What can we do about postpartum depression?

Getting depressed after your baby arrives isn’t a rare malady. If you’re a new mother suffering from this condition, you’re hardly alone.

According to Dr. Byron Calhoun, vice-chair of the Obstetrics and Gynecology Department at West Virginia University, up to 80 per cent of new moms experience the temporary emotional slump of "postpartum blues." A smaller but significant number – 10 to 40 per cent – fall victim to clinical postpartum depression.

Postpartum psychosis – which sometimes involves behaviours such as hallucinations and delusions – is much less common, occurring after about one in 1,000 deliveries.¹ But it has the potential for extremely serious consequences.

Recognize the signs

The first thing to do about postpartum depression is to recognize its signs.

• Feelings of sadness, unhappiness or overwhelming despair just when a mother is "supposed to feel" happy and fulfilled.
• Difficulty sleeping, even when the baby is asleep.
• Loss of appetite or wanting to eat much more than normal, which can lead to significant changes in weight that aren’t consistent with pregnancy or birth.
• Fits of crying, seemingly "for no reason."
• Trouble concentrating, with a very short attention span.
• Turning from being even-tempered and easygoing to irritable, chronically angry or anxious every day.

When the more severe postpartum depression is present, thoughts of suicide or the impulse to harm the baby aren’t uncommon. These feelings need to be taken very seriously and reported to a healthcare provider immediately – if not by the mother, then by her husband or other relatives or friends.

Take immediate action

After recognizing the symptoms, it’s time to take immediate and aggressive steps to find professional help. Yet one report indicated that when women with postpartum depression knew "something wasn’t right," only about 20 per cent actually sought appropriate medical and psychological assistance.²

Why do so many new mothers avoid seeking the help they need?

Shame and fear 

One reason is a sense of shame. Karen, a new mom, feels like she’s going completely crazy. Her thoughts are irrational, even bizarre, and she knows it. Yet she feels the pressure of cultural expectations; they’re particularly strong because she’s a Christian. She’s expected to feel happy, not sad and depressed, at this special time in her life. Unfortunately, she feels quite the opposite – and guilty that she does.

Fearing exposure, she hides her terrifying emotions – even from her husband, friends and relatives. She doesn’t feel comfortable telling her doctor about this ordeal. She tells herself that if she can just tough it out, the disturbing thoughts and feelings will soon go away.

Women like Karen tend to blame themselves, assuming their feelings indicate weakness or that they’re "bad mothers." Yet such self-blame wouldn’t be present if the mood swings were associated with other causes such as a thyroid imbalance.

What to do

You don’t have to suffer postpartum depression in silence. You can take action, even before it strikes.

Plan ahead. Being prepared before the birth of your baby can really make a difference. Be aware that a wife is at greater risk if she has a history of even minor postpartum depression, if she’s facing stressors like marital problems or the recent loss of a loved one, or if she has bipolar disorder or a family history of depression.

Early in the pregnancy, discuss these factors with your physician and with a professional mental health therapist. They can help you plan appropriate preventative care.

If you’re the wife, don’t hide. If you had no reason to expect problems when your baby arrived, you may find yourself blindsided by overwhelming "crazy feelings." Enormous guilt and shame may have come seemingly out of nowhere; you may feel you’ve been run over by a Mack truck.

Don’t try to hide these emotions. Talk about them. Consult your doctor; if indicated, seek a psychiatrist who can prescribe the best medication to address the biochemical imbalances that lie behind the reactions you’re experiencing.

Find a Christian counsellor who can help you put your feelings into perspective, and who may be able to assist you in finding a good support group. You may want to talk to your pastor, too.

Be honest with your husband about what you’re going through. Let friends and relatives know that they can help by giving you some breaks from the constant demands of your infant.

If you’re the husband, be proactive. Men can play a pivotal role in helping – or hindering – their wives’ battles with postpartum depression.

While your wife is still pregnant, review the signs of postpartum depression. After the baby arrives, you’ll be more sensitive to subtle indicators that your wife may be hiding a strong undercurrent of feelings. If she begins to display some of the more severe symptoms, but won’t address them, you need to intervene. Ask, or even insist, that she see her physician or a counsellor with you. You can also help arrange for support from others, especially in giving her respite from baby care.

Even though you may sometimes feel overwhelmed yourself, it’s important that you not run away from your wife’s struggle. She needs your sensitive, patient support.

Nurture yourself and your relationship. If you’re the new mother, don’t expect your husband to provide for all your needs. Your depression is undoubtedly creating considerable stress for him and for your other children if you have any.

Take care of yourself; you’re worth it. You’ll need some personal "down time" to do that, and some "date nights" with your husband.

Postpartum depression isn’t unusual, but it’s a serious matter. Don’t hesitate to ask for help from both loved ones and professionals. Those who seek treatment when symptoms appear usually have a very favourable outcome – and spare themselves and their families untold stress and damage.

¹ Dr. Paul C. Reisser et al, Complete Book of Baby and Child Care (Wheaton, IL: Tyndale House Publishers/Focus on the Family, 1997), p. 109.

² News release, “Postpartum Mood Disorders Can Cause Death and Ruin Lives” (National Depressive and Manic-Depressive Association, May 6, 2002), p. 1.