I am so excited to provide outreach and education regarding Perinatal mental health. Perinatal mental health refers to a woman's mental health during pregnancy as well as the first year after birth. This can cover many topics including pregnancy, infertility, birth, loss, postpartum, and new parenthood.
For this blog I will focus in on Postpartum Mood Disorders, specifically the most well-known subtype - postpartum depression. The other postpartum mood disorder subtypes are: anxiety (with or without depression), panic attacks, OCD, and psychosis. Many people are under-informed on Postpartum Depression (PPD) so I wanted to cover 5 common myths.
1. Myth: Postpartum depression is very rare.
Truth: Postpartum depression is THE MOST COMMON complication from childbirth, affecting an estimated 20% of mothers. The vast majority of women (estimated 7 out of 10) with a perinatal mood disorder downplay or hide their symptoms. Only about 15% of women who meet criteria for PPD get professional help. It is also important to know that suicide is the leading cause of death for women during pregnancy and one year after birth, so it is imperative that we stop being afraid to talk about postpartum depression and that we understand the symptoms as well as how to get help.
2. Myth: Sufferers of postpartum depression cry all the time.
Truth: Postpartum depression (PPD) is defined as a mood disorder that can affect women after child birth. The symptoms are often (not always) anxiety, sadness, irritability, feelings of guilt, rage, dread or exhaustion. It is different than “Baby Blues” which affects about 85% of new mothers. Baby Blues is when a mother feels weepy, irritable and anxious but those symptoms resolve within a few weeks after childbirth. When feelings of sadness, irritability and anxiety linger beyond the 2-3 week time frame, one might be concerned about PPD. In my clinical experience, anxiety or feelings of guilt is what brings women into treatment. Women tell me they have racing thoughts and worries about their baby. Or they feel like a terrible mother and they are doing everything wrong (even when there is no evidence to support this!) Women tell me they just want to feel like themselves again, that they don’t like feeling this irritable or worried.
3. Myth: Postpartum Depression is caused by hormones
Truth: While hormones can play a factor, it is not the full picture. Parents who adopt and fathers can experience PPD (1 in 10 men). Here are some risk factors – sleep deprivation, a history of mood disorder or family history of a mood disorder, perfectionist personality, depression or anxiety during pregnancy, marriage difficulties, history of trauma, pregnancy complications, traumatic birth experience, or other stressors including job, illness, major socioeconomic problems and so on. That’s a lot, right?! No one is immune to developing PPD so we all need to remember to be kind to each other and stop with any blame game. If you have PPD it is not your fault and you are not a bad parent.
4. Myth: Most women with PPD get help.
Truth: (okay I cheated and sort of gave you this answer already). As mentioned, the majority of women with PPD downplay or hide their symptoms. Most women feel they can’t tell anyone, not their partner, friends, family, or doctor. Mother’s worry others will think they are bad parent, or that there is something wrong with them because all other mothers seem happy. During pregnancy all women are screened for gestational diabetes which affects about 6% of women. There is no mandatory screening for postpartum mood disorders (even though there is an easy and free 10 question screener called The Edinburgh Postnatal Depression Scale) and by comparison PPD affects about 20% of women. This reflects to me that the medical community is mostly overlooking mental illness. Whether these messages about PPD are implicit or explicit – the message is still the same – that mental illness is either something bad or something to ignore. This is STIGMA - a very serious problem that prevents people from getting help they need. You can help decrease stigma by openly talking about mental health and being conscious and compassionate when talking about people with mental health struggles.
5. Myth: Postpartum depression is difficult to treat
Truth: PPD is VERY treatable! If you are someone you know is struggling - you are not alone and you will get better. Here is how…
Exercise - A Duke study demonstrated that briskly walking three times a week is just as effective in treating depressive symptoms as antidepressant medication (see full study below). That is pretty powerful. Exercise is not always an option for postpartum women. Many women are healing from birth or surgery and have not received the clearance to exercise. If you are cleared to exercise, start small and set yourself up for success. It is even more successful if you can bring in social support. Perhaps walking with a friend or family member or trying a group class.
Social Support – We are social animals and being social lowers the stress response in our body. Your experience of support may be very different from other people’s so you have to find what works for you. Perhaps it is a support group, family member, friend, an exercise class, place of worship, or moms group.
Therapy – Contrary to many people’s fears, talk therapy does work! Cognitive-behavioral therapy and interpersonal psychotherapy are the most evidence-based treatments for Postpartum depression. You can find a therapist through www.psychologytoday.com or www.goodtherapy.org.
Medication - Antidepressant medications are not the only option for treating depression but for many mothers they may be the best choice. Although there is some risk associated with antidepressant use, the risk of untreated depression may be even greater. And all risks and benefits must be carefully weighed for each mother and discussed thoroughly with her physician.
Omega-3 fatty acids EPA and DHA – new research shows that these fatty acids can help in both prevention and treatment of mild depression. Please speak to your physician before taking any new supplements.
Please remember - our bodies don’t differentiate between psychiatric illness and other physical illness. Only society does! So please treat your body and soul with an abundance of kindness and compassion.
Interested in more? Please let me know if there are any topics you would like me to cover.
Data in this blog was retrieved from the following sources
National Alliance on Mental Illness www.nami.org
Postpartum Support International www.pospartum.net
Centers for Disease Control and Prevention www.cdc.gov
Duke Study on Exercise, https://today.duke.edu/2000/09/exercise922.html