Hope and Help for Postpartum Depression

“There is a two-week period after birth where mood shifts called the 'baby blues' are expected,” explains Kelli Cavaliere, a psychotherapist in New York City who specializes in treating people with postpartum mood issues. “After that time, symptoms such as feelings of extreme sadness, mood swings, difficulty connecting with the baby, feeling empty, crying a lot, or feeling worthless or like a bad parent, could lead to a diagnosis of PPD.” Many people with PPD will also experience anxiety.

As hard as it is to go through these feelings at such an important time, know that PPD is highly treatable. From therapy to medication to support groups, there are many strategies that can help you feel better.

“You can be happy and thriving, and so can your kids,” says Diane Solomon, Ph.D., a psychiatric nurse practitioner and certified nurse-midwife in Portland, Oregon. “You do not need to suffer with PPD.”

It may be hard to make sense of what you’re feeling and what you should do about it. But you can find ways to care for yourself and your mental health while also caring for your new baby. Here are answers to some common questions about PPD that can help you improve your symptoms and get the support you need.

Why Do I Have Postpartum Depression?

Any parent can experience postpartum depression. It’s not because you did something wrong.

In fact, postpartum depression may be more common than you think. According to the National Library of Medicine, about 1 in 7 birthing parents can develop PPD. As many as half of cases of PPD go undiagnosed. Many people don’t have the support they need to get diagnosed. Others feel afraid to tell others how they’re feeling.

Like many mood issues, some people are more likely to develop PPD than others, due to a mix of both genetics and environmental factors. Caveliere says risk factors can include:

• Being diagnosed with depression or PPD in the past
• Complications during pregnancy or birth
• Financial stress
• Thyroid issues
• A history of trauma

You may also be at risk if you're feeling unsafe, have conflict in your life, or don’t have support from a partner, family, or friends. “All those things that make life easier when you have a baby may not be in place,” says Solomon.

Even if you’re in an ideal situation post-birth, it’s still possible to get PPD. It’s also possible not to experience it after one pregnancy but develop it when you have another baby.

Partners of birthing parents can have PPD too. “About 1 in 10 non-gestational parents experience depression in the postpartum period,” adds Cavaliere.

What Can I Do to Feel Better?

If you have PPD or just think you do, there are several strategies that can help—and the sooner you begin them, the better:

1. Seek Treatment

Talk to your doctor about what you’re feeling. This can be your primary care doctor, an ob-gyn, a midwife, or family care physician. It’s important to get the help you need.

“Some people are afraid to tell their providers how they’re feeling,” says Solomon. Don’t feel ashamed, or that you need to pretend to be happy all the time after having a baby.

Your doctor may recommend treatment or refer you to a mental health professional. There’s no one-size-fits-all treatment for PPD. There are a variety of strategies your provider may want you to try, including psychotherapy, antidepressant medications, or other medications. If you’re chest/breastfeeding, your provider will find medications that are safe for you to use.

“A therapist trained in perinatal mental health can help with finding the right mix of things that will provide relief, help you process the changes that happen after the baby is born, and find a sustainable way to take care of yourself and the baby,” says Cavaliere. To find a qualified therapist, you can search the Postpartum Support International provider directory.

2. Get Support

Talking to other parents with PPD can help you feel less alone. You can find an in-person or online support group for PPD through Postpartum Support International, or ask your provider for recommendations of local groups. You can also talk about how you’re feeling with other parents here in the Twill Care for Pregnancy community.

If you have loved ones that you trust, you can tell them what you’re going through. They may be able to lend an ear when you want to talk.

In addition to mental health support, you may also need support for taking care of your baby and getting things done around the house. Ask friends and family members for the help you need, if you have them nearby.

You might also consider hiring a postpartum doula, a trained professional who can help care for you, your baby, and/or your home. “A postpartum doula is so valuable—they are a social support, they know what to expect, and they make you feel better about what you're doing as a parent when you’re unsure,” says Solomon.

Check to see if your health insurance covers all or part of the cost of a doula. In some states, it is covered by Medicaid.

Another idea is to hire an in-home helper to take care of the house while you tend to yourself and your child. A night nurse or nanny can care for the baby overnight so the parents can get some rest.

“The adage, ‘It takes a village to raise a child’ sounds like it’s all about the baby, but the parents need a village too,” says Cavaliere.

3. Care for Your Body and Mind

Even as you’re taking care of a new little person, it’s still important to take care of yourself. As challenging as it can be, try to get quality sleep, eat well, and move your body.

Sleep may seem impossible in the beginning but it should become easier as your baby gets older and starts sleeping longer stretches “Restoring sleep is a huge part of the treatment,” says Solomon.

You might take a nap while your baby naps, and even though your schedule may not be normal, try to go to bed and get up at the same time each night and morning. Your postpartum therapist may have other sleep strategies for you to try, too.

Strive to eat a healthy diet of whole, unprocessed foods. Move every day, once your doctor has cleared you for exercise. Even just taking a walk can make a difference.

Ask your doctor for personalized exercise guidelines, since they may be different depending on your health and the type of birth you had. The American College of Obstetricians and Gynecologists says it’s safe for most people to exercise after giving birth as soon as they feel ready. ACOG suggests most postpartum people get 150 minutes of moderate-intensity aerobic activity each week. If you had a cesarean section birth or experienced complications, you may need to wait a bit longer before exercising.

“These things may not look the same as they did before the baby, but are helpful nonetheless,” says Cavaliere.

How Long Will It Take to Feel Better?

Although it may not be an overnight change, you can expect the symptoms of PPD to improve with treatment. “Every two weeks, at least, you should feel a little better. Your symptoms are better, you find that you're smiling or laughing, you're sleeping better, and you're starting to enjoy things again,” says Solomon. “If not, you need to let your care team know.”

If you’re sticking to your treatment but aren’t feeling better, don’t get discouraged. It most likely just means your approach needs to be modified. Keep in touch with your provider about what you’re experiencing.

“I know it can be hard to advocate with doctors or therapists, but no one is a better expert on your experience than you,” says Cavaliere. “If something isn't working, try adding or pivoting.” That doesn’t mean to stop medication without your doctor’s approval. But it could mean talking to them about changing or switching your treatment. It could also mean joining a new parent support group, talking with your partner about how you can work better as a team, or taking some extra time each day to meditate.

“Just like a menu at a restaurant, you have some things you like and some things you don't,” Cavaliere adds. “You will find the right balance to feel more like yourself.”

For more info on postpartum depression, visit the Office on Women’s Health. Anytime you need help or support, call or text the National Maternal Mental Health Hotline at 833-943-5746.

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