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Psychology Today

Psychology magazine published every two months in the United States.

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Postpartum Depression isn't Just the "Baby Blues"

10/05/2018 06:00AM | 435 views

By Suzanne Degges-White Ph.D.

Most expectant parents are warned about the “baby blues,” which describes a relatively mild bout of depression that occurs in around 80 percent of new mothers. Some of the typical symptoms include irritability, insomnia, anxiety, unexpected tearfulness, and unpredictable mood swings. These usually show up around the fourth or fifth day after delivery and symptoms take a relatively quick course to resolution. (It may be interesting to note that mothers of daughters, have been found to be less likely to experience even this little dip in the road after childbirth – likely due to sex-related hormones. Unfortunately, a baby’s gender doesn’t offer any protection against development of full-on PPD.

 

Why Does PPD Happen?

There isn’t a solid explanation for why some new mothers go from the blues to full-blown postpartum depression (PPD). The American College of Obstetricians and Gynecologists has suggested that PPD is “likely to result from body, mind, and lifestyle factors combined.” The baby blues have been attributed to drops in estrogen production in the body, but postnatal depression might actually be located deep in the brain where affective processing was found to be compromised.

Researchers found that women with PPD don’t register emotional cues and emotional responses in the same ways that non-depressed mothers do. Their inability to notice their babies’ signals and messages likely accounts for their inability to build strong emotional bonds with their infants. About 15 to 29 percent of mothers experience PDD, and their children are affected by their mothers’ PPD, even if they carry no actual memory of their mother’s distress.

In their attempts to determine why hormonal changes have a stronger impact on some women and less on others, studies have found numerous psychosocial factors contribute to the development of PPD. Some new mothers feel isolated and over-burdened emotionally and physically caring for their newborn. Some new moms lack any real support – both emotionally and instrumentally. In some cases, women may be grieving their old identity prior to becoming a mother – this may be their professional identity or a feeling of possessing an independent identity apart from mother and caregiver. In this age of lookism, selfies, and Photoshopped images, many women may grieve the changes in their appearance and body along with a perceived loss of sexual attractiveness.

While childbirth and motherhood are indeed fulfilling experiences for many women, there is too little attention given to the losses that women may suffer during this transition. In fact, some researchers consider PPD to be a bereavement or grief process.

Objects in the Mirror Are Closer Than They Appear

Not surprisingly, the greater the discrepancy a new mom finds between her expectations and her new reality of life with an infant, the more likely she is to experience depression. Relationships between a mom and her partner can add to this discrepancy and a poor relationship between parents has been found to be one of the most consistent contributors to PPD. New mothers may be surprised and dismayed at the limited emotional and practical contributions of their partners.

New Parenthood May Be More Like an FX Drama Than a Hallmark Movie

Another aspect of this discrepancy is conflict between the idealized vision of motherhood and the harsh reality of 24/7 caring. Faced with this conflict, women may struggle internally yet be fearful of expressing their feelings aloud. New mothers are hesitant to express disappointment in their new roles and many around them may not encourage these feelings to be expressed.

It is helpful if a new mom is able to let go of unrealistic standards. By accepting and discussing her feelings with caring others (friends, family, professional helpers), she can begin to make sense of her confusing and conflicting feelings and receive the necessary validation for these that she needs. It is extremely important that her losses and their magnitude are recognized and validated prior to directing her focus to the potential joys and benefits of motherhood.

Depression Affects Both You, Your Son, or Your Daughter

While a daughter is naturally more emotionally aware and socially oriented than a son, a mother’s PPD will affect each gender differently. Research shows that daughters living with depressed mothers will show an increase in emotional sensitivity, perhaps reflecting an attempt to step into the caregiver role for their moms. Sons, however, seem to block the negative emotional displays by their mothers, which may reflect the male brain’s proclivity to avoid emotional conflicts. While all of the long-term effects a mother’s depression bears on her offspring are still unknown, research indicates that this can compromise cognitive development, including language development.

A depressed mom may show little response or interest in her child or, alternately, be hypervigilant. If an infant’s cries do not draw the attention or care of her mom, the child may retreat into a withdrawn state, as well. Newborns rely on their parents for social cues, emotional learning, and responsive interactions to grow into healthy, responsive adults. Fortunately, depression is definitely treatable at this stage in a new mother’s life. Unfortunately, as we noted in an earlier chapter, motherhood is promoted widely as a time of joy and fulfillment. New mothers who feel less than overjoyed and fail to meet cultural “new mom” stereotypes may feel too ashamed to ask for assistance. So, if you, a friend, or partner are feeling blues that just won’t fade and the infant is heading towards the one-month benchmark, it is important to contact a health professional to ensure that the baby receives the best mothering possible.

Other suggestions for new mothers suffering from PPD:

  • Seek professional help for marital difficulties that arise or are exacerbated by the new arrival
  • Find supportive people and reach out to them
  • Don’t isolate yourself even if it that is what you most feel like doing
  • Ask for help – both emotional support and instrumental support
  • Read books and find resources that provide an honest, balanced appraisal of the motherhood experience – it’s not all baby powder and giggles
  • Treat yourself as well as you can – eat right, get exercise, and steal sleep where you can
  • Seek professional help to increase the likelihood you will feel better sooner

Seek professional help immediately if:

  • You’re no longer able to function normally
  • You can’t cope with everyday situations or stress
  • You experience thoughts of harming yourself or your child
  • You feel anxious, scared, and panicked most of the day

Depression puts a wedge between a mother and her child, but effective treatment can remove that obstacle to a healthy relationship.

 

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