Post-Partum Depression: Moving Out of the Shadows into a Community of Support

Post-partum depression (PPD), the most common complication of pregnancy, is finally transitioning from a topic discussed behind closed doors to being in the national headlines. The Food and Drug Administration’s announcement that it has approved the first drug (brexanolone) to treat post-partum depression dominated the news cycle recently. Meanwhile, celebrities are using their national media platforms to share their experiences with post-partum depression. Many, including Alyssa Milano, Serena Williams, and Chrissy Teigen, have candidly admitted that their wide circle of support and access to the best medical care didn’t shield them from this condition that is experienced by as many as 400,000 American women each year.

Despite these more open discussions about PPD, we have a long way to go before women become more comfortable and confident about sharing their experiences and seeking help. Concerns or even fear about the judgment or criticism they will experience if they talk about feeling sad, inadequate, and hopeless lead to women downplaying or even hiding their symptoms. Add to that the public and personal pressures to move seamlessly and happily into motherhood, and it’s not surprising that women delay or never receive the support and help they need to manage post-partum conditions.

Preparation and Understanding are Key to Knowing “It’s Not Just All in Your Head”

Given the prevalence of PPD and advantages of early diagnosis and treatment, understanding what PPD is, how to treat it, and where to get help are key.

There is no single cause of post-partum difficulties. Physical and emotional issues both play a role. Drops in hormone levels, including those produced by the thyroid, contribute to fatigue and feelings of sadness. Sleep deprivation and being overwhelmed with new responsibilities, as well as an inability to carve out time for self-care can worsen what new mothers are feeling physically and mentally.

Post-partum medical conditions can be bucketed into three diagnoses that have different symptoms and variations in duration and treatment options:

Baby blues is the most common post-partum condition, with between 50% to 75% of new mothers experiencing the symptoms noted below, according to the Cleveland Clinic. Baby blues generally last a week or two, and can be treated with extra support from family or outside help as well as rest, good nutrition, and exercise.
Post-partum depression, experienced by roughly 1 in 7 new moms, has symptoms that can be more debilitating, and impact the ability of a new mother to care for herself and her baby. Depending on the severity of symptoms and accessibility of treatment and support, PPD symptoms can last a year or longer.
Post-partum psychosis is the third and relatively rare post-partum condition. It is characterized by severe symptoms such as extreme anxiety and suicidal thoughts that develop in the first week after delivery. Immediate help should be secured if these symptoms occur.

Post-Partum Medical Conditions, Symptoms, Duration, and Treatment

Source: Mayo Clinic.

Celebrities Open Up about PPD

Serena Williams: “I think people need to talk about it more because it’s almost like the fourth trimester, it’s part of the pregnancy. I remember one day, I couldn’t find Olympia’s bottle and I got so upset I started crying … because I wanted to be perfect for her.” (Harper’s Bazaar UK)
Alyssa Milano: “That first night, after we returned from the hospital, I suffered my first anxiety attack. I felt like I had already disappointed my child.” (Time)
Chrissy Teigen: “I also just didn’t think it could happen to me. I have a great life. I have all the help I could need: John, my mother (who lives with us), a nanny. But post-partum does not discriminate. I couldn’t control it. And that’s part of the reason it took me so long to speak up: I felt selfish, icky, and weird saying aloud that I’m struggling. Sometimes I still do.” (Glamour)

Post-Partum Support Options

Doulas, nannies, and outside help with household chores
Support groups at local hospitals, family planning clinics, and community centers
Trusted online resources (National Women’s Health Information Center, Postpartum Support International, Medline Plus, Postpartum Health Alliance)
Employer resources and support
And of course, contact your Axia Women’s Health provider to discuss treatment and local support

Don’t Forget Self-Care

In addition to the treatment options noted above, ensuring that you have time to care for yourself in the weeks following delivery is not a selfish endeavor. It’s the wise “make sure your oxygen mask is secure before assisting others” mindset. Here are some ideas to consider.

Ask for help and acknowledge that it’s a sign of strength to know what needs to be done and to figure out how that’s going to be accomplished. It’s okay to admit that it may take a village to keep up with the demands of caring for yourself and your baby for several weeks. Secure the help you need and never look back.
Limit visits of family and friends for two weeks unless the primary reason for the visit is to help with cleaning, cooking, shopping, laundry, etc. This is the time to firmly communicate the support you need to allow you to focus on your baby and yourself. Don’t feel guilty about refusing to entertain guests. There will be time for that later.
Carve out small chunks of time to take a hot shower, walk around the block, have a cup of tea, or visit with a friend. Even as little as 10-15 minutes can give you the mental and physical space to rejuvenate.
Resist the pull to be sedentary. When you’re exhausted, exercising can seem like the last thing you want to do, but even short periods of easy exercise, with your physician’s approval, can lift your mood and help you feel like yourself again.
Connect with other new moms. Whether it’s the moms from your neighborhood or a support group at your hospital, talking about your experiences with other new mothers can provide comic relief and helpful tips about managing this new phase of your life.

How you feel after giving birth may seem like it’s out of your control, but what is within your control is getting the help and guidance you need to care for yourself and your baby. New mothers need to trust that how they are feeling is not some weakness on their part, but instead a common condition that can be treated with help from medical professionals or other support systems. And there are consequences to toughing it out on your own. Left untreated, PPD can last for months and potentially become a chronic depressive disorder.

Remember, we’re here for you. This is the time in your life when being honest and open with care providers is more important than ever. Trust us with your concerns, and know that we provide a safe space for discussing post-partum conditions.