Mama and Baby Blog Series : Maternal and Postpartum Depression

Mama and Baby Blog Series : Maternal and Postpartum Depression

Mama and Baby Blog Series: Postpartum Depression

May is National Maternal Depression Awareness Month, so it feels like a natural fit to include it in my Mama and Baby Blog Series :).

If you’re just joining in, I’m hoping to help Mamas navigate the world of motherhood. It can be an overwhelming journey, so we’re going to cover everything from birth recovery to first foods for babe. Catch up on Part One of this Series, Recovery from Birth.

Don’t forget – if there is anything that you’d like to see in this series – burning questions that you may have, experiences that you’ve learned from, whatever it may be – please leave a comment and I’ll be sure to address it!

Before we dive deep into the world of Maternal Depression, something to note – Maternal Depression and Postpartum Depression are commonly used interchangeably, when, in fact, postpartum depression is just ONE type of maternal depression – the most common.

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Please know that if you are struggling with any form of maternal depression, you are not alone. It is more common than people realize. In fact …

According to the Centers for Disease Control, 11-20% of women who give birth each year have postpartum depression symptoms. If you settled on an average of 15% of four million live births in the US annually, this would mean approximately 600,000 women get PPD each year in the United States alone.

There’s something missing from the CDC’s statistics though – it only counts live births. Women who miscarry or whose babies are stillborn are also susceptible to postpartum depression. Therefore, if you consider that 15% of the 6 million women who have clinically recognized pregnancies annually will get PPD, that’s 900,000 women each year … just in the USA alone!

In fact, more women will suffer from postpartum depression and related illnesses in a year than the combined number of new cases for men and women of tuberculosis, leukemia, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, lupus, and epilepsy.

Here’s the sad part of the whole equation: only 15% of women with postpartum depression ever receive professional treatment. This means about 850,000 women each year are not getting the help they need. Part of the reason for lack of treatment is the fact that many physicians, including obstetricians and pediatricians, do not screen. Another part of the reason is the stigma that exists that either prevents mothers for asking for help or in following through on treatments like therapy or psychiatric medication.

Yet it’s not just 850,000 women we should be worried about. It’s hundreds of thousands of children who are in harm’s way. We know postpartum depression affects children’s development and puts them at a higher risk of future psychiatric illness. In fact, infants exposed to a mama with postpartum depression during infancy has a bigger impact on a child’s development than later exposure to postpartum mental illness, such as after a sibling is born.

With those statistics in mind, let’s look at what Maternal Depression looks like.

Four types of maternal depression

Traditionally, there are four recognized types of maternal depression:

  • prenatal depression
  • “baby blues”
  • postpartum depression
  • postpartum psychosis

Although all types have similar symptoms, the prevalence rates, some symptoms and time frame of the depressions differ. Statistically speaking, the prevalence rates of each are are follows:

  • prenatal depression: 10-20% of pregnant women
  • “baby blues”: as high as 80% of new mamas
  • postpartum depression: 11-20% of new mamas
  • postpartum psychosis: 1-2 per 1,000 new mamas

Symptoms of maternal depression

While many of the symptoms are the same across the four types of depression, a woman with postpartum depression experiences these symptoms much more strongly and can be impaired to the point where she is unable to do the things she needs to do every day. Unlike the baby blues, which begin shortly after delivery, and resolve within a couple of weeks, postpartum depression can begin at any time within the first year after giving birth and lasts longer than the blues.

Prenatal depression includes symptoms such as:

  • crying or weepiness
  • sleep problems (not due to frequent urination)
  • fatigue
  • appetite disturbance
  • loss of enjoyment of activities
  • anxiety
  • poor fetal attachment
  • irritability

“Baby blues” symptoms usually resolve by two weeks post delivery, and includes symptoms such as:

  • feeling overwhelmed
  • irritability
  • frustration
  • anxiety
  • mood lability (ups and downs – mom is elated one minute, and crying the next)
  • feeling weepy and crying
  • exhaustion
  • trouble falling or staying asleep

If the following symptoms persist for more than 14 days post-delivery, it is considered postpartum depression:

  • frequent episodes of crying or weepiness
  • persistent sadness and flat affect (mom won’t smile)
  • fatigue
  • feelings of inadequacy or guilt
  • sleep disturbances (not due to baby’s night awakenings)
  • appetite disturbances
  • irritability
  • mood instability
  • overly intense worries about the baby
  • difficulty concentrating or making decisions
  • lack of interest in the baby, family or activities
  • anxiety may manifest as bizarre thoughts and fears, such as obsessional thoughts of harm to the infant
  • poor bonding with baby, no attachment
  • feeling overwhelmed
  • thoughts of death or suicide
  • may also present with somatic symptoms: headaches, chest pains, heart palpitations, numbness, and hyperventilation

If a new mama exhibits any of the following symptoms of postpartum psychosis, it is considered a medical emergency and psychiatric hospitalization may be necessary:

  • auditory hallucinations and delusions (often about the baby, and often of a religious nature)
  • visual hallucinations (often in the form of seeing or feeling a presence or darkness)
  • insomnia
  • feeling agitated and angry
  • anxiety
  • paranoia (a paranoid delusional system may inhibit her from sharing her delusion)
  • delirium (waxing and waning symptomatology: appears normal one moment and is floridly psychotic the next)
  • confusion
  • mania (hyperactivity, elated mood, restlessness)
  • suicidal or homicidal thoughts
  • bizarre delusions and commands to harm the infant (not just an obsessional thought)

Causes of Maternal Depression

While there is no single cause of postpartum depression, there are some physical and emotional issues that may play a role.

Physical changes: After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply – which can leave you feeling tired, sluggish and depressed.

Emotional issues: When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.

In addition to the physical and emotional issues that may play a role in maternal depression, there are a number of factors that have been suggested to increase the risk of developing maternal depression. Postpartum depression can develop after the birth of any child, not just the first. The risk increases if:

  • you have a history of depression, either during pregnancy or at other times
  • you have bipolar disorder
  • you had postpartum depression after a previous pregnancy
  • you have family members who’ve had depression or other mood stability problems
  • you’ve experienced stressful events during the past year, such as pregnancy complications, illness or job loss
  • your baby has health problems or other special needs
  • you have difficulty breastfeeding
  • you’re having problems in your relationship with your spouse or significant other
  • you have a weak support system
  • you have financial problems
  • the pregnancy was unplanned or unwanted

What to do if you think you have maternal depression

Ask for help! I know, it’s easier said than done, especially given the stigma surrounding mental health issues. But consider this: the best way to take care of your new baby is to take care of yourself. I encourage you to seek mental health services from your primary doctor, midwife, or a therapist if you feel like you might have any form of maternal depression. While the natural remedies below may be effective, they do not replace the essential evaluation, assessment, and follow-up of a care provider. A healthcare provider will be able to evaluate your symptoms and help you create a comprehensive prevention or treatment plan. They also provide an important safeguard against worsening symptoms and a spiraling inability for self-treatment.

These natural remedies for maternal depression should be integrated with whatever treatment plan your healthcare provider suggests.

Natural Remedies for maternal depression

Natural remedies may serve as prevention when used as soon as postpartum depression symptoms first appear and may be an important aspect of maintaining your mental health once initial healing is achieved.

Food is medicine
When you’ve hit the postpartum period, it’s easy to turn to processed, quick to make foods. Combine exhaustion and depression, with a needy baby and you may find it very challenging to prepare meals. Nutrients make a huge difference in your body’s ability to regulate hormones. During times of stress, change, and healing, your body uses excess nutrients. You need these vital components to balance your hormones and support the neurotransmitters in your brain.

Eating as many nutrient-dense foods as possible helps postpartum recovery. The more variety of nutrient-dense foods you can eat in your diet, the better chance you have of not having any deficiencies which could contribute to maternal depression. Make sure you’re eating lots of healthy fats which help to nourish your brain health. This includes avocados, coconut oil, grass-fed butter/ghee, olive oil, wild caught fish & seafood, egg yolks, and raw nuts & seeds.

Another important tip is to up your protein. Eating small amounts of protein throughout the day helps keep blood sugar levels even, and therefore stabilizes mood. Eating grass-fed meat, free range organic poultry, and wild caught fish and seafood, along with slow burning carbs such as sweet potatoes, squashes, lentils, and non-gluten whole grains has also been shown to boost production of serotonin, which is a neurotransmitter in the brain that has a calming effect. A lot of people choose to meal prep before having the baby knowing that the demands of a newborn limit quality cooking in the kitchen. Preparing healthy freezer meals ahead of time is a great way to prepare for times when you are short on energy or time to cook.

Another reminder is to try and limit your caffeine intake. Consuming too much caffeine has been shown to suppress serotonin levels. While it may give you the pep you need in the morning, continuing to drink caffeinated beverages all day can leave you jittery, anxious, and unable to sleep. If you’re breastfeeding it is recommended to have no more than 300 mg of caffeine a day anyway.

Get as much sleep as you can
It’s no surprise that lack of sleep has been linked to depression. And while sleeping may seem like an impossible feat with a newborn, it’s a well known fact that when you go without quality sleep, your ability to function and mood are directly affected. There is truth in the statement, “sleep when the baby sleeps”. A quick little nap or even closing your eyes to rest for twenty minutes here and there is important when keeping up with the demands of a newborn.

Get outside for exercise and Vitamin D
Exercise is truly one of the best ways to treat maternal depression naturally. And, bonus points if you do it outside so you can get in some Vitamin D! Just 15 minutes of sunlight exposure three times a week minimum without sunscreen, will help maintain the much needed Vitamin D requirements.

As a general rule, I recommend that mamas do not return to postnatal exercise until their bleeding has stopped. If a woman gave birth via cesarean section, she needs to wait 6 weeks before getting back into the swing of things. If you push yourself too hard in the beginning, you can actually be setting yourself back from real recovery. That of course does not mean you need to be held hostage in your house for 6 weeks. Get outside with your baby for a long walk every day can be considered a great start to your road back! If possible, aim for at least 90 minutes of outside exercise per week.

Placenta Encapsulation
I talked about this a bit in Part One of this Mama and Baby Series, and I am a huge proponent of getting it done. The placenta is a fascinating organ that surrounds the fetus in the womb and allows for the exchange of nutrients, blood and waste with the mother. Eating ones placenta has actually been around for centuries and was often practiced in Chinese medicine. While no studies have conclusively proven the benefits of consuming one’s placenta, many mothers state that it speeds up recovery by reducing postpartum bleeding, boosting energy and elevating mood, and therefore relieving postpartum blues.

Take a deep breath
Studies have shown that breathing and mindful techniques have positive and profound affects on your body and mind. Try to begin for a minimum of 5 minutes a day of quiet, uninterrupted time for yourself to focus on enhancing your inner calm and to practice your deep breathing. If you can make it 20 minutes depending upon the demands of the day, then do it! By going into that quiet and calm place through mediation or deep breathing, it will allow you to reconnect with yourself. Meditation often allows people to target the negative thoughts that are plaguing them and begin to let them go. When deep breathing is practiced regularly, people benefit from the ability to quickly go back into that calm state when stressful situations arise.

Consider massage a necessity
Massage is well known for relaxation, stress reduction, pain relief and other health benefits. Unique postpartum benefits include hormone regulation, reduced swelling, better sleep and improved breastfeeding. A recent study has shown that postpartum mamas who received two massages a week for five weeks had significantly decreased stress and anxiety levels.

Massage greatly improves postpartum hormone balance. Estrogen and progesterone hormone levels are very high during pregnancy and decrease after delivery. Studies indicate that massage reduces the stress hormone cortisol which, as we know, wreaks havoc on both the mind and body.

10 Tips to help manage maternal depression

Set realistic expectations. Don’t pressure yourself to do everything. Scale back your expectations for the perfect household. Do what you can and leave the rest.

Stick to a routine. It can be a daily routine or a weekly routine. Even seasonal “routines,” activities or rituals done at particular times around the year, strengthen our sense of rhythmicity and resilience.

Make time for yourself. If you feel like the world is coming down around you, take some time for yourself. Take time with your appearance, grooming, self care. Caring for your body can help you feel better.

Avoid isolation. Talk with your partner, family and friends about how you’re feeling. Ask other mothers about their experiences. Breaking the isolation may help you feel human again.

Spend time with other adults. Talk with supportive and understanding people. Perspective, normalization, and community are essential for the new parent.

Keep a journal. Express your thoughts and feelings by writing them out.

Nurture yourself. What feeds your soul or makes your feel wonderful? Do these things, go to these places.

Laugh regularly and laugh hard. I’m talking full-belly, can hardly breathe, you’ve never laughed so hard in your life kind of laughing. Visit with people who make you laugh, read your favorite humorous web sites, or watch a TV show that always provides a chuckle.

Ask for help. Try to open up to the people close to you and let them know you need help. If someone offers to babysit so you can take a break, take them up on it.

Find a local support group. Birth doulas, midwives, and childbirth educators should be able to help you find a maternal depression support group in your area.

In a Nutshell

1. It’s estimated that between 11-20% of women who give birth each year have maternal depression symptoms, so you aren’t alone!
2. With a combination of natural remedies and potentially help from a health care provider, you can move past maternal depression.
3. Asking for help is the first step! There are plenty of local resources available to new Mamas. If you are looking for support in the Boulder area, please reach out and I’ll provide you with contact details for local practitioners and groups.

Let’s Talk!

I’d love to use this space as a forum of sorts, providing inspiration and community among my readers, so … I want to hear from you!

Did you suffer from maternal depression as a new mama? If yes, what helped you get through it?

Do you have any tips and tricks to share with new Mamas that helped in your postnatal mental recovery?

Spread some Maternal Depression lovin’! Sharing is caring, and I bet you have some friends who would love to read this too :).

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