A new addition to the family brings with it lots of changes. New parents experience a myriad of emotions in the first weeks of their new infant’s life. While a birth is anticipated over a long period and every couple expects it to be a joyful and uplifting experience, it also can create some changes that are unanticipated. New parents expect to be sleep deprived and to have some challenges with breastfeeding, schedules, and trying to figure out what their baby needs. However, unanticipated emotional responses may also come up for new parents. Depression is the often unanticipated response that can happen due to the birth of a child. The expectation of almost all parents is to have a happy blissful feeling about a birth. Although this may be the case for a majority of families, a sizeable minority of new moms have a different response. Peripartum depression (PPD) is the term that is used to include depression in pregnancy and postpartum (after the birth) depression. 18.4% of women experience depression during pregnancy and 19.2% experience depression after giving birth (Dtsch Arztebl Int. 2012 Jun;109(24):419-24.).
Many new moms may feel weird or different because of their responses or feelings about pregnancy and/or after the birth. They may not realize how common PPD is for parents of newborns, and thus, feel alienated and hesitant to speak up about it. This reluctance to outreach to others can intensify the new mother’s depressive symptoms, negative self-talk, and sense of isolation. New dads may struggle to understand why the mother is feeling down. They may genuinely want to help and support her to get past the depression, but add pressure by saying things like, “Snap out of it. It’s not that hard.” These responses can unintentionally further increase the new mom’s sense of isolation and alienation. So the question becomes, what can we do to support new mothers and to identify PPD earlier?
Symptoms and Risk Factors:
• feeling restless
• trouble sleeping
• extreme exhaustion (can be emotional and/or physical)
• changes in appetite
• difficulty focusing
• increased anxiety and/or worry
• disconnected feeling from baby and/or fetus
• losing interest in formerly pleasurable activities
In postpartum psychosis, which occurs less frequently, new moms may experience fear that the baby could be accidentally harmed and/or feel urges to harm the baby. If we notice irritability and mood shifts early, a mom can get the support she needs and we can circumvent the roller coaster she would otherwise experience. Mothers who have a history of anxiety and/or depression, history of depression within the family, experience social isolation (e.g., minimal support network) and/or a difficult birth are more at risk for having PPD. Women who have these risk factors do not always get PPD and some get it without any of these risk factors, so they are used more as a guide to identify who would more likely be at risk. If a woman has these factors present in her history, then it is helpful for family members and the woman to know more about the signs of PPD, as responding promptly, can help arrest the course of depression.
What can family, partner and friends do to support new moms who are experiencing PPD?
Family members can encourage new moms to get support and to make their medical providers aware of symptoms. It is crucial to get support in place, as the recovery from PPD is much smoother with support and intervention. Self-care such as physical activity, communication, sunshine, rest, and getting outdoors can help with the depressive symptoms and decrease a mom’s sense of isolation. It can also help to break the cycle of negative self-talk. A local support group can be a good place for new moms to be with others having a similar experience and understand what she is going through. Lastly, once a mother understands her own experience, she can help educate and identify others who may experience PPD in her family and/or community. Moms supporting other moms can go a long way in breaking the silence and stigma around this common phenomenon.
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Regina Faridnia, LCSW has been licensed since 1999 in Louisiana and since 2010 in California. She obtained her Master of Social Work in 1997 from the University of Washington. Regina works with all ages and specializes in maternal mental health, substance abuse, Native American issues, Middle Eastern families, anxiety, depression, and stress. Regina integrates modalities such as EMDR (eye movement desensitization and reprocessing), CBT (cognitive behavioral therapy), and mind body medicine to help alleviate stress, trauma, anxiety and depression. She also works part time in an obstetrics/gynecology clinic at a local hospital as a Psychiatric Social Worker. Regina’s qualitative research regarding cultural diversity was published in What’s News (University of Washington School of Social Work Newsletter) in 1997, and she has been a speaker at the University of California Santa Cruz American Indian Resource Center regarding the Indian Child Welfare Act in 2013.