It’s normal to have the ‘baby blues.’ After giving birth, hormones, fatigue and stress can contribute to some temporary tears. But it’s not normal to feel so depressed for so long after giving birth that it affects the care you’re able to give your baby.
Postpartum depression (PPD) affects about 13 percent of new mothers and occurs when a woman meets the criteria for a major depressive episode within four weeks of delivery. Five or more depressive symptoms must be present for at least two weeks and represent a change from previous functioning. Women who have been diagnosed with PPD once are at higher risk for the disorder following subsequent pregnancies.
Other risk factors include low socioeconomic status, poor social support, a stressful, high-risk pregnancy, family history of depression and domestic violence, says Dr. Raul Artal, professor and chairman of obstetrics, gynecology and women’s health at Saint Louis University and a SLUCare obstetrician/gynecologist on staff at SSM St. Mary’s Health Center. He adds that the American College of Obstetricians and Gynecologists recommends women be screened for depression at least once per trimester during pregnancy.
“The gatekeepers for this issue are the ob/gyns that these patients will see six weeks after they deliver, so unless somebody’s going to a psychotherapist through the pregnancy, typically we will get a referral from the ob/gyn that says that they suspect perhaps this patient is dealing with some postpartum issues,” says Dr. Erin Shannon-McGowan, a clinical psychologist specializing in holistic psychotherapy.
The only problem with this approach is that many women experience the onset of PPD within three weeks of childbirth, so by six weeks postpartum, the depressive episode already has lasted well beyond the two-week diagnostic period. “There’s an awful lot of research that’s been done on how that affects the baby,” Shannon-McGowan says. “You have the first six weeks of this mother-child dyad that’s very dysfunctional. During the first six weeks of a baby’s life, many, many things are going on neurologically, and the interesting thing is that a baby must have eye contact with the mother at a 12- to 15-inch distance, which is optimal. Baby needs to gaze into mommy’s eyes, and mommy needs to gaze back. If that doesn’t happen, new areas of the brain don’t get lined up. It’s a critical period, and if you miss it, you’re out of luck.” For this reason, seeking help as soon as possible is crucial.
Easing PPD may involve medication, but also requires the support needed to ensure the new mother is eating a healthy diet, getting enough rest and performing routine daily functions, such as showering and dressing or taking a walk. Talking with a counselor or therapist and seeking support groups composed of other new parents also is helpful. “If you attack it in more of a holistic framework, you’re going to address many areas and you’re going to get relief much more rapidly,” Shannon-McGowan says.
Most important, women who experience postpartum depression must remember that “you haven’t done anything wrong,” Artal says. “You should seek help.” LN