The Truth About Postpartum Depression

By Robyn Alagona Cutler, MFT

Did you know that 20% of women experience postpartum depression or another mood and/or anxiety disorder at some point in the first year after having a baby, making this the most common complication of childbirth?

Most women are not being properly screened for these potentially serious mood disturbances, making them some of the most under-diagnosed and under-treated health concerns facing women.

Why is this happening?

Many providers have around 15 minutes to conduct the 6-week postpartum exam, leaving them little time to talk about the emotional adjustment to motherhood. If the topic is broached, many providers do not have the resources and referrals to provide their patients, leaving women to struggle in confusion and isolation.

postpartum depression mom

What can be done?

1) Public Awareness:

The American College of Obstetricians and Gynecologists just released their revised guidelines that state that women should be screened and that “Systems should be in place to ensure follow-up for diagnosis and treatment” of Postpartum Depression. (ACOG, Committee Opinion, Screening for Postpartum Depression, No. 631, May 2015). When doctors and other care providers follow-up and ask moms how they’re doing, it decreases stigma and increases the chances that women will be identified and offered support.

2) Education:

Although risk factors can play an important role in preventative care, Postpartum Depression and Anxiety does not discriminate. It affects women of every culture, race, ethnicity and socio-economic status.

Some important risk factors to pay attention to are:

  • A personal and/or family history of depression and/or anxiety
  • A lack of social support (at any point in the prenatal or postpartum period)
  • A previous miscarriage, a complicated experience becoming pregnant, a difficult or unwanted pregnancy, a difficult or traumatic labor and/or delivery
  • Medical intervention (Neonatal Intensive Care stay) or other health problems with mom or baby
  • A traumatic childhood

Postpartum mental health difficulties can manifest as:

  • Baby Blues– 70-80% of women experience Baby Blues, which can begin 3-5 days after the birth of a baby and can last up to 14 days. It is caused by the enormous fluctuations in hormones that come with pregnancy and birth and can include symptoms of weepiness or crying, impatience, irritability, restlessness, anxiety, fatigue and insomnia (even when baby is sleeping), sadness, mood changes and poor concentration. In some cases it resolves on it’s own. It is best to consult a care provider right away, if you are feeling any of the above.
  • Postpartum Depression– 15-20% of women will experience more significant symptoms of depression with the onset anytime during pregnancy and up to 12 months after birth (with some research showing indications of onset and/or duration lasting longer). Symptoms may include anger, sadness, irritability, guilt, lack of interest in baby, changes in eating, sleep, trouble concentrating, hopelessness and sometimes thoughts of harming baby.
  • Postpartum Anxiety– Symptoms may include extreme worries or fears often over the health and safety of baby. Panic attacks may occur. Co-occurrence is common with depression.
  • Postpartum OCD– Symptoms include repetitive, upsetting and unwanted thoughts or mental images (obsessions) and sometimes a need to repeat behaviors (compulsions) to reduce anxiety. These thoughts are disturbing and scary to the person experiencing them.
  • Postpartum PTSD– Often caused by a traumatic birth experience or past trauma. Symptoms may include flashbacks, anxiety and a need to avoid things related to the event.
  • Bipolar Mood Disorders– Experienced as two phases- highs (Mania) and lows (Depression). The severity of the highs and lows determines what kind of Bipolar Disorder is diagnosed and treated.
  • Postpartum Psychosis– Occurs in 1% of women. Symptoms include seeing images and/or hearing voices (hallucinations) that other’s can’t. There may also be periods of confusion, memory loss and mania. This is a severe and dangerous condition that needs immediate medical attention.

3) Support:

There are psychotherapists, psychiatrists and groups specifically designed to treat and support women through this time. If you or someone you know is struggling with postpartum depression or other postpartum mental health concerns, even if you are not sure, ask and assist them in getting support.

Robyn Alagona Cutler, MFT offers Individual, Couple & Group Therapy for new moms and their families (Lic # 45108).

**POSTPARTUM GROUP FOR MOMS now enrolling!**

Call 415-952-0290

www.wellsanfrancisco.com

 

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