For many new moms, postpartum depression was not part of the birth plan. Preparing for lack of sleep? Check. Diapers at the ready? Double check. But a general sense of worthlessness, hopelessness, and deeper exhaustion than is manageable? For nearly one-fifth of new moms, these emotions are a surprising new reality.
The good news is, postpartum depression (often shortened to “PPD””) is highly treatable with therapy. Read on to learn about what the possible causes are for PPD, plus symptoms to keep an eye out for. And if you are, or your loved one, is already experiencing symptoms of PPD, learn more about treatment options – and get started by finding a perinatal therapist who can help.
Causes of postpartum depression
There’s no single cause that we can point to as the major cause of postpartum depression. Rather, it’s a combination of factors. Research shows that causes of postpartum depression may include the combination of:
- Biological sensitivities to hormonal changes
- Genetic vulnerability
- Societal pressures
- Spiritual theories
- Individual beliefs and expectations about parenting
A sudden shift in life roles and new demands may trigger PPD, too
There are both psychological and physiological changes that occur during pregnancy. In addition to the hormonal changes, it’s a period of time where the woman gets a lot of attention, prepares for parenthood, has dreams and expectations about what parenting will be like, receives explicit demands from society about “what they are supposed to do,” and puts implicit demands on themselves about how they “should” prepare during their pregnancy for their new baby.
Once the baby enters the world, the shift transfers from focusing on the pregnant woman to focusing on the baby. The new mom may experience fatigue and sleep deprivation, a perceived loss of freedom, control, and self-esteem, experience a tangible difference between the fantasy and reality of motherhood, all while needing to learn new skills to manage the new demanding role.
And then there are explicit myths and misconceptions about pregnancy. For example, not every woman who is pregnant is in a loving relationship, not every pregnancy is wanted or brings fulfillment, and not every pregnancy creates a healthy baby. In complicated pregnancy situations, the risk for developing PPD may be especially high.
The peak of risk for PPD is 3 months after birth
Most women are at risk for developing PPD three months after birth. However, it can start days, or even months, after childbirth.
Generally speaking, postpartum depression is considered as such if the symptoms occur within the first year after birth.
Symptoms of postpartum depression
Symptoms can differ, but often they include:
- Lower mood
- Lack of interest in the baby
- Feeling really overwhelmed
- Inability to take care of oneself or family
- Mood swings, appetite and sleep disturbances
- Feelings of anger, guilt, and/or fear
- Difficulty concentrating or making decisions
- Possible thoughts of harming the baby or oneself
Postpartum depression affects 14-21% of new moms
Approximately 14-21% of mothers experience PPD.
PPD kicks in at different times
Of the percentage that develops PPD:
- 26.5% of the episodes began before pregnancy with more chronic patterns
- 33.4% had their onset during pregnancy
- 40.1% of the episodes began during the postpartum period
PPD lasts for different amounts of time
Between 20 and 25% of mothers with PPD have episodes lasting 6 months or longer.
Women with a history of mood disorders are more likely to develop postpartum depression
Such mood disorders include (but are not limited to) a history of depression, bipolar disorder, or a history of PPD from a previous pregnancy.
Postpartum depression is more severe than baby blues, and lasts longer
Baby blues lasts anywhere from two days to two weeks, and the symptoms are generally mild. Baby blues are not considered a mild form of depression.
Baby blues affect 60 - 80% of new moms, and are caused by the extreme hormone fluctuations at the time of birth. The baby blues are unrelated to stress or psychiatric history, and often peaks 3-5 days after delivery. Symptoms may include crying, feeling overwhelmed with motherhood, fatigue, and some emotional lability.
The diagnosis of PPD, on the other hand, requires a minimum period of two weeks of the new mom presenting with depressed mood and/or loss of pleasure or interest in daily activities. These are often accompanied alongside other symptoms, as listed above.
Treatment options for postpartum depression
Start with early prevention methods.
Know your risk by assessing your own psychiatric history as well as family history of mood disorders. You can decrease your risk of PDD by mobilizing a support network; this may include, family, friends, doulas, new mom groups, childbirth education classes, and seeing a therapist, and by taking care of your basic needs through having adequate nutrition, sleep, and exercise. Higher risk women may also benefit from taking a preventative medication (often an antidepressant).
Treatment for PDD includes accessing social support, seeking psychotherapy, and following any recommended medical interventions.
Cognitive behavioral therapy, interpersonal psychotherapy, dialectical behavioral therapy, psychodynamic psychotherapy, and psycho-educational group therapy can all be effective treatment options. The best treatment is the one that works for you!
How can a loved one help someone with PPD?
Validate their experience and encourage them to seek care! PPD is treatable.
Destigmatize! PPD is not their fault. Show compassion and empathy for what they are going through.
Normalize how hard motherhood can be! There is no manual for motherhood, and people often have to do some trial-and-error to figure out what works for them.
Let them sleep! Sleep disturbances are implicated in mood disorders (whether it’s sleeping too much, or not enough). Restorative sleep will help new moms better manage their moods and work through any anxiety or depression.
What should I look for in a therapist for PPD?
It’s most important to find a clinician who you trust and who has experience with perinatal conditions. For the fastest symptom relief, I personally recommended working with a clinician who specializes in cognitive behavioral therapy or interpersonal psychotherapy. It is also extremely helpful to explore your own beliefs about motherhood, and to look at what may be impacting your ability to bond. This can be achieved in individual therapy or in a group setting.
If you’re ready to start your search for a perinatal specialist who can treat postpartum depression, you can do so on Zencare below.