Thoughts on Postpartum Depression
Postpartum depression is a mood disorder that can affect women after childbirth.
Mothers who experience postpartum depression may have feelings of extreme sadness, anxiety, or exhaustion, and for up to 1 in 7 new moms, it may interfere with daily activities that include caring for themselves and others. It is critical that the general public be made aware of what these more severe cases look like, so women and their families can identify the warning signs and seek help quickly.
In my therapy office, most of my postpartum clients worry about accidental harm coming to their child in their care, by dropping them or unintentionally leaving them somewhere, for example. Many postpartum women have experienced thoughts like these, but most do not share them with others, as they feel embarrassed or dismiss them as a normal part of the adjustment period. Without a doubt, motherhood is an anxiety-producing state for most women, often triggering fiercely protective feelings combined with a sense of helplessness.
To distinguish normal parental anxiety from postpartum depression and anxiety symptoms, it is crucial that doctors and therapists ask careful, specific questions about the kinds of thoughts women are having about their baby.
I rarely have a client volunteer having scary thoughts without my asking her directly if she was experiencing them. We DO know that the key to assessment is determining the frequency and severity of the thoughts, and how the woman reacts to them. Most of the women I’ve treated are startled and disturbed by these images of their babies getting hurt or dying. The thoughts feel intrusive and out of character for these clients, as they want nothing more but to keep their babies safe. It generally helps these women to be reassured that these thoughts are uncomfortable but quite common, and do not mean that they don’t love their baby. But as the article indicates, and from well-publicized stories of mothers murdering their babies, thoughts can become beliefs and delusions that manifest into psychosis. This is when tragedy strikes. Families, friends, clinicians and medical professionals must be on the lookout for these horrifying cases. They are real and can happen to any woman who has given birth.
I also want to comment on the importance of sleep deprivation on postpartum families, which was not mentioned in this article. Sleep deprivation is often one of my first areas of focus during an assessment. We know that chronic sleep deprivation causes cognitive impairment, decreased memory and attention span, and decreased alertness, not to mention the long-term medical complications. When we don’t sleep enough, we are more likely to have exaggerated emotional responses, feel overwhelmed, process information more slowly and struggle with daily tasks. I have worked with clients who were so exhausted that they actually began to hallucinate. But these women were not psychotic and didn’t require psychotropic medication. The hallucinations immediately disappeared once these women were getting a solid 4-5 hours of sleep per night. And let’s not forget about fathers who are bleary-eyed, concerned about their partners and often stumbling through their own daily responsibilities! Many dads and even parents of adoptive children can exhibit symptoms of postpartum depression and anxiety, so we know the symptoms are not caused exclusively by the hormonal and physiological factors involved in pregnancy and childbirth. Therefore, we must acknowledge that postpartum illness is much more complex and far-reaching than previously believed.
The good news is that with ongoing mental health treatment, help with caregiving and increased social support, people do get better. The key is to seek help and support early on. My hope is that we will continue to see articles like this one circulating in the media. These discussions help to spread public awareness of an illness is that is still considered taboo in many social circles.