Beyond Baby Blues
Find Relief From Postpartum Depression
There are women who have lived through postpartum mood disorders who actually become enthusiastic about the subject. That may be hard to imagine, but, when one has experienced something as intense as an emotional upheaval during postpartum, it’s hard to forget. One wants to help others avoid the pain and suffering if possible.
Dawn Baynes, a Baltimore resident and Maryland state coordinator for Postpartum Support International (PSI), continues to work closely on research around postpartum disorders despite the fact that her own experience with postpartum depression occurred many years ago. Baynes gave birth to a son through an emergency Caesarean-section 11 years ago. Two weeks after the birth, her father died.
It was at about one month post birth, that she began to have difficulty eating and sleeping. She felt dizzy upon standing, and she had what she calls “weird thoughts.” For one, she experienced panic attacks when she was alone with her son. She wanted to care for him perfectly, but at the same time she was afraid that she wouldn’t. She needed other adults around to convince her that she was a competent mother.
As many new mothers experiencing postpartum problems, she felt embarrassed to talk about her feelings. It took three months before she started to open up and seek treatment. Her obstetrician promptly referred her to a psychiatrist, but this doctor focused on her father’s death and the usual adjustments of being a new mother. Antidepressants helped somewhat. A lot of time passed, and she still continued to have the “weird thoughts.”
Eventually, she made contact with PSI, and she was urged to have her doctor check her thyroid levels. It was discovered that she had low levels of thyroid hormones. When she was prescribed Synthroid, she noted improvements within one to two weeks. The close bonding feelings that she felt right after birth returned.
Baynes later learned that she had specifically experienced a postpartum obsessive disorder. She also found out that her own mother and grandmother had had postpartum disorders. “Why hadn’t they shared this with her?” she wonders. Since her own experiences were so intense and resulted in a marital break-up, she has been devoted to working with PSI. She generally works with women callers on a case-by-case basis, and finds that support groups are difficult to orchestrate.
Postpartum Mood Disorders
When people hear about postpartum disorders, most immediately think about depression. There are other forms of disorders that involve a range of emotions from simple blues to anxieties to severe psychoses. Some are quite common; others are quite rare.
Most common are the baby blues. For most new mothers, baby blues implies low mood–comparable to a post-holiday, big event letdown. Affecting about 50 to 75 percent of new mothers, the blues dissipate fairly quickly.
Postpartum Depression, on the other hand, occurs in about one in 10 new mothers and can happen anywhere from a few days after birth to up to one year. Ann Stoline, M.D., a mother of two toddlers, is also a psychiatrist who specializes in working with women’s mental health, including perinatal disorders.
She sees perinstal patients with symptoms which range from the blues to depression to psychosis, often weeks or months after giving birth. Some of the feelings her patients describe include irritability, sadness, anxiety, trouble sleeping (even when the baby sleeps), problems with bonding, obsessive concerns about the well-being of the baby, repetitive images of accidents or concerns about hurting the baby.
Postpartum Psychosis is the least common form and affects about one in 1,000 women. It is the most severe form of the postpartum mood disorders and requires urgent treatment. The symptoms of Postpartum Psychosis are very intense and include agitation, delusions, hallucinations, insomnia, unusual feelings or behavior.
Sheppard Pratt’s brochure Feelings After Birth: Postpartum Adjustment, helps readers to understand an important aspect of postpartum mood disorders, stating, “All of the symptoms from the mild to the most severe are temporary and treatable with support and skilled professional help.”
Often confused or dismissed as fatigue from being a new mother or clinical depression, Postpartum Thyroiditis is yet another postpartum disorder, differing from the others in that it is an identifiable condition–either hypothyroidism or hyperthyroidism. Postpartum Thyroiditis is treatable with medication.
The Kelly G. Ripken Program at Johns Hopkins Hospital is devoted to helping people understand thyroid diseases. According the program’s website, “One of every 20 women develop thyroid inflammation within a few months after delivery of their baby, a condition called postpartum thyroiditis. Symptoms of hyperthyroidism or hypothyroidism may not be recognized when they occur in a new mother.
They may be chalked up to lack of sleep, nervousness, or depression.” The site further explains that if a woman has had an episode of postpartum thyroiditis, she is likely to develop the condition in future pregnancies. The Kelly G. Ripken Program may be contacted at 410-614-1174 or visited at their website at: http://thyroid-ripken.med.jhu.edu/.
Why It Happens
There is a mix of reasons as to why postpartum mood and adjustment disorders occur in new mothers. Hormone imbalances, modern life idiosyncrasy, and previous history with mood disorders–all of these have been talked about in relation to postpartum depression. Whatever the exact cause, it is a turbulent roller coaster ride. To be sure, feminine biorhythms are disrupted in varying degrees.
Anne Stoline, M.D., is currently in the process of developing Millwood Place, an all-inclusive service center for women’s mental health needs. She sees perinatal patients, often weeks or months after giving birth, whose symptoms range from the blues to depression to psychosis.
“This is hard to bring forward,” says Stoline, of postpartum depression, noting that the difficulty is that it often involves feelings that run counter to the expectations around motherhood. “Very often there is a fair amount of guilt,” Stoline adds. Patients describe experiencing irritability, sadness, anxiety, trouble sleeping (even when the baby sleeps), and problems with bonding, obsessive concerns about the well being of the baby, and repetitive images of accidents or concerns about hurting the baby.
To help her patients, Stoline says that she always hears the birth story, and she works around calming any trauma around the birth. At times, antidepressants can help coax the mother back into a calm state so that she can experience the natural process of mothering, something that is often disrupted in our modern world. So much of our lives are built around schedules, including induced births. “Women need to be protected from the modern world,” says Stoline.
Treatment may also involve therapies and education that allow for empowerment of the woman such as journaling, healing touch, and active listening.
Family Involvement in Treatment
While they are happening to only women’s bodies, these postpartum disorders certainly affect the immediate family. Involving significant others in the prevention and treatment goes a long way toward helping the new mother.
Stoline incorporates varying degrees of family involvement in the treatment of postpartum disorders. Many husbands come in the beginning of treatment to understand the situation and to ask questions. As Stoline explains, it can be hard to understand when you have never experienced anxiety or depression yourself.
Where to Turn for Help
Dawn Baynes suggests that if the feelings last more than two weeks, they’re probably more than the baby blues. She urges women to see a doctor, talk about what they are experiencing with family and friends, save their energy for the baby, and leave the housework.
“You should not feel guilty about your thoughts,” Baynes says to women who call PSI. “Super mother syndrome will end up making you fail. You need to get out and separate yourself from your child. If you don’t, it can increase feelings of resentment for your child.”
PSI has a comprehensive website offering articles, research contacts, chat rooms, conference, and workshop listings. A quarterly newsletter is provided for members, an extensive lending library is made available, and free technical advice is offered for those interested in starting support groups in their community. Jane Honickman, PSI national coordinator based in California, says she will also lend direct support to anyone who has suffered from a postpartum disorder. Contact PSI at 805-967-7636 or visit its web site at www.postpartum.net.
Depression After Delivery is another national organization offering support for postpartum depression at www.depressionafterdelivery.com or you can reach the organization at 800-944-4773.
Overcoming Postpartum Depression, A Doctor’s Own Story (1998, Nightengale Rose Publications) is a book-on-tape by Lois V. Nightengale, Ph.D., a clinical psychologist who herself experienced postpartum depression. Along with tons of self-care/pampering suggestions in the section “Tips for Addressing The Baby Blues,” Nightengale includes this one: “Hand squeezes, hugs, and kisses between Mom and Dad, to keep you both going.” Her book can be ordered by calling 800-898-8426.
If you wish to find a doctor or therapist to speak to, contact the Therapy Referral Service of Sheppard Pratt, 410-938-5000.
If you are a new mother, be sure to check in with yourself and ask if you’re really feeling good. Remember, there are many people out there to help if you aren’t. You are not alone. Postpartum troubles have happened to many of us. You only need to reach out or have a loved help you in that process. (Published 10/2000. Updated 09/08)BC