What is Postpartum Depression? 

People go through many physical and mental changes during pregnancy. Postpartum Depression (PPD) symptoms occur in new parents once a baby is born and a pregnancy is over. Many new parents experience sadness within the first few days after the birth of their child due to a variety of reasons such as hormonal changes, traumatic birth experiences, adjusting to parenthood, and adjusting to no longer being pregnant after 9 months. These sad feelings typically go away within a few days. This short period of intense emotions is known as the “baby blues”. If these feelings persist for longer than 2 weeks, they are then classified as postpartum depression. 

 

What are the symptoms of Postpartum Depression? 

Symptoms of PPD usually occur within the first few weeks after giving birth, but they can also begin during pregnancy or months after delivery. 

 

Symptoms include: 

• Depressed mood or severe mood swings
• Excessive crying
• Difficulty bonding with your baby
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you're not a good mother
• Hopelessness
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Restlessness
• Severe anxiety and panic attacks
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide

Why don’t I feel close to my baby? 

One of the most common and distressing symptoms of PPD is feeling disconnected from your new baby. Society says having a baby should be the happiest moment of your life and that you will immediately love your baby more than anything. When this doesn’t happen, new parents may feel guilty or ashamed. In reality, there are many factors that can lead to feeling disconnected from your baby such as a traumatic birth, having your child stay in the hospital for a long period of time, lack of social support, and more. This is very normal and can be addressed in PPD treatment. 

 

How common is Postpartum Depression? 

PPD is not talked about openly, which leads many parents to think they are alone in their struggles or that something is wrong with them. In reality, one in nine new mothers experiences PPD. 

 

Can fathers have Postpartum Depression? 

Yes! Paternal PPD can have the same symptoms as maternal PPD. It is not due to the hormonal changes of pregnancy. Instead, it is caused by the major life changes that come with having a child.

 

What causes postpartum depression symptoms? 

Depression can be caused by a combination of the following genetic, biological, environmental, and psychological factors:

 

• Brain chemistry: Pregnancy leads to many hormonal and physical changes in the body, which directly impact the brain. During pregnancy, progesterone and estrogen levels increase dramatically. These changes in hormone levels are important for preparing the body for pregnancy, but they can also lead to feelings of depression and anxiety. Research has also shown that a first time pregnancy directly changes the structure of the brain and these changes continue to progress for up to two years postpartum. In particular, the gray matter of the brain tends to shrink. The function of this is to optimize the brain structure for parenthood, but sometimes this process can also cause emotional changes.
• Genetics: If you have a relative with postpartum depression, you may be more likely to become depressed.
• Life events: Life events can trigger depression symptoms including stress, the death of a loved one, upsetting events (trauma), isolation, and lack of support, birth of a baby, major routine changes due to the new child, moving into a new home, loss of a pregnancy, fertility struggles, etc. 
• Medical conditions: Medical conditions and physical illness can cause depression, including ongoing physical pain and illnesses, hyperemesis gravidarum, diabetes, cancer, and Parkinson’s disease. 
• Medication: Some medications have depression as a side effect. There are many medications that are safe for pregnant people to take, but the side effects may still lead to an increase of depression symptoms. 

 

The symptoms of postpartum depression can continue or are maintained by the way we think and the way we behave. 

 

• The way we think can keep us stuck in Depression: 

• • • Unhelpful thoughts like “I will never be a good parent”, or “This is hopeless. I’m not cut out for parenthood” can keep us stuck and make it harder to get out of the depression cycle
    • At Prospera, we call these thoughts - “thinking traps”. 

• The way we behave can keep us stuck in Depression: 

• • Doing or avoiding things (i.e. staying in bed, ignoring calls, not showering, not playing with your baby, not going out with friends) that feel good in the short term (but make us feel worse in the long term) can also keep us stuck in the “depression cycle”.
  • At Prospera, we call these behaviors - “behavior traps”

What can I do to get better? What are my options for help? 

Postpartum Depression can convince us that nothing will help and it can keep us in a cycle of unhelpful thinking, feeling, and doing (or not-doing). The good news is that there are things that you can do that will help. There is a lot of evidence to support that any or a combination of the following can help reduce symptoms of PPD:

 

• Psychotherapy or Mental Health Coaching: A talk therapist or a mental health coach can support you through your PPD. Cognitive-behavioral therapy (CBT) is a research-based approach that has been shown to decrease depression by changing the way you think and behave. Prospera coaches are trained in CBT techniques because we know that these skills work! The Prospera program involves the following steps:
  • Your Prospera coach will help you learn to identify thinking traps that might be contributing to your depression. Then you will work to challenge your thoughts by thinking about the situation in a new way, with the goal of coming up with an alternative thought that is less distressing and more balanced.
  • With Prospera, you will also learn to spot the behavior traps that keep you stuck in your depression cycle. You will learn to break free from your behavior traps by learning to use counter behaviors, which means acting opposite of what your emotion is telling you to do by purposefully scheduling activities you enjoyed in the past. For example, a behavior trap might be scrolling mindlessly on your phone for an hour, which might be what you feel like doing in the moment, but only makes you feel worse over time. A counter behavior might be to get outside for a walk for 30 minutes. These counter behaviors will help to increase your motivation and help you challenge your depressive thoughts and predictions, which can decrease your depression over time. 

• Medication: There are many psychiatric medications that are safe for pregnant and breastfeeding individuals.  Antidepressants and other types of psychiatric medication may help. Research shows that a combination of medication and therapy/coaching is helpful. Talk to your doctor for more information and always inform them of your pregnancy/breastfeeding status. 

• Lifestyle changes: Consistent exercise, sleep, time outside, socializing, and a balanced diet have all been found to improve mood and reduce symptoms of postpartum depression. Sleep is highly disrupted when you have a baby, but it is important to make time to rest. Take as much time as possible to sleep when you can. Often postpartum depression can make it difficult to engage in a healthy lifestyle, so therapy or mental health coaching may be helpful to start establishing a routine.   

• Alternative approaches may also be helpful for some people, including light therapy, brain stimulation therapies, faith-based, holistic, and mindfulness-based approaches. 

It may take time to find the best approach or combination of approaches to alleviate your symptoms of postpartum depression. You can always check in with your medical doctor to rule out medical and other possible causes that may be causing your symptoms.