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Understanding postpartum mood disturbances

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Most women experience some form of postpartum mood disturbance following the birth of their child. For many, the symptoms are mild and disappear within two weeks. But a small percentage of mothers go on to develop one or more postpartum mood disorders including depression, anxiety, and psychosis.

The good news is that with intervention, women can recover.

This was the case with Julie O’Neill. Shortly after her daughter was born, this mother began experiencing troubling symptoms.

“It started in the hospital when I had problems with breastfeeding, and by the time I got home, I was feeling all the pressures of new motherhood,” she says. “That first week, I was very teary, but I chalked it up to baby blues and thought I’d be OK soon. By week two, I found myself waking up shaking due to panic attacks. I wasn’t able to eat or sleep either. Having been a social worker, I was familiar with the symptoms of depression and knew I needed help.”

“Up to 80 percent of new mothers experience baby blues and have mild feelings of depression, but problems that persist beyond two weeks could be pointing to postpartum depression,” says Janet Brown, a perinatal behavioral health specialist. “And its appearance may be delayed for up to a year after giving birth.”

Dr. Katharine Weymouth, a private practicing psychiatrist specializing in women’s mental health, agrees.

“The symptoms go beyond fatigue, irritability, and difficulty concentrating. That’s considered normal when caring for an infant,” she says. “Postpartum depression can include sadness, irritability, insomnia, fatigue, feelings of guilt or worthlessness, change in appetite or concentration, difficulty enjoying things, and recurring thoughts of harming one’s self.”

In addition to postpartum depression, mothers may experience one or more of the four postpartum anxiety disorders or postpartum psychosis, a rare condition characterized by disorganized thinking, hallucinations, and delusions. With any of these conditions, early detection and intervention is key.

“What many people don’t realize is women are at risk for these conditions while pregnant as well. So I suggest they talk with their doctor before they conceive to avoid potential problems, particularly if they have a history of depression or anxiety,” says Weymouth.

By week’s end, O’Neill had contacted her physician. But the doctor on call phoned in a prescription her insurance wouldn’t cover.

“That Monday, I took myself to the hospital, and they referred me to their Perinatal Behavioral Health Department,” she says. “There I was diagnosed with postpartum depression and anxiety. They put me on medication with continued monitoring and recommended I join the support group offered through the hospital. Six weeks later, I was feeling better.”

For Crystal Lohr, intervention wasn’t immediate, and she suffered severely as a result. A week after giving birth to her daughter, this single mother started having nightmares that left her trembling in sweaty sobs.

“A-year-and-a-half later, I began having painful anxiety attacks that felt like someone was squeezing my rib cage and stabbing me in the heart. I didn’t want to interact with my daughter, either. I would sit and watch her play, but instead of joining in, I’d curl up in a ball and cry,” she says of her now 3-year-old. “I knew I needed help, but I thought I could take care of it myself. On top of that, I was embarrassed and didn’t want anyone to know.”

Then two-and-a-half years later, while taking her daughter for a checkup, Lohr broached the subject.

“I told the doctor I knew I suffered from postpartum depression, and now it had gotten worse. So she asked me, ‘On a scale from one to 10, how happy are you right now — 10 being the happiest?’ I told her ‘three,’ then burst into tears,” she says.

Lohr was diagnosed with anxiety and severe depression that stemmed from postpartum.

“The doctor explained that it’s like a disease and needs to be treated. I started on Citalopram [an antidepressant], and a week later, I was feeling better,” she says.

Treatment options vary depending on the disorder and severity of symptoms.

“Some women do fine with support groups. But others may need one-on-one therapy with a mental health professional to help develop new coping strategies,” says Brown. “Medication may also be administered where symptoms are significant.”

One thing O’Neill found particularly helpful were the support group meetings.

“It was good to be with other moms who were feeling the same way. We connected through our struggles and drew strength from one another,” she says.

O’Neill, in fact, continued to attend meetings even after she had recovered, to encourage other moms, and has since started a second support group that meets at a different location. More recently, she joined the team of Postpartum Support International to work as an advocate for new mothers and their families.

Today, she’s on a mission: “I want to tell mothers that postpartum depression is treatable, and you’re not alone. With the help of support groups, counseling, and medication, it will get better,” she says. “Now that I’m expecting again, I have the tools to get through this, should it happen again.”

Denise Yearian is the former editor of two parenting magazines and the mother of three children.

Updated 4:57 pm, July 9, 2018
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