She was told by family members and friends not to worry. It was simply a case of the “baby blues,” and the gloom she felt after the birth of her son was normal and would soon pass.
Yet her symptoms continued over the next several months and grew more intense. She tried to hide her feelings because she felt ashamed that, while everyone around her seemed so happy about the new baby, she couldn’t get past her feelings of despair.
While the baby blues are common due to hormonal factors and fatigue, the symptoms are usually mild and will disappear within a few days or weeks. Post-partum depression (PPD), however, can be overwhelming and last for months, if not years.
“Any new mom can get post-partum depression,” said Judy McCarthy Dalton, a midwife at Open Door Family Medical Center. “Yes, there are red flags, like if there is a past history of depression or anxiety, or if there was post-partum depression following previous births, but any new mother is at risk.”
PPD affects as many as 1 in 7 women giving birth in the United States – a ratio that is likely higher, as many women are hesitant to report it or receive treatment.
This is a serious mistake, mental health clinicians say. PPD, they insist, needs to be treated no differently than any other serious illness, e.g., diabetes or high blood pressure.
This is a particularly important topic to address during Mental Health Month in May.
“Being teary eyed and having fatigue is part of being the mom of a new baby, and you need support from the people around you. But, if you start meeting criteria for a major depressive disorder like PPD, you need medical help,” said Shonny Capodilupo, Senior Director of Behavioral Health at Open Door Family Medical Center. “Post-partum depression will go away by itself, but invariably it will come back and when it does it’s often worse and harder to recover from. It’s extremely important to intervene with treatment as soon and as aggressively as possible.”
Suffers of PPD face an ongoing constellation of symptoms that may include mood swings, anxiety, irritability, feeling of being overwhelmed, crying, lack of concentration, loss of appetite and trouble sleeping.
Primary Care, Mental Health Teams Working Together
In many cases, PPD first presents during pregnancy, which is why Open Door’s mental health clinicians work closely with their midwives to flag patients with the disorder, said Capodilupo, in order to get them into treatment as early as possible.
Appointments are made with mental health providers both during prenatal care and four weeks following delivery for all new moms at Open Door. Midwives educate patients on the signs and symptoms of post-partum depression. They help them establish relationships with the mental health team.
“When they come back to see us four weeks after giving birth, we ask if they have adequate support at home, and see if they’re happy or struggling,” said Dalton. “It’s important to have those mental health visits during and after pregnancy. If they miss a mental health visit, we try to stay on top of it by getting the appointment rescheduled so things won’t get out of control. We want the patient to have established relationships with the mental health team, know who to call and feel comfortable reaching out. It’s really a team effort.”
Treatment can include medication and psychotherapy, as well as instructions on what new moms can do help themselves (which may include recommendations on getting more rest, exercising and eating healthier). At times, this can include treating pregnant women with antidepressants.
“There is no evidence that medication will hurt the unborn child,” said Dr. Jay Samander, a psychiatrist with Open Door. “You can’t just say ‘It’s not a big deal, just buckle up, and you’ll be okay.’ If you do a risk/benefit analysis, being depressed and not eating or sleeping can have far worse effects on the mother and unborn child than taking an antidepressant when you’re pregnant.”
The bottom line, say experts, is that new moms and their families need to be aware that anyone can get PPD, know the signs and symptoms and, if necessary, get treatment.
“It’s like when you get on an airplane and you’re told by the stewardess to put the oxygen mask on yourself before you put it on your child,” said Capodilupo. “You first have to be healthy and well enough to care for your child. If PPD is left untreated, and you’re deeply depressed, how effective will you be as a parent to that very vulnerable child?”
