Post Partum Depression & Anxiety
Depression is hard enough whether you're struggling with it as a teenager or an adult. The worst possible time to experience depression however, is just after having a baby, otherwise known as postpartum depression. Mental illness has always had a stigma, but I argue that the greatest stigma of mental illness surrounds postpartum depression and the under diagnosed postpartum anxiety. So many women experience it, yet rarely do they speak up about it or seek help--especially in the beginning stages.
Most women don't talk about the difficulty that they are faced with and their "fourth trimester." There is an internal expectation for so many that mothers are just supposed to love every second of it and, if they don't, there must be something organically wrong with them! So women put their feelings in the shame cave and and try to pretend they are not there. It's my experience, however, that many women are relieved to hear when they visit my office that it's normal to have thoughts like, "What the hell have i done? Where is my life and identity that I knew? I feel like a milk truck and if one more person asks me for something I'm going to loose it." Once they understand their brain is simply offering thoughts about doing something that is incredibly hard and it doesn't mean anything about them as a person or a mother, the healing can begin.
Giving birth and becoming a mother is one of the most difficult times of a woman's life. She's physically at her weakest just having grown a baby and then birthed it, yet being asked to do the most she's ever done on virtually no sleep. And when you're exhausted and hungry everything is magnified. And let's face it, eating with one arm when you remember to also becomes a challenge. You may not be able to control the circumstances of motherhood, but you can learn how to not make your thoughts mean anything about you as a mother.
Let's talk about where postpartum comes from and how to do our best to prevent it naturally during pregnancy, as well as how to take the stigma away so that you can ask for help if you need it.
From a Chinese medicine perspective, postpartum depression is often times a sign of blood deficiency. This can be caused by loosing abnormal amounts of blood during birth vaginal or C-section. It can be caused by not eating enough nourishing fats and proteins and lacking foods high in iron while you are pregnant and just after delivering. It can also be caused by having multiple children back-to-back with long periods of breast-feeding. The Chinese perspective believes that you use the Essence that you would turn into your uterine lining for a period and turns it into breast milk. So if you are cycling at the same time as breast feeding, you can seriously tax a woman's system. Unless the mother takes the time to rebuild herself with nutritiously dense food and rest (good luck with a toddler), she can set herself up to go into her next pregnancy deficient.
One of the best things you can do during your pregnancy is to make sure to take in ample amount of DHA, and blood building foods like egg yolks, hormone free grass fed beef, avocados and coconut oil. DHA should be taken at a dose of 450 mg throughout your pregnancy. Sometimes this needs to be added to your prenatal vitamin in addition not all prenatals carry enough DHA. Nettle tea and black strap molasses is an age old herbal remedy that is safely taken throughout pregnancy to help bolster the blood, specifically through its high mineral content. Most women find the taste of the tea palatable during pregnancy and postpartum.
Knowing the signs postpartum depression and educating your partner, your friends and your family about its symptoms can also be helpful. It's also a good idea to give your partner permission to contact your midwife, doula, or OB/GYN if he suspects suffering. Let them error on the side of caution and get you treatment before it becomes a landslide.
Remember: Growing, birthing and raising a tiny human is no small feat. It's not all rainbows and butterflies, especially if you feel alone. Hone your communication skills while you are pregnant and ask for help so that you can rest from time to time when your bundle of joy arrives. Learn to manage your expectations about "doing motherhood perfectly". There is good reason the saying, "It takes a village to raise a child," exists! You didn't conceive or birth this child alone, so don't take in the wonder woman archetype channeling the idea you have to raise him or her alone, especially when you are worn out and at your whits end. There is great strength in the vulnerability to be able to ask for assistance whether it's for an afternoon off or medical assistance to stop the progression of postpartum depression. Be vulnerable. Be brave and reach out. It might just be the most important lesson you'll ever teach your child!
If you think you or someone you know are affected here are the key points to understand how and when to get help with a professional and what the difference is between the baby blues and PPD.
Signs and Symptoms of PPD can include any of the following and last for 2 weeks to 12 months.
Postpartum Depression Onset & Frequency of Occurrence
In the US, estimates of new mothers identified with PPD each year vary by state from 8% to 20%, with an overall average of 11.5%. 11
Expert opinions vary as to the timing of the onset of PPD. For example, symptoms of PPD can begin:
• During pregnancy or following childbirth up to 4 weeks Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) definition2
• During pregnancy or following childbirth up to 12 months The American College of Obstetricians and Gynecologists (ACOG) definition8
• Without treatment, symptoms may persist for months or up to a year.9
Symptoms include
EMOTIONAL • Feeling sad, hopeless, empty, or overwhelmed • Crying more often than usual or for no apparent reason • Feeling worried or overly anxious • Moodiness, restlessness, or irritability • Anger or rage • Persistent doubt about your ability to care for your baby • Thoughts of harming yourself or your baby
PHYSICAL • Physical aches and pains • Changes in appetite • Lack of sleep or oversleeping • Difficulty concentrating
BEHAVIORAL• Loss of interest in things that are usually enjoyable • Avoiding friends and family • Having trouble bonding or forming an emotional attachment with your baby
The Baby Blues Onset & Frequency of Occurrence
Generally peaks within the first few days post delivery and resolves without treatment within 2 weeks. 3,7
Estimated to affect 80% of mothers. 3,12
Symptoms include 3,12
• Sadness • Frequent crying • Anxiety • Mood swings • Irritability • Insomnia • Anger • Fatigue
IF YOU ARE WORRIED YOU ARE EXPERIENCING PPD OR THAT YOU WILL VISIT https://www.postpartumdepression.com/ TO MAKE A PLAN AND GATHER TIPS ON HOW TO SPEAK TO YOUR PROVIDER WITHOUT BEING DISMISSED.
IF YOU ARE EXPERIENCING SUICIDAL THOUGHTS CLICK HERE TO FIND THE HOTLINE THAT BEST FITS YOUR SITUATION https://afsp.org/find-support/im-having-thoughts-of-suicide/
References: 1. FAQ091 Labor, Delivery, and Postpartum Care. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013:1-3. 2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association Publishing; 2013. 3. Earls MF; Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039. 4. Prevalence of Self-Reported Postpartum Depressive Symptoms–17 States, 2004-2005. Centers for Disease Control and Prevention website. https://www.cdc.gov/mmwR/ preview/mmwrhtml/mm5714a1.htm. Accessed November 2, 2017. 5. Robertson E, Celasun N, Stewart DE. Risk factors for postpartum depression. In: Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T. Postpartum Depression: Literature Review of Risk Factors and Interventions. Toronto, Canada: University Health Network Women’s Health Program; 2003. 6. Depression Among Women. Centers for Disease Control and Prevention website. https://www.cdc. gov/reproductivehealth/depression/index.htm. Accessed May 3, 2018. 7. Postpartum Depression Facts. National Institute of Mental Health website. https://www.nimh.nih.gov/health/publications/ postpartum-depression-facts/index.shtml. Accessed July 12, 2018. 8. Screening for Perinatal Depression. ACOG Committee Opinion No. 757. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;132:e208-212. 9. Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry. 2014;22(1):1-22. 10. Moses-Kolko EL, Roth EK. Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Womens Assoc. 2004;59(3):181-191. 11. Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL. Trends in postpartum depressive symptoms—27 states, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep. 2017;66(6):153-158. 12. As reviewed in Thurgood S, Avery DM, Williamson L. Postpartum depression (PPD). Am J Clin Med. 2009;6(2):17-22. 13. Abramowitz JS, Meltzer-Brody S, Leserman J, et al. Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Arch Womens Ment Health. 2010;13(6):523-530
