Perinatal Depression

What better time to have your emotions change than when your hormones are already going crazy?

Perinatal (meaning: before and after the birth of a child) Depression is a type of mood disorder. It affects women during pregnancy and after childbirth. There are rare cases where the mother and the baby is at risk. Included in this form of depression is:

  • Prenatal depression: depression beginning during pregnancy.
  • Postnatal (or postpartum) depression: after a child is born, there is a drop in certain hormones. This depression happens after the birth of a baby.

Mothers who have perinatal depression will experience “feelings of extreme sadness, anxiety, and fatigue that may make it difficult for them to carry out daily tasks…” such as her and her newborn baby.

Causes of perinatal depression:

First of all, I want to make sure that everyone is aware that this is a real medical illness. Any mother can be at risk for perinatal depression. They can be at risk regardless of age, race, income, culture, or education. Also very important to know, is that this is not brought on by anything the mother had done, so there is no blame of the mother.

According to the National Institute of Mental Health, “research suggests that perinatal depression is caused by a combination of genetic and environmental factors.”

If the mother has a personal or family history of depression or bipolar disorder or if they have experienced perinatal depression before with a previous pregnancy, they would be at greater risk to develop perinatal depression.

Baby Blues

This is different from postpartum depression. The difference between the two is that baby blues only last the first 2 weeks after childbirth. Baby blues are “wild mood changes and feelings of worry, unhappiness, and exhaustion…” (other than just caring for a new baby). Baby blues is considered normal because you are caring for someone you just met, who needs around-the-clock care.

If these feelings last longer than two weeks, it is referred to as postpartum depression, which is considered severe. They will feel some relief with treatment if they do have postpartum depression.

Postpartum Psychosis

This is a severe mental illness that occurs after childbirth. It is very dangerous and is a medical emergency and they need to seek help immediately. They are at higher risk to hurt themselves and/or their child(ren). When you hear of mothers killing themselves or their very young children, this is pretty much what they have.

In this mental illness, they have delusions (thoughts or beliefs that are not true) and hallucinations (seeing and hearing, or even smelling things that aren’t there). They have mania (a high, elated mood that often seems out of touch with reality), paranoia, and confusion. As scary as this seems, recovery IS possible.

Signs and symptoms

  • Fatigue or odd decrease of energy
  • Feelings of guilt, hopelessness, worthlessness, or helplessness
  • Difficulty concentrating, making decisions, and remembering
  • Difficulty sleeping (even when the baby is asleep), over sleeping, or waking up early in the morning
  • Headaches, aches or pains, cramps, or digestive problems that don’t have any clear physical cause and/or does not ease with treatment
  • Having trouble sitting still or feeling restless
  • Irritability
  • Persistent sad, anxious, or “empty” mood
  • Persistent doubts about being able to care for their new baby
  • Abnormal appetite and/or weight changes
  • Trouble with bonding or forming an emotional attachment with the baby
  • Loss of interest or pleasure in well loved hobbies and activities
  • Thoughts of death, suicide, and/or harming themselves or their child(ren)

Treatment

Using therapy, medication, or both is mainly the type of treatment used. If there is no reduction in the symptoms, brain stimulation therapies can be used. A good website to check out if you are interested in the different brain therapies is http://www.nimh.nih.gov/braintherapies.

Talk therapy, or psychotherapy would be used as a type of therapy. There are 2 different types:

  • Cognitive Behavioral Therapy (CBT)
    • This therapy helps people with depression and anxiety
    • This therapy helps teach different ways to think, behave, and react to situations
  • Interpersonal Therapy (IPT)
    • This therapy is evidence-based and used to treat depression, including perinatal depression
    • According to the National Institute of Mental Health, it is “based on the idea that interpersonal events impact mood and vice versa..”
    • This therapy is used to improve communication skills within relationships, to develop their social support networks, and to develop realistic expectations that allow them to deal with crises or other issues that may be contributing to their depression.

Medication is mostly combined with therapy. Mothers are commonly treated with antidepressants. Doctors have to be more careful because some moms breastfeed their babies and they need to make sure that the medication is okay for the baby as well as well as working to minimize the baby’s exposure to the medication. Antidepressants usually can 6-8 weeks to show any signs of it working. They can also come with side effects.

Resources

I really only brushes the surface of this topic, so if anyone is interested in a little more information of perinatal depression, here are a few federal resources for you to look through. 🙂

I have had the honor of talking to some special women who have suffered through this. It is not something to take lightly, as it can get very dangerous. These are very hard to read, so read with caution. I’ll let them tell their stories.

———————————–

I had PPD and PPA. I didn’t realize I had it until our first was almost 9 months old. I had been working overnights since she was 3 months old so I had attributed some of the symptoms to that stressor in my life. But what really clues me in was the absolute rage I felt inside for the most mundane inconveniences or even just the dog whimpering or husband sighing. I did go on some medication for about a year before I was able to manage it through vitamins, exercise and just being more intentional with my sleep. When I start not doing things for myself I really slip back fast!

Antepartum Depression is depression that occurs during pregnancy closer to labor. I’m assuming depression during any stage early on and up to shortly before delivery would fall under Perinatal Distress. I struggled a lot after I lost (baby). Obviously it was very hard to grieve but also be strong. It was also hard to grieve when there was no way to have any sort of closure. I couldn’t leave the hospital. So we couldn’t have a funeral or bury her until I could discharge. And we had no way to know when that would be. I spent a LOT of time alone during the day. Listening to the sounds of women have babies all around me. I cried a lot. I was given antidepressants. But they didn’t seem to help much. Or at least I didn’t think they did. But I thought the purpose of taking them was to make you feel happier. And that’s not what they do. They simply take the edge off. I surrounded myself with things to remind me of her. Honoring her and keeping her memory alive is how I grieve. It’s how I process the pain I feel. After I had (name), finding the balance of happy and sad was incredibly difficult. It was a battle within. If I grieved losing her, I wasn’t grateful for (name). But if I allowed myself to be happy, I was dismissing her existence. Then my best friend, who was pregnant with her first (she was due 6 weeks after me) called and told me she had gone in for her 37 week appt… there was no heartbeat. I rushed to her side. She introduced me to a friend as her best friend, and told her she needed me to be there because I was the only person she knew who understood what she was going through. And I felt like an imposter. Because yes, I also lost my first born. But I also came home with a baby. So I didn’t feel like I understood the way she felt I might. It made me feel worse for grieving (baby) so much. Because again… I had a baby. She was going to come home with nothing. I think I still struggle with the battle. Even though I’m capable of telling myself I can be grateful for my living children AND be sad she isn’t here.

With (name 2) I was great… until we found out he was a boy. It was so hard knowing how badly we both longed for the girl God took from us. I know deep down no baby could replace her. And I would still grieve. But some things would be easier. I felt like I had failed. So again. I struggled with depression during pregnancy. My postpartum wasn’t as bad with (name 2). It was short lived. I think because we had so much going on, I didn’t have time to be sad. Or to think really. Then we got pregnant with (name 3).

(Name 3) was a surprise. And (dad) and I just knew, his MeMa had sent us the girl we longed for. She had died a month before (name 2) was born. But then we found out… another boy. And to make matters worse, our gender reveal, was an epic fail. Backstory, my mother in law also had three boys and never got her girl. So imagine being at the Golf Course, among 100’s of people for a fireworks show. Then announcing just before the shows start, that we were doing a round of fireworks for our gender reveal. The fireworks were pink. All night long we were congratulated on our baby girl… that wasn’t a girl. It was like a cruel joke. I went on Zoloft shortly after. It helped some.

Again, a lot happened after (name 3). We always have something going on. I weaned off my Zoloft and have therapy a go. Talking through your issues with an unbiased party. But also with someone who is there to do nothing but support you in a reasonable way, was the best way to get through my depression. It became evident that meds weren’t going to do much for me. Therapy was what suited me best.

I think the most important thing to know, is that depression in general is varying. It doesn’t look the same for everyone. What works in terms of treatment isn’t the same for everyone. And it is COMPLETELY normal. The combination of everyday struggles and personal struggles can be overwhelming. Throw in fluctuating hormones and your in for a whirlwind. It just takes everything to the next level. There is no one way to make it better.

I literally will never understand the stigma. I don’t know anyone who hasn’t at some point struggled with some form of depression. Why are there people out there who treat it like something to be ashamed of? Something that needs to be kept hush hush? I don’t get it.

Postpartum depression for me was constant crying… lonely nights I fed my son while my sons father slept his night away. No help, abused mentally and physically from him. I hated my body, body dysmorphia escalated tremendously after having my son. I constantly wondered how I would ever make it the next 18 years.. I coped by taking baths after my son finally was in bed and I had time to relax and get out of my head. After I left my abusive relationship my mental health got so much better. But I still struggle really bad about the same time every night. It’s between 8:30 when I put my son to bed until I get my brain to turn off around 1:00 am when I finally fall into a drifting sleep… For example, When I hung out with you guys this past weekend I got there at 9 and by 10:30 when I left I was so secluded and depressed and in my own head I felt a burden I felt not welcomed I felt out of place and a voice in my head told me I needed to leave.

I had postpartum depression as well as postpartum anxiety. My brain was a living hell. I was too anxious to leave my house because i was convinced that someone was going to take my baby. Then I was too depressed to leave my bed. So I laid in bed with my baby and believed that a plane was going to crash through the roof of my house and kill us all. At that point I knew I couldn’t battle this alone. My OBGYN prescribed me some medication for my symptoms and I have been fine on medication since. As of right now it is not a good idea to take myself off of the medication even though it has been 2 years since my last baby was born. Becoming a mom has completely changed my chemical makeup and I will most likely have the effects forever.

Of course!! So with our oldest I had postpartum depression that began around 6 months postpartum. I kept silent about it until one night I packed a bag and was going to leave. Idk where I was going to go but I felt like (dad) and (name) were so much better off without me. I ended up talking myself out of it but keeping my bag packed. A few days later I decided instead of leaving with no where to go I was going to just end things period. (Dad) came home from work and called my dad, I went to a doctor and was put under a 24 hour watch. From then on I was on medication (citalopram) until I weened off months later when I felt much better! After our 2nd I began taking medication right at birth but it wasn’t enough. From my 6 week visit i spoke with my ob and she got me set up with therapy! I went for a year after that and was diagnosed with PPD (as I knew), PPTSD, PPOCD and derealization disorder. Through therapy I learned coping mechanisms for my ocd and derealization and it helped me overall with my depression just to speak openly about how I feel.

With our final baby I began taking citalopram immediately after birth again. Since she was born at 32 weeks everyday when I was there with her in the NICU a therapist would come talk to me to check in. Since I have the history of depression and an suicide attempt they wanted to keep an extremely close eye on me. Since she came home I have a social worker who calls every other week to check in on me and we chat. Next month I will begin therapy once again to help get me through the immediate postpartum period!

Growing and taking care of a baby is hard. It’s even harder when you are fighting your mental health. It’s important that moms, whether new or veteran, get love and support from their families and friends. They need to be in tune with their emotions and are able to read their bodies to determine if something is off. You are not alone mommas!

If you know someone in a crisis: Call 911 in an emergency. National Suicide Prevention Lifeline at 1-800-273-8255. TTY at 1-800-799-4889. The Crisis Text Line is open 24 hours a days, 7 days a week. Text HELLO to 741741.

– Bipolar Weirdo


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