Join me as we explore the common Challenge of Post-Partum Depression, things to be on the look out for and interventions.
Welcome back to first breaths to first steps. This is Bev Garrison, your host. Today and welcome to 2022. I thought we would do a little bit of information and put it out there about postpartum depression. Not necessarily the happiest topic that we have, but definitely something that I think. Maybe it doesn’t necessarily get as much attention as we need it to get. So that moms and dads are informed.
Just a quick reminder and disclaimer that my podcast isn’t put out there to take the place of any sort of primary care medical advice it’s merely for informational purposes only. So let’s get started postpartum depression. I remember we have three boys and I talk a lot about my family, but I remember with my first child.
Thinking, gosh, I’m a couple of days in, and I’m not quite as happy as I think I should be. This baby’s crying. I’m exhausted. And being a person in medicine and having known that. It’s going to be sleepless nights and having that expectation. I think I was still kind of taken back that I had some baby blues. Maybe not necessarily postpartum depression, but. I was really surprised at this should be one of the most joyous situations and life experiences. And I really didn’t necessarily feel. As happy as I thought I would.
Typically having a baby is an exciting and joyful time, but it can also be a time of increased fear, stress, anxiety. You’ll read a lot out there. Some of the statistics are even up to one in eight women will experience postpartum depression within the first six months. And that number being higher in women, moms that have had previous history of depression. Or postpartum depression with a previous pregnancy.
It’s common for most women to experience kind of those baby blues. Like I was talking about 60 to 70% of women will report feeling sad. Tired. Occasionally overwhelmed in the first two to three days of giving birth. That lasts for maybe a couple of weeks, but when those feelings, intensify or prolonged, we may be looking at more of a postpartum depression type situations. There are some numbers out there about 30 to 35% of those with a history of depression, mood disorders, or anxiety are likely to develop that postpartum depression with pregnancy and delivery.
What is postpartum depression? You know, Defining wise, it’s usually described as a complex. Mix of emotional, physical, and behavioral changes. That’s experienced by some women shortly after delivery, it can be considered severe. Prolonged intense form of baby blues. Typically it’s something that’s lasting a little longer, not getting over it in the first couple of weeks.
It may be even effect up to millions of women a year. If blues don’t resolve or they become a little bit more severe, it’s definitely a classic picture of postpartum depression. But a lot of symptoms will vary from person to person. And so it may not look the same in everyone. But symptoms that women with postpartum depression may experience include lack of interest in your baby.
Shame guilt, the feeling of inadequacy. Excessive crying. Irritation anger. Panic attacks, little interest in socializing. Depressed mood feeling withdrawaled or definitely feelings of hopelessness. About 50% of women diagnosed with postpartum depression, usually experienced symptoms of depression prior to birth.
But not always. The American academy of pediatrics has outlined that more than 400,000 infants are born to depress mothers every year. So it’s a pretty. Large statistic, a pretty impactful situation.
Post partum depression, doesn’t discriminate with respects to race, culture, or class. Anyone who welcomes a child into their life may experience PPD.
Symptom intensity may vary from person to person, like I said, and you may have some risk factors that maybe set you up for that. It’s important to note that new dads can also be affected with postpartum depression. Dad’s present the same way that moms can present. Feeling sad, fatigued. Overwhelmed anxious.
Maybe even noting changes in eating or sleeping patterns. It’s stated that 4% of new fathers experienced depression within the first year of welcoming their babies. Half of the new fathers whose wives had postpartum depression may also experience depression within a year.
Why does postpartum depression occur? Well, there’s a lot of physical changes, especially surrounding that birth time. So right after birth, estrogen and progesterone. Drop in mom. Thyroid hormones may also be affected immediately after birth. Sleep, definitely rest deprivation or a set up for emotional difficulties and inability to successfully handle emotions. Sense of loss of identity. Now it’s not me. It’s we. Anxious about caring for your baby and definitely changes in body image, making you feel maybe less attractive or just not a hundred percent. As strong as you were prior to, and can kind of set you up for that. Risk factors for postpartum depression.
Any sort of previous history of mental health. Issues, including depression. Can set you up a person with a previous history of postpartum depression is 10 to 50% more likely to come down with depression in subsequent childbirths. A history of bipolar disease. Previous postpartum depression with prior pregnancies.
Family history of. Depression. So it kind of plays into that genetic piece as well as increased stress. Any babies with special needs, a weak support system for parents unplanned or unwanted pregnancies. Financial challenges and relationship problems tend to be things that we see in that history, when we’re talking back retrospectively to parents who have experienced that type of depression after delivery.
Both mom or dad, obviously it can have a negative impact on paternal relationships as well as new baby’s development. So it’s super important to. Make sure that we have information out there. And that we’re educating people.
How is postpartum depression diagnosed? Definitely by a provider it’s typically based on symptoms. Sometimes moms and dads wouldn’t notice.
But a lot of times outside perspective, spouse, family, friends, I may notice that things are kind of changing. Most OB GYN at six weeks will screen when they’re checking their patients back after delivery. And sometimes at least I know in the pediatric practice that I worked in. We screened moms, even though they weren’t our patients.
At that two week visit and typically with any initial weight checks immediately after discharge. Nurses were instructed to check in on how are you feeling? How are you doing? How are things. At home coping mechanisms, things like that. A lot of times providers, if they’re suspicious of any type of postpartum depression, we’ll also check labs.
Just to make sure that there aren’t any physiologic things. Or underlying things that could be playing a role in that type of depression, including thyroid hormones and the underlying disease or anemia.
Warning signs that we have with postpartum depression, a lot of times you think of really just the symptoms of being detached from the baby.
Increased stress being around the baby thoughts of harming yourself or others. And a basic inability to get through the day. I think that women are well aware that this is a possibility, but I think just as I was, they can be kind of taken back when it’s typically such a joyous occasion.
There’s not really a lot as far as preventing postpartum depression, nothing is foolproof, but definitely during pregnancy, you want to make sure that you’re talking with your PCP or OB GYN. Your providers should be performing depression screens for you. And definitely screening after baby is born.
When do you get help? Early intervention is always the best as with anything, right.
If postpartum depression. Was a previous part of your life. It’s a major risk for reoccurrence. So you want to make sure that you’re really in tune and have that on. The forefront. Around your delivery time. If Blue’s last greater than four to six weeks, and it’s changing your ability to act and interact with your baby, it’s definitely time to get some help and reach out to your support systems.
Consider. If you had a previous history of depression. Maybe following up sooner than that typical six week recheck with your OBG GYN, making sure that you’re talking about that in the prenatal time to kind of say, Hey, I have this history. I’d like to maybe meet with you at three weeks versus waiting all the way to six weeks.
Symptoms typically don’t fade. That’s a sign that you might need help. They’re escalating. Getting worse, it’s becoming difficult to kind of carry on and care for your baby. And you’re feeling overwhelmed.
Treatment for postpartum depression can take many forms. Mental health support and therapy, obviously, no matter what.
It may be enough if your symptoms are mild, just getting some support in that arena can definitely be helpful. Medications are out there and they do work. It’s a risk benefit ratio. We’re always like, oh, I just don’t want to take. Very much while I’m pregnant, but you’ve got to think about the risk of newborn development in utero versus the benefit of.
Not depressed mom during pregnancy and baby’s exposure to a depressed parent. After delivery. There’s lots of data on antidepressants in pregnant moms. Some data even suggests that there’s more information on antidepressants than even the use of antibiotics and pregnant moms. And so there’s some good safety profiles with few problems to the baby.
And their development, which is usually the number one concern for most people. Difficult to get information on treating versus effects of exposure to a depressed mother. Retrospectively that’s, hard to look back at that. But, we also noticed that when moms are depressed,
We see increased use of tobacco alcohol non-prescription medications as well. So, It’s something really to talk with your provider about and come up with this custom plan. Or approach to say, Hey. If I’m starting to feel these things, I would like to try this first. I would like to. Explore this I would like to get into therapy. And then maybe also consider using medication.
So what’s the plan. The first and foremost, the plan with postpartum depression, assess safety, make sure that there’s no risk for mom or dad. And others, including baby or other children that might be at home. Second. I always say, look at lifestyle changes. There are some things that you can do that don’t involve medication, identifying stress, how you’re going to work to relieve that.
I talk a lot about developing a postpartum plan. We talk a lot about developing a birth plan, which is super important, but I think really there might be just as much importance in a postpartum plan. Having that time to think about, okay, what are we going to do? Who can help us during the day? If we need to get rest, who can help us at night? Is there anyone that can stay for a bit of time overnight to help us out? Identifying, and maybe coming up with some game plans and things that you can try beforehand.
Is super helpful. Sleep hygiene. Thinking about how to make sleep. Quality better, which you’re like, right. Bev. I have a baby, how am I going to sleep better? But really looking at who can maybe help you. I always remember working in clinical practice. I would prescribe. New parents. You need to get one nap a day when your baby’s napping you nap, it will make nighttime look so much better.
Evaluating home situation, getting coaching for current and or upcoming changes. That you’re anticipating. Third thing is looking into mental health services. What counselors, what therapists do you have at your fingertips that you can use? Counseling behavioral changes to deescalate. Feelings of stress, feelings of anxiety, journaling.
Continuing with physical activity, kind of making a plan as to. How do I stay active after having my baby? A lot of times that activity can really help with your. Mental awareness and your ability. To process. Work on roll, transitioning from. An individual, a professional to parent, and really talking that out with your birth partner, your spouse, to identify what’s the best thing and being proactive.
And lastly, looking at medications, if all the above tactics, lifestyle changes. Mental health , assessing safety, if none of the tactics that you have in place for that are working. It’s a good time to consider medication. If you’ve had a previous history of postpartum depression, like I said before,
It’s a good idea to think about medication and seeing whether or not that’s something that you need to do ahead of time. If your past medical history is positive for previous. Postpartum depression with previous pregnancies. Early intervention. As I mentioned before, is the best. Data’s showing. When those with previous history had time to think about medication and treatment modalities, that those moms felt so much better and were compliant with therapy and medication.
Moms that didn’t have time to plan for treating postpartum depression. We’re more conflicted and less compliant. And not likely to follow their treatment plan. Consider severity of disease prior, if you had a pretty rough go. With postpartum depression and a previous pregnancy, you definitely want to make sure that.
You are. Either considering staying on medication. And have a therapy plan in place. And knowing that that’s a possibility, I think just bringing that thought to the forefront. Is the way to go.
What about those who only have postpartum depression at no previous history of mental health disease? There’s not a lot of data in this realm, but you want to monitor closely. Quickly after delivering monitor, but at the end of the day, Early intervention is the best.
So in summary, remember that. Postpartum depression is common. One out of eight women, 4% of new dads may experience that sort of feeling.
And it’s treatable. It’s not that you don’t have any options. Feelings of postpartum depression are more intense. They tend to last longer than those of just baby blues. A term used to describe. The worry, sadness and fatigue, many women experience after having a baby. And most people get better with treatment. So it’s good to remember who are your support systems? Talk with your healthcare providers beforehand. Talk with your health coaches beforehand, just to get you in the best possible place.
Hopefully you found the information in this podcast helpful on postpartum depression. If you have further questions or concerns, or would like to work with me? Coaching you and your new family from first breaths to first steps. Reach out to me @ bevgarrison.com until next time, be well.