increase the new mom’s sense of isolation and alienation.  Then, the question becomes what can we do to support new mothers and how to identify Peripartum Depression (PPD) early?

Symptoms & Risk Factors:

The symptoms of Peripartum Depression can include irritability, crying, feeling restless, trouble sleeping, extreme exhaustion (can be emotional and/or physical), changes in appetite, difficulty focusing, increased anxiety and/or worry, disconnected feeling from baby and/or fetus, and losing interest in formerly pleasurable activities.   Less frequently in postpartum psychosis, it can include fear that the baby could be accidentally harmed and/or urges to harm the baby.  If we notice irritability and mood shifts early. then mom can get the support she needs to help circumvent the rollercoaster she would otherwise experience.

Risk factors for Peripartum Depression include a history of anxiety and/or depression, history of depression within the family, social isolation (ie. Minimal support network) and/or  a difficult birth.  Women who have these risk factors do not always get PPD and some get it without any of these risk factors. These symptoms are more of a guide to let us know who would more likely to be at risk.  If a woman has these factors present in her history then it is helpful for family members and the woman to know more about the signs of Peripartum Depression, as responding promptly can help to arrest the course of her depression.

Supporting new moms who are experiencing Peripartum Depression:

Family members can encourage new moms to make their medical providers aware of symptoms because it is critical for them to be involved as part of the support and intervention process. Self Care such as physical activity, communication, sunshine, rest, and getting outdoors can help with the depressive symptoms and decrease a mom’s sense of isolation.  It can also help to break the cycle of negative self-talk.  A local support group can be a good place for new moms to be with others having a similar experience and be with others who understand her experience.  Lastly, once a mother understands her own experience she can help educate and recognize others who may experience peripartum depression in her family and/or community.  This can go a long way in breaking the silence and stigma around this common phenomenon.