Pregnancy and motherhood bring images of idyllic, glowing, bonding mother-baby moments, beginning with a sweet hand on a ripe, full belly and culminating in close ups of those sweet little fingers and toes being kissed and coddled. We picture bright-eyed, cooing babies and long touching conversations with fellow moms, and a general outpouring of community support and rejoicing at the miracle of birth and the joy of motherhood. The general expectation out there is that mothers should know how to negotiate multiple challenges and tasks with poise, grace, and selfless dedication to their dear swaddled newborn.
When the reality of a difficult or traumatic birth, delayed healing, sleepless nights, a screaming baby, and the biological slap of hormonal changes all occur, it is no wonder that 50-80% of mothers experience so called “baby blues” in the first two weeks postpartum. During those initial two weeks, it is more common than not that the new mom will experience vacillating periods of anger, sadness, restlessness, mood swings, fatigue, crying, and feeling s of inadequacy.
Furthermore, what about the women whose symptoms persist and/or worsen as time goes by? What happens when the physical exhaustion, isolation, and overwhelming strains do not resolve? Indeed, one in four women will continue to experience some form of postpartum depression or anxiety beyond those two weeks as they adjust to the overwhelming demands of motherhood. When “baby blues” extend beyond the two week period, it’s time to seek help.
Postpartum Depression (PPD) occurs in 10-20% of women, and despite being highly treatable, often goes undiagnosed and untreated. Spouses are often the first ones to notice that something is amiss, yet many times they are unsure what can be done or how to help. In addition, they are at risk themselves to fall into depression as they try to muddle through the demands of being a new parent.
Research shows that spouses of women with PPD commonly experience increased depression, increased overall stress, and decreased role satisfaction. Research also shows that babies of mothers with PPD are at increased risk for developmental delays and emotional challenges, if PPD is left untreated. For women who have experienced PPD in the past, the likelihood of it reoccurring increases for all future pregnancies. On the outside, women with PPD may seem very “overwhelmed” and/or “anxious.” Symptoms of PPD include:
- Frequent crying spells
- Feelings of sadness, anxiety, worthlessness, hopelessness
- Difficulty concentrating and remembering things
- Emotional numbness, feeling of being trapped
- Lack of energy
- Emotional withdrawal from family, friends
- Excessive concern (or lack of concern) for the baby
- Thoughts of (or fear of) hurting self or baby
- Loss of interest or pleasure in things previously enjoyed
Many women are afraid to share how they are feeling due to a sense of shame, guilt, and/or fear. In addition, there is tremendous stigma related to talking about PPD , which is confounded by media portrayal of violent, out-of control women whose distorted thinking led to horrific cases of infanticide and/or suicide. Thankfully, postpartum Psychosis is extremely rare, occurring in less than .1% of women. When a woman has thoughts of harming her child or herself, it can feel devastating and yet the fact that it feels so alarming is an indicator that the mother is firmly connected with reality and is not likely to act on such thoughts.
As women struggle in the grips of PPD, common thoughts are: “this isn’t what I expected” and “it’s not supposed to be this way.” Rather than recognizing the experience as PPD, many women are likely to blame themselves for their feelings and to become more despondent and disconnected in their shame and guilt. It is hard for someone in the throes of PPD to be able to recognize what is happening to them and to try to assert control. This is the role for husbands, partners, friends, and family members – all of whom are key in helping connect mothers with PPD support and treatment. Although PPD is one of the most treatable forms of depression, the sad reality is that so often woman do not seek treatment themselves and their support system is ill-equipped to make the necessary intervention.
Treatment for PPD is generally a combination of talk therapy and medication. Mother-baby groups can also be a helpful component of the recovery process. Talk therapy helps recognize and correct distorted thinking patterns, find tools and resources to help increase coping skills and build support systems, and engage partners, friends, and family members in the recovery process. Because a large component of PPD is biochemical, antidepressant medications are often key to help regulate brain chemistry to help women recover and regain emotional stability.
Specialized mother-baby dyad groups can help to increase bonding and attachment and spur development of a healthy, non-anxious mother-baby attachment. Mothers groups in the community can also be helpful to normalize experiences, promote bonding, and create supportive friendships. Research, however, does not confirm that attendance at social groups alone is sufficient to decrease the symptoms of PPD. Anecdotally, women who attend such groups sometimes report increased feelings of isolation and despair after attending groups, especially when conversations stay at a superficial level and/or there is a general presentation of women in the group easily mastering the tasks of motherhood.
It takes a community to come together for new mothers. Understanding how to recognize signs of PPD and knowing how to help treatment is essential. The following local and international resources are a good place to get started if you or someone you care about is struggling with postpartum depression or anxiety:
Arapahoe/Douglas Mental Health Network - www.admhn.org
To meet the needs of mothers in the community, Arapahoe/Douglas Mental Health Network is partnering with the Healthy Expectations program at Children’s Hospital to launch a new, comprehensive Mother/Babies Support Group. For more information, contact Terri James-Banks , LCSW at 303-999-2300.
Postpartum Support International - www.postpartum.net
A Mother’s Wings (a program of Mental Health America of Colorado) - www.mhacolorado.org
Sweet Beginnings - www.oursweetbeginnings.com
Mothers of Preschoolers – www.mops.org
Colorado Mountain Mamas - www.comountainmamas.com