According to a 2013 study published in JAMA Psychiatry, one out of seven mothers suffers from postpartum depression (PPD). That’s 14 percent of all new moms. Katherine Stone, founder of Postpartum Progress, makes a good point that more women will suffer from postpartum depression and related illnesses this year than the combined number of new cases for men and women of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease and epilepsy. Even though, according to Dr. Ruta Nonacs of Massachusetts General Hospital and Harvard Medical School, PPD is the most common complication associated with pregnancy and childbirth, few women are screened. It certainly took me by surprise after the birth of my daughter, which is why I like to bring awareness to it whenever possible.
Here are some typical symptoms of PPD to watch out for in yourself, a daughter, or a friend, followed by a few strategies for recovery.
Symptoms of Postpartum Depression
Symptom 1: A Deepening Blue
In her book A Deeper Shade of Blue, Dr. Nonacs explains that the symptoms of depression are usually mild at first — your typical blues — but they worsen over time. The significant shifts in hormones that occur in the days and weeks after delivery are bound to trigger some moodiness, she explains. These blues are to be expected and are generally benign. “Depression is different,” she writes. “With depression, the negative emotions you experience are more intense, more pervasive, and more persistent.”
Although she says that some women have a sudden onset of depressive symptoms right after delivery, typically PPD develops gradually over the first two to three months after the baby is born.
Symptom 2: Disconnection and Apathy
Not only is a depressed mom incapable of bonding with her newborn, she struggles with all kinds of emotional attachment. This is evident in her speech and in her interactions with friends, family, and co-workers. She is disconnected from all persons and activities that once gave her joy and experiences a kind of apathy that keeps her isolated from her world.
Symptom 3: Guilt
The depressed mom feels immense guilt for not enjoying early motherhood and for not being able to bond with her baby. She feels as though she is a failure at this role and isn’t equipped to raise a child. She wants to experience the mommy bliss that other mothers do, and beats herself up for her negative attitudes toward motherhood.
Symptom 4: Inability to Concentrate
A mom experiencing PPD can’t focus, make a decision, or articulate thoughts. She operates in a fog, as she feels completely overwhelmed. Simple tasks like feeding her baby create stress as her cognitive capacity is diminished.
Symptom 5: Insomnia
A woman with PPD has trouble sleeping, even when her baby is sleeping. The irregular sleeping pattern of her baby matched with her own depression and anxiety prevent her from nodding off, which, in turn, contributes to her insomnia and diminished mental state.
Symptom 6: Irritability
A depressed mom is often irritable and angry, lashing out at husbands, family members, and friends for no reason at all. She may be annoyed by everything and is incapable of patience. Some depressed moms feel resentment toward their babies.
Recovering from Postpartum Depression
Postpartum depression is very treatable, which means you or your wife or your daughter will be back to herself in no time. Each person recovers at her own rate, so try not to compare with other women. Here are a few strategies that helped me as a new mom.
Recovery Strategy 1: Get Real
I remember walking over the bridge of Spa Creek, a few blocks from my home, when I was nine months pregnant one hot June afternoon. A woman looked at my protruded stomach and said to me, “You have the easier job now, when the baby is inside.” I cursed that woman for weeks until I had my overdue baby, and realized she was right. Few people warn us that our lives are going to be turned upside down by the seven pounds we bring home from the hospital. Everything (EVERYTHING) has to shift to make space for this new being.
As new mothers, I think we help our mental health by getting real and saying, “Wow, part of this motherhood gig is really hard… I miss my old life.” We’ve entered a completely new world and are transitioning through a significant culture shock. Sometimes it’s good to acknowledge our difficulty adjusting to all of it.
Recovery Strategy 2: Start Talking
Journalist Tracy Thompson begins her insightful book The Ghost in the House with two brilliant lines: “Motherhood and depression are two countries with a long common border. The terrain is chilly and inhospitable, and when mothers speak of it at all, it is usually in guarded terms, or in euphemisms.” That’s why we need to start talking… often, and for long periods of time, maybe through tears.
One of the most therapeutic things I did during the baby years was form a playgroup at my house with other new moms. I said it was to socialize my kid, but the real motive behind the group was to vent to other mothers about how I had memorized all the lines to Finding Nemo because it was the only thing that would calm my son down at two in the morning when he couldn’t sleep.
Recovery Strategy 3: Beg for Help
“One of the most challenging aspects of caring for young children is the social isolation,” Dr. Nonacs writes. “In traditional cultures, a woman’s family gathers around the mother after the birth of a child. They help her learn how to care for her child … Nowadays most women with young children spend most of their time at home, alone.”
I wasn’t very good at asking for help, and I paid for it. I ended up in an inpatient psychiatric unit. If I had to do it all over again, I would plead with relatives to help out. I would barter with them, negotiate, promise to name the next kid after them if they babysat for a night. I would have cashed out some of our savings to get relief. In retrospect, it would have cost far less than the hospital fees.
Recovery Strategy 4: Sleep
Brain experts have always made the connection between and insomnia and depression, but new research suggests that chronic sleep disturbances may precede and maintain depression. “When you are sleep deprived,” writes Dr. Nonacs, “everything is more difficult. It is harder to concentrate, and performing certain tasks or making even the simplest of decisions may seem totally overwhelming. You may also feel more anxious, more irritable, or overly emotional.”
Recovery Strategy 5: Keep Some of Your Self
It’s easy for women to lose their identities in their new role as mothers — letting parental responsibilities absorb every aspect of their being. But motherhood doesn’t have to erase your prior existence, including hobbies, friendships, and work projects you once enjoyed. In fact, hanging on to a bit of your old self can make you a better mom, less resentful of the Winnie the Pooh keychain that won’t turn off. Squeezing space in your schedule for some activity not related to your baby can help build emotional resilience.
Recovery Strategy 6: Watch Your Shoulds
New moms are great at “shoulding” themselves. “I should be a more attentive mom.” “I should have Johnny on a nap schedule.” “I should love watching the Disney channel for three hours a day.” Erika Krull, a mental-health counselor, writes in her Psych Central blog: “It’s the combination of ‘must, can’t, won’t, should, could’ kinds of thoughts with the high level of emotion that can send moms down into the pit of depression or anxiety. Black and white thinking is a setup for disappointment, despair, lack of satisfaction and meaning, and low self worth.”