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AAMFT Consumer Update
Postpartum Depression
 Somehow women have learned to expect
that the birth of a baby automatically produces exhilaration and joy. They
are led to believe that the period following childbirth should be the
happiest time in their lives. In truth, it is one of the most stressful
and anxiety producing periods in the life cycle of a family. More than
half of the women who give birth each year experience some negative change
in their mental health. For 10 to 15% of those women, the period following
childbirth becomes a nightmare as they experience sleeplessness,
confusion, memory loss, and anxiety during the already stressful
adjustment to motherhood.
New mothers are especially vulnerable to
depression anytime within the first year after delivery. Along with the
overwhelming demands of caring for an infant comes a loss of time with one's
spouse, the loss of adult friendships, and
a loss of freedom and familiar routine.
This is also a challenging time for the entire family, as they attempt to
adapt to a new way of life, while knowing that their lives will never
again
be
the same.
What is postpartum depression?
Postpartum depression is a biological illness caused by changes in
brain chemistry that can occur following childbirth. During pregnancy,
hormonal levels increase considerably, particularly progesterone and
estrogen ,
and fall rapidly within hours to days after childbirth. Also, the amount
of endorphins, the feel-good hormones that are produced by the placenta
during pregnancy, drop significantly after delivery. Even the thyroid
gland can be affected by the enormous hormonal changes that are associated
with pregnancy and childbirth, leaving women more at risk for depression.
How do I know if I
have postpartum depression?
Experts identify three broad types of postpartum mood disorders that
are classified according to the severity and the duration of symptoms. The
"baby blues" affects approximately 50 to 75% of new
mothers and generally surfaces within a few days of delivery. Women with
the maternity blues describe more tearfulness, irritability, and anxiety
than usual with an overall sense of overwhelm. Because these symptoms
usually decrease by two weeks without medical or psychological help, most
women do quite well with added rest and extra help caring for their
infant, along with reassurance and emotional support that their feelings
are normal and temporary.
Psychosis is an extreme form of postpartum depression. Although
it is rare, psychosis is a life-threatening emergency that requires
immediate medical treatment to protect both you and your child. If you
have psychosis, you may be experiencing some of the following symptoms:
- Hearing sounds or voices when no one is present
.
Feeling afraid that you might harm yourself to escape the pain.
Having thoughts about harming your baby.
Rapid weight loss and refusal to eat
Going without sleep for forty-eight hours or more.
Feeling as though your thoughts are not your own
Feels like you are "going through the motions" of taking
care of your baby without feeling much love.
About 1 out of 10 women who give birth will
develop a postpartum depression. If you think that you are one of
them, you might be:
- Crying more than usual
- Feeling sad much of the time
- Unable to concentrate and feeling in a fog
- Finding it difficult to remember where you've put things
- Unable to enjoy the things that you used to enjoy
- So exhausted but still unable to sleep even when your baby sleeps
- Tired most of the day
- Feeling like you will always feel this way
- Afraid to be alone
- Wishing you were dead instead of having to feel this way any longer
Frequently,
symptoms go unrecognized because you may think they are part of the stress
of caring for a new baby. You might delay in asking for help out of
embarrassment, guilt,
and a mistaken belief that a "good mother" should be capable of
handling the overwhelming adjustment of caring for a new baby with little
or no
need
for help. Also, weaning a baby from the breast and the return of
menstruation are significant hormonal events that can alter the
biochemical balances in the body and affect the timing of a depression.
Am I at risk for a
postpartum mood disorder?
Although there is no exact way to predict a
postpartum depression, it is possible to identify the factors that
increase your risk. The most important risk factor is your personal and/or
family history of a depression or a bipolar disorder. If you have had a
previous postpartum depression, that also increases your chances of
another depression. In addition, your risk increases if you have been
depressed during pregnancy and have a history of premenstrual mood
syndrome.
Stressful situations that include marital
tension, health problems with the baby, a complicated pregnancy or
delivery, and a lack of social support increase your risk for a postpartum
depression. Among the psychological factors that predispose you to
postpartum depression are a childhood history of sexual abuse or trauma,
chemical dependency in your family,
and confusing or negative feelings
about the pregnancy and uneasiness about your new role as a mother.
What are the
treatments for a postpartum mood disorder?
Decisions about treatment for postpartum mood
disorders vary according to the severity of symptoms. Professional
opinion, however, often supports the use of antidepressant medications in
combination with psychotherapy from a qualified family therapist. Family
and couples therapy is also effective, allowing the family and/or partner
to better understand the depression and be a source of support for the
mother. A marriage and family therapist may work with the couple to
explore the history of each person's feelings, and will focus on solutions
that the family can implement right away.
Group psychotherapy, involving the
participation of other women who are experiencing a postpartum mood
disorder, has also been found to improve depression by reducing the
feelings of isolation that many women feel in the early months after
childbirth. It is important to know that if you are breastfeeding, it may
not be necessary to stop while taking antidepressants. Be sure to consult
with your doctor about medication options that are appropriate for your
particular circumstances.
Can I prevent postpartum depression?
Although a postpartum depression might not
always be preventable, it certainly is possible to diminish the severity
of symptoms, should they occur. Even before delivery, locate the stressors
in your life and eliminate them. Put a support system in place during
pregnancy so that you will feel less alone and overwhelmed after the baby
arrives. In the months following childbirth, plan for free time, get
plenty of rest, and do not deny your feelings or feel guilty for having
them. Educating yourself about postpartum mood disorders is one of the
best ways to ensure early diagnosis and proper treatment. Postpartum mood
disorders are treatable, and seeking the help of a qualified therapist is
essential.
Consumer Resources
Organizations
Postpartum Support
International
927 N. Kellogg Avenue
Santa Barbara, California 93111
805.967.7636 (fax) 805.967.0608
www.postpartum.net
___________________________
Depression After Delivery
91 East Somerset Street
Raritan, New Jersey 08869
1.800.944.4773 (4PPD)
www.depressionafterdelivery.com
___________________________
Books
Postpartum Survival Guide by Ann Dunnewold, Ph.D & Diane G.
Sanford, Ph.D New Harbinger (1995). A practical, comprehensive guide that addresses
the range of postpartum adjustment problems.
The Postpartum Husband by Karen Kleiman, MSW. Xlibris Corporation
(2000). This book includes practical solutions and specific
recommendations to help partners cope with the impact of depression after
the birth of a baby.
The Birth of a Mother by Daniel Stern, M.D. Basic Books (1998). An
in-depth and sensitive look at the emotional and mental life of expectant
and new mothers.
Mothering the New Mother by Sally Placksin. New Market Press
(2000). A support and resource guide that addresses the needs of the new
mother during the first year after delivery.
The text for this brochure was written by Diana Lynn Barnes, Psy.D.,
LMFT.
Keywords: baby-blues, postpartum psychosis, mood disorder.
Click
here to purchase this or other informative materials from AAMFT.
Marriage and family therapists are mental health professionals who treat a
wide array of disorders, working with individuals, couples, and families.
Marriage and family therapy clients report that they are highly satisfied
with the services they have received, and research shows that marriage and
family therapy is a cost-effective, short-term, and results-oriented form
of treatment.
The American Association for Marriage and Family Therapy (AAMFT), the
professional organization representing marriage and family therapists,
believes that therapists with specific and rigorous training in marriage
and family therapy provide the most effective mental health care to
individuals, couples, and families. This brochure is courtesy of:
the AAMFT.
Visit the AAMFT
TherapistLocator.net, a public service of the
AAMFT. There you will find information about a range of problems facing
today's families, and you can search for a qualified family therapist in
your area.
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