"The only thing that seems eternal and natural in motherhood is ambivalence.” – Jane Lazarre, novelist.
There is a tremendous societal pressure on mothers to see the period after their child's birth as a time of bliss. But for many mothers this is not the case. Rather, it is often a time of ambivalence, irritability, anxiety and hopelessness.
“I just want to sleep. I feel terrible and I’m afraid I’m going to drop my baby. Sometimes I imagine my arms may just give out and the baby will fall to the floor. I can’t speak to anyone about this so I pretend that everything is fine but sometimes I wonder if everyone would just be better off if I weren’t here.”
These thoughts are typical among new mothers I have treated. Many do not realize that they suffer from a common and treatable condition. Postpartum depression may appear to be the baby blues at first -- but the signs and symptoms are more intense and longer lasting, eventually interfering with a mother's ability to function.
Postpartum Depression affects 15-20% of new mothers and ranges in severity from mild anxiety to major depression. Here we will focus on the most common form, that of major depression.
Patients and caregivers often overlook the symptoms of postpartum depression. Like most types of major depression, postpartum depression is characterized by: depressed mood, irritability, anxiety and loss of interest in general.
In addition, women who suffer from postpartum depression often express ambivalence toward their newborn child and commonly doubt their ability to care for the child.
How should women suffering from Postpartum Depression be cared for?
Ideally, women at risk - those who have been depressed in the past either post partum or otherwise or have a family history of depression - should meet with a therapist to create a wellness plan to be prepared for her child's arrival.
Once a mother shows symptoms of postpartum depression, she and her doctor should review her medical history and consider a physical exam and lab tests to rule out reversible causes of depression such as thyroid dysfunction or anemia. Then they can make a treatment plan based on the severity of the symptoms and the degree of functional impairment experienced by the new mother.
For mild to moderate depression, non-pharmacologic options such as psychotherapy can be helpful. A healthy diet and plenty of sleep are essential. The human brain needs continuous sleep to recharge.
Friends and family can lend a hand and offer emotional support and encouragement and provide hands-on help taking care of the baby.
At night, a loved one (partners need to pitch in if there is one) can help feed the newborn with a bottle so the mother can sleep. During the day, a loved one or friend can take the baby for a walk, hold the baby, or do household chores to give the new mother much needed time for herself.
Believing the myth that “new mothers love each and every moment with their babies” can push some mothers to ignore their own needs. When we are depressed it can feel as though the walls are closing in around us. A few minutes of exercise, a short walk outside and a breath of fresh air can go a long way to help the recovery process.
When a mom shows signs of more severe postpartum depression or does not respond to non-psychotropic treatments, antidepressant medications taken along with psychotherapy have been proven to be effective. For nursing mothers, antidepressant medications must be chosen with the safety of the baby in mind. When a mother presents with severe postpartum depression, particularly for patients who are at risk for suicide, inpatient hospitalization may be considered.
Recognize the Symptoms and Know What to Do
New mothers and those who surround them should be made aware not only of the symptoms of postpartum depression but also that it is a common and highly treatable condition.
There is no reason for a new mother to suffer in silence and shame. Getting help from a trained professional helps develop a game-plan to lessen the depression and anxiety and enable the mother to enjoy this time.
I have found that the simple act of talking about feelings often helps to alleviate symptoms in my patients. As a therapist, often the most important thing I can do for my patients is to listen to them, encourage them, and normalize what a difficult and challenging time this is for new parents. With proper treatment and care, the process of becoming a mother can truly be an exciting time, full of new adventures, growth and a tremendous amount of love.
Resources if you are struggling with Postpartum Depression:
Postpartum Support International http://www.postpartum.net
Center for Postpartum Health http://www.postpartumhealth.com
American Psychological Association http://www.apa.org