In all the fun and joy of preparing for birth, very few give postpartum depression anything more than an obligatory nod. Most people are inclined to skip over it when preparing for a baby, because of they, naturally, think it will never happen to them. Some may just resolve to deal with it if they face it and otherwise leave it alone.
Nobody can possibly prepare every little detail about the coming life with their baby. But a little basic understanding of postpartum depression can go a long way toward prevention and management, should the need arise. I certainly cannot provide you with all there is to know about PPD in a single blog post, but I hope you will gain some basic knowledge to help you be aware and prepare.
First, what causes postpartum depression? We still have so much to learn despite the amount of research that has been done already. Each case is unique, and the way it is experienced and manifested differs from woman to woman. Causes can be rooted in something mental, emotional, physical, or spiritual, or any combination of these.
Physically, as a woman recovers from birth, her hormones take a while to readjust to a new normal. During this time, it is likely that she is not getting adequate nutrition to support this process if she doesn’t have enough help at home. If she is breastfeeding, prolactin is at work as well, trying to perform its essential function. In addition, she is also likely sleep deprived of caring for a new baby.
Emotionally, a woman can understandably feel overwhelmed by the demanding job of caring for her new baby. If and when her partner returns to work this stress can be amplified especially if there is no additional help at home.
The symptoms of postpartum depression are easy to observe. It is classified as a condition that can be self-diagnosed. Postpartum depression is not to be confused with baby blues, which generally only last a few days after birth. Conversely, postpartum depression tends to be more extreme and rather relentless.
Many women feel ashamed about the possibility of having postpartum depression because motherhood is “supposed” to be the happiest time of your life. In theory. The reality is often much grimmer than we presupposed, as this season of life involves so much life adjustment, difficult navigation, and physical strain involved in baby care. Women are afraid to admit that they are depressed during this time for fear of being shunned.
Some general signs to watch for:
Women are more likely to experience PPD if they have:
The standard postpartum follow up visit with a care provider after birth is a full 6 weeks. That means a woman is sent home from the hospital on her own, and they do not see a professional who can help them for 6 whole weeks. This is a huge gap in maternity care in the US. After birth, a lot can happen in a couple of days, let alone 6 weeks.
The exception to this rule is the home birth midwife. Home birth midwives usually see their clients several times between birth and 6 weeks, but only 3% of births in the US are attended by home birth midwives. The majority of other providers do not do visits before 6 weeks.
This is significant because one of the most well-known causes of postpartum depression is the lack of support.
Both birth and postpartum doulas are in a unique position with a mother. Doulas can come and visit a mother to provide support, but they can also be a perceptive eye in this sensitive time. A doula sees the mother in her own home, in her element. Even though birth doulas generally do not to postpartum doula work, most birth doulas tend to stay in touch with their clients long after the birth. They can be a source of emotional support, and they can provide resources for professionalhelp and support should it become needed.
In theory, a postpartum doula can help prevent postpartum depression. We know that postpartum depression can be caused by stress, breastfeeding problems, emotional demands, or lack of support. We also know that the postpartum doula helps support all of these issues. When she hires a postpartum doula, a new mother does not need to juggle the demands of the household, worry about meals, or handle the housework. She can get adequate rest too since the doula helps the mother make sure she is getting some sleep. A postpartum doula can help reduce stress in an indescribable way.
If you think you may be experiencing Postpartum Depression, it’s so important to talk to someone. It can be managed in a number of ways that range from additional support to herbal supplements to medication. You must know that you are no less of a mother because you are struggling with postpartum depression – there are 3 million known sufferers in the US alone. You do not need to suffer in isolation.
For more information, check out these resources:
Preferred Counseling / Support Groups
Alexia Johnstone, LMHC
Mental Health Counselor
Expressive Arts Therapist
Mara Acel Green LICSW
Massachusetts Postpartum Depression Treatment
Boston – Massachusetts General Hospital’s Center for Women’s Mental Health
Boston – Brigham and Women’s Hospital Women’s Mental Health Program
Boston – Judith Robinson MD, Tufts Medical Center
Boston- Vivian Halfin MD, Tufts Medical Center
Cambridge – Laurie Ganberg LICSW
Cambridge – Suzan Wolpow LMHC
Lexington – Ellen Hilsinger MD, 781-863-5225
Roslindale – The Leggett Group
Somerville – Vicky Reichert LMHC
Wakefield – Janice Goodman
Waltham – Jewish Family & Children’s Services PPD Support
Waltham – Jessica Foley MA
Watertown – Mara Acel Green LICSW
Wellesley Hills – Deborah Issokson PsyD
Westborough – Carolyn Chapman MSW
Worcester – Univ. of Mass. Medical School Women’s Mental Health Program
Worcester – Birchtree Psychology, Rachel Smook PsyD
For more PPD specialists in Massachusetts, visit the North Shore PPD Task Force’s provider list
If you are seeking therapy offering a sliding scale fee based on income, or free counseling services, you might try: La Alianza (Boston, Roxbury)