When It Isn’t the Happiest Time of Your Life: Dealing with Postpartum Depression

An average of one in eight mothers suffers from postpartum depression.

With nine months of anticipation, a woman expects the birth of her baby to be the best moment ever. Such a life changing event deserves excitement and joy, true, but also brings fear and anxiety. While the range of emotions can seem overwhelming, depression is the least expected and often most hidden, but is the one mothers should talk about the most.

Facts About Maternal Depression

The term maternal depression describes a spectrum of conditions from prenatal depression and postpartum blues to postpartum depression and postpartum psychosis. ‘Down time’ after giving birth is fairly typical, and the psychiatric community estimates 50%-75% of all mothers suffer from ‘baby blues’ the first two weeks after childbirth. The numbers for postpartum depression average one mother in eight.

“Society tends to stigmatize a mother who doesn’t show signs of loving her baby, and that can keep a lot of women from seeking help,” said Stacey Leakey, Ph.D., children’s treatment manager at The Parent Child Center of Tulsa. “Know that it’s okay if you’re upset. We often try to create a blind spot for everything that isn’t ‘wonderful.’ But if you have negative feelings, you’re not the first mother to feel that way.”

Maternal depression comes because of all the changes in a new mother’s life. A new baby signals greater fatigue and exhaustion, and can trigger bad memories from a mother’s own childhood. And if the “picture perfect” ideal is not reality, that can also increase the odds. Postpartum blues last a few weeks, and are lessened with rest and a support system of family and/or friends.

Postpartum depression and psychosis, on the other hand, require medical help.

“Postpartum depression is different from major depression. They look the same and are treated the same, but are physiologically different,” explained Dr. J. Martin Beal, DO of Tulsa OB-GYN Associates. While on staff at the OSU College of Osteopathic Medicine, Dr. Beal was part of a team that conducted studies to better understand postpartum depression. “The big question is does the mother have postpartum depression, or does she have depression that was not diagnosed until she had a baby, so the condition is called postpartum.”

Screening for Postpartum Depression

To combat this misconception, Dr. Beal screens every patient for depression. The evaluation doesn’t take long, and he feels it’s time well spent. Treatment for the more pronounced versions of maternal depression includes medication and therapy, ranging from six months to one year.

“When mothers don’t come to the gynecologist about issues of depression, it’s often the pediatrician who first recognizes the problem,” Dr. Beal said. “When babies fail to thrive, it is often because the mother has untreated postpartum depression.”

Leakey explained depression hurts the mother/child relationship by hindering the ability for attachment. Babies need emotional nurturing and protection, and a level of stimulation that is often beyond the ability of a depressed mother.

However, many depressed women are very good mothers who try to push through the depression. That’s often when it takes intervention from a doctor or family member before the mother can see she truly needs medical help.

Factors that Point to Postpartum Depression

Parenting is most affected when depression occurs with other socio/economic or physical problems, such as extreme poverty and substance abuse. According to Dr. Beal, even cigarette smoking is an indicator, as a mother who smokes five cigarettes per day has an almost 100 percent chance of experiencing postpartum depression.

Leakey offered a number of factors that point to maternal depression risk, including:

• Prior history of depression
• A family history of depression
• Hormonal changes the mother experiences during pregnancy
• Genetics
• Absence of community network
• Poor environment that ranges from food insecurity, poor housing, lack of financial supports
• Uninvolved husband or partner

The Importance of Treatment

Attachment begins when an infant is around two months old, as parents respond to children’s cues. The infant starts reciprocating in his actions and looks toward his parents.

This is not the only way parents and children relate to one another, but one of the most important. It lays the foundation for which children feel secure or trusting about their world and ability to explore it.

If a mother puts off treatment for postpartum depression, she is less able to effectively respond in ways that reinforce the attachment process, indicating future risk for infants that include:

• Reduced self-control
• Aggression
• Poor peer relationships
• Difficulties in school

“That’s why it’s so important mothers don’t put off getting help,” Leakey explained. “The faster they begin treatment, the less likely babies will develop long-term problems.”