4 Things Everyone Should Know About Postpartum Depression

When Jessica Porten recounted her harrowing experience seeking help as she struggled with postpartum mood issues in a post on social media that went viral, many were horrified. She detailed how she took her baby with her to her postpartum appointment with her OB/GYN and mentioned her recent struggles to the nurse practitioner. Instead of getting the help she sought, police were called and escorted Porten and her 4-month-old to the Emergency Room, where she never did see a physician.

Tens of thousands reacted to her post, and it reignited the conversation about postpartum depression and other perinatal mood issues, including anxiety and intrusive thoughts. While those issues are not new, Porten’s story highlights how new moms, who often struggle on many levels, also often don’t get the help they need.

Indeed, Porten is far from alone.

“Postnatal mood disorders are not as rare as people may think,” says Dr. Angela Kuznia of the Family Medicine Department at Michigan Medicine.

Statistics vary, but many estimates, including by the Centers for Disease Control, say as many as one in five new moms have postpartum depression or postnatal mood disorders. That number could be even higher, given that a recent study out of North Carolina State University published in the Maternal and Child Health Journal found 20 percent of women did not disclose their symptoms to their care providers.

Porten’s post has “brought a lot of attention to the women who suffer and the barriers they face, and that’s led to increased calls for action,” says Jo Kim, PhD, director of the NorthShore University HealthSystem Perinatal Depression Program.

“I hope my story helps normalize these conditions for not just moms, but for society as a whole,” says Porten, who adds her hope that the conversation will focus on removing barriers to healthcare that many moms face.

4 Things Everyone Should Know About Postpartum Depression and Perinatal Mood Disorders

1. Postpartum depression is just one kind of perinatal mood disorder

While many people use the term postpartum depression, “depression is only one part of it,” says Ann Smith, president of Postpartum Support International (PSI) and a nurse practitioner and nurse midwife who faced her own struggles with perinatal mood disorder.

Postpartum depression is one of a number of conditions that falls under the umbrella term “perinatal mood disorders,” which has become the more commonly accepted way to reference mental health issues following delivery of a baby.

A mom doesn’t have to be depressed to be diagnosable. “Many people are not depressed but they are very anxious. Others have intrusive thoughts,” explains Smith.

Postpartum psychosis is a separate condition in which the mother experiences a break from reality. Unlike perinatal mood disorder, postpartum psychosis is rare, occurring in just one or two of every 1,000 births. It includes delusional thinking and irrational judgment and should be considered an emergency that requires immediate treatment.

2. It can happen at any point

Some women think that if they are fine following the birth of their first child that they won’t have any issues with their second child, but that’s not always the case.

“Moms can struggle at any time. Just because it didn’t happen with their first baby doesn’t mean it won’t happen with other children,” says Kim.

3. Perinatal mood disorders are treatable

Porten reports that she is doing better now. While there are still times that are not easy, she says “the contrast between how I feel now, and how I felt when I walked out the hospital is like night and day.”

“Of all the mental illnesses, perinatal mood disorders are probably the most treatable. What’s frustrating is that so few people get treatment and get good treatment,” says Smith. She says that good treatment needs to come from someone who is specifically trained to treat perinatal mood disorders.

“With the right treatment, people get better quickly,” says Smith.

4. There’s a big difference between the baby blues and perinatal mood disorders

The “baby blues,” or a period of sadness or anxiousness after the birth of a baby, is very normal and quite common, says Kuznia. The baby blues are often connected to the typical hormonal shifts and the lack of sleep new moms experience.

What is not normal, however, is when those feelings last for beyond a month or two, or if they are impacting the mom’s ability to function.

Other symptoms of perinatal depression include:

  • Inability to sleep, even when you have the chance to sleep, or sleeping too much
  • Loss of pleasure or interest in activities
  • Crying a lot for no reason
  • Feeling overwhelmed and not being able to cope
  • Appetite changes — usually loss of appetite with weight loss
  • Feeling agitated
  • Fatigue, decreased energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Decreased concentration or ability to make decisions
  • Thoughts of death or suicide

Ways to Seek Help

Kim says that while many moms fear being labeled a “bad mom” for reaching out for help, the exact opposite is true.

“The best way to be the best mom you can be is to start with taking care of yourself. If you’re not addressing what’s going on with you, you’re compromised and that compromises your ability to care for your children,” she explains.

There are many ways moms and those who love them can seek help when dealing with perinatal mood disorders.

If there is an immediate threat to the safety of the mom or baby, call 911. The Suicide Prevention Hotline is also available 24/7 at 1-800-273-8255.

When it is not an emergency, help is still just a phone call away.

  • PSI warmline at 1-800-944-4773 serves people from around the country and offers information, support, and resources in both English and Spanish.
  • The NorthShore MOMS Line at 866-364-MOMS (866-364-6667) is a free, confidential hotline staffed 24 hours a day, seven days a week by licensed mental health clinicians who can provide support, information, and resources to pregnant and postpartum women and those who care about them. They can connect people with providers in their area trained in treating postnatal mood disorders.

An additional option for seeking help is to contact a healthcare provider with whom the woman who is suffering already has an existing relationship. Kim recommends that women first read these tips for talking to one’s healthcare provider about mood concerns, and to use this downloadable risk assessment form from the Postpartum Stress Center to help get the conversation started. Moms can also use the “New Mom Mental Health Checklist,” a tool available on Postpartum Progress that women can use to summarize their symptoms and risk factors and start a conversation with a healthcare provider.

A therapist with perinatal expertise can also be very helpful. Some communities have free support groups that offer nurturing environments in which women realize that they are not alone and receive help and support.

There isn’t a one-size-fits-all approach and a mom needs to find what works best for her. Smith urges moms to not give up and to pursue the best possible treatment for them, noting that if someone says they have been struggling for a while, they haven’t yet found the right treatment for them.

What Are the Best Ways for Friends and Families to Be Supportive?

Porten says that having a strong support system has been “paramount” for her. That support system was in place when she went to her postnatal appointment, aligning with the results found in the NC State study referenced previously, which found that women with the strongest social support networks were most likely to report their perinatal mood disorder symptoms to healthcare providers.

Relatives and friends often want to support new parents but aren’t sure how to, and they also wonder about how to raise the issue of postnatal mental health.

Kuznia recommends that they start a dialogue prior to the birth. That dialogue can continue after the birth. The experts recommend asking questions such as “How are you feeling about everything?” and “How can I help you?”

If a mom says or appears to be struggling, there are a few things her supporters can do. Smith says that if someone says, “You seem to be suffering. Would you like it if I tried to find you help?” most people are very grateful. Partners, family members, or friends can call one of the phone numbers above to find possible treatment providers in the area or can offer to go to a doctor’s appointment with the mom to support her and help answer questions.

Other ways to support new parents include offering concrete suggestions of help, such as volunteering to watch the baby while mom gets a shower or some much-needed rest, making a trip to the grocery store, fixing meals, helping clean the house, or getting the car washed.

Smith says that while the physical help is critically important, offering understanding is just as important. She stresses that friends and family should make the effort to educate themselves and be careful not to stigmatize. Instead, stress to a new mom that she doesn’t have to do it all perfectly and on her own.

“A lot of new parents don’t know how to ask for help or feel like they must be the ones to do all the tasks. But when we look at how children have been raised over time, it’s a community effort,” says Kuznia.

If you’d like to help those struggling with perinatal mood disorders, consider donating to Postpartum Support International, a nonprofit organization.

 

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Shannan YoungerShannan Younger is a writer living in the western suburbs of Chicago with her husband and teen daughter. Originally from Ohio, she received her undergraduate and law degrees from the University of Notre Dame. Her essays have been published in several anthologies and her work has been featured on a wide range of websites, from the Erma Bombeck Humor Writers Workshopto the BBC. She also blogs about parenting at Between Us Parents.

Shannan is the Illinois Champion Leader for [email protected], a campaign of the United Nations Foundation that supports vaccination efforts in developing countries to ensure life-saving vaccines reach the hardest to reach children. “Vaccines are one of the most effective ways to save the lives of children in developing countries and I’d love nothing more than to see diseases eradicated,” Shannan says. “We are so close to getting rid of polio for good!”