Few parents are prepared for the life-changing event of their first child’s birth. They quickly discover that human babies are completely helpless. They remain dependent on others, especially the mother, for all their needs for a very long time, compared to any other in the animal kingdom. The transition to motherhood puts women’s bodies through phenomenal changes. The ensuing hormonal fluctuations are similar to what occurs during adolescence. However, the state of emotional upheaval peaks right after childbirth.
This is when many women get overwhelmed and desperate for a time-out to heal themselves. Yet it’s also when the hard lifting of motherhood begins. Sleepless nights, social isolation and sheer exhaustion sets in. This can make motherhood feel much less enjoyable than one imagined, triggering typical postpartum disorder symptoms in some women. The symptoms can generally be broken down into three categories, ranging from mild to severe. It starts with the postpartum blues as the mildest. Postpartum depression requires treatment and postpartum psychosis is the most severe, requiring in-patient intervention.
Postpartum Disorder Symptoms: The “Blues”
More than 50% of new mothers will experience postpartum blues after the baby arrives. This is often an unhappy phase for women when the loss of agency and independence sets in as a reality. It causes sadness, weepiness, irritability and even anxiety because motherhood can be exhausting. Fortunately, the condition does not require treatment because most women recover in about two weeks.
The easiest way to get through the postpartum blues is to surround yourself with a support network. To help you look after your baby, accept help from well-wishers for all other tasks, including your meals, laundry, picking up groceries, etc. Ensuring you set aside time to focus on self-care, exercise and connectedness will tide you over the hump.
For 10%-15% of women, however, the blues last longer than two weeks. As a new mother, if you find yourself experiencing depression-like symptoms, contact your family physician as soon as possible. While fatigue, sleep disturbances and loss of appetite exist as normal facets of postpartum life, feelings of excessive guilt, worthlessness, self-harm and suicide are not. Postpartum depression meets the same diagnostic criteria as any other depression. You may exhibit signs of anxiety, obsessive-compulsive disorder and even post-traumatic stress disorder (PTSD), along with the depression.
Your physician will sift through all your postpartum disorder symptoms before making a diagnosis. This involves a thorough investigation of your medical history, a physical examination and blood tests. Indeed, some women with a thyroid disorder or anemia can present with similar symptoms and they are completely unrelated to postpartum disorders.
To treat postpartum depression, your physician will likely recommend psychotherapy as the first line of treatment. In particular, Cognitive Behavioural Therapy and Interpersonal Therapy have scientifically proven their worth to help you for the long-term, well beyond your symptomatic phase. Your therapist might also suggest other supportive interventions like meditation, mindfulness training and progressive muscle relaxation techniques. They help you sleep better and ease anxiety symptoms. In addition, you might benefit from regular workouts that include resistance training or aerobic exercises to help you boost your energy levels.
Depending on the severity of your symptoms, your doctor may supplement your psychotherapy treatments with medications, like SSRIs or other antidepressants, as well as benzodiazepines to relieve anxiety symptoms.
Postpartum psychosis is a rare psychiatric disorder, affecting less than 0.2% of postpartum women. This severe condition often manifests itself like bipolar mood disorder, with depressive lows followed by exhilarating highs. Women suffering from postpartum psychosis also exhibit disorientation, delusional beliefs as well as hallucinations. Typical symptoms of this postpartum disorder vary, with changes occurring rapidly over hours. There is a risk of infanticide and suicide with this condition. Family members need to intervene to offer support and treat this as an emergency.
Postpartum psychosis requires hospitalization, antipsychotic medications and mood stabilizers. Women with severe symptoms may gain rapid relief from Electroconvulsive Treatment (ECT), which is generally well-tolerated.
Medicating while Breastfeeding
If you are breastfeeding, you may have some reservations about taking medication. In fact, this is the main reason why many women avoid treating their postpartum disorders. However, before you withhold treatment, speak to your physician so scientific facts drive informed decisions.
Evidence confirms that breast milk will contain secretions of medications used for treating postpartum disorder symptoms. However, the concentrations vary depending on the medication, your metabolism, the dose as well as frequency of dosage. The human body metabolizes psychotropic medications in the liver. Premature babies may be at higher risk for exposure because their livers cannot process the medications effectively. However, the liver of a two or three-month-old baby surpasses the capacity of adult livers, leaving older infants better poised to tolerate them.
For pregnant and breastfeeding mothers, most clinicians will only prescribe antidepressants that are supported by data. To that end, scientists have studied SSRI class medications in abundance. Data compiled from rigorous tests on breast milk and infant blood samples are encouraging. They depict minimal medication exposure to nursing infants with negligible side effects. Smaller studies have shown similar results for anti-anxiety medications. Generally, drug levels are not measured on mothers or babies unless you are on very high doses or your baby starts exhibiting atypical behaviours like irritability, excessive drowsiness or feeding disturbances.
Mood stabilizers for bipolar disorder or antipsychotic agents present higher risks for breastfed babies. If you require such medications to treat your disorder, then your physician will review all variables and balance the impact of withholding your treatment against the known and unknown risks of medication exposure on your baby, along with the benefits of breastfeeding.
Who Develops Postpartum Disorder Symptoms?
Neither age, marital status, education level nor income have any bearing on which women will exhibit typical postpartum disorder symptoms. However, a 2001 study suggests that you are more likely to do so if you have inadequate social supports, are in an unhappy marriage or experience a stressful life event during your pregnancy.
If you normally suffer from premenstrual syndrome, your sensitivity to hormonal fluctuations also puts you in a higher risk category. In addition, women with medical histories of major depression or bipolar disease have a strong correlation to postpartum psychosis, although half the women inflicted by this serious condition have no history of psychiatric illness at all.
Being Gentle With Yourself
Many new mothers compete with unrealistic images of women in prime form, breezing through motherhood with their perfect babies, even though these images on Facebook and Instagram are but snapshots in time. Motherhood is hard and it will challenge you to the limits of your capacity at times. However, as your child changes and grows you will have plenty of new opportunities for enjoyable moments together.
Familiarity with typical postpartum disorder symptoms can empower pregnant women and allow them to engage in open and candid discussions about them with family members. Often, you will not be able to see the forest for the trees. This dialogue may allow a loved one to recognize your postpartum disorder well before you realize it, yourself. During the early days of motherhood, pay as much attention to your mental and emotional needs, as you do to your physical health. This is a time to be gentle with yourself and your expectations.
In addition, do not let the social stigma of mental health problems stand in the way of you enjoying motherhood. Postpartum disorders do not mean you are failing as a mother. On the contrary, seeking treatment speaks volumes about your innate desire to love and care for your child.
If a postpartum disorder has cornered you into a miserable and isolated place where you cannot derive joy from being with your baby, then reach out for help. Contact a professional for an assessment. Suffering postpartum disorder symptoms in silence is completely unnecessary when effective treatments remain readily available.
About The Author
Rebecca Loucks MSW, RSW is a Registered Social Worker and co-owner at Beaches Therapy Group serving clients for over 10 years. We specialize in psychotherapy treatments for women experiencing postpartum disorder symptoms. Contact us for a free initial assessment to determine how we can help. Let’s discuss how our therapy sessions are a worthwhile investment towards happy and healthy relationships.