Postpartum Depression Impacts Everyone, Not Just Mothers
September 07, 2022
Angela Kuntz, MD, Medical Director of Admissions & Women's Psychiatry
Postpartum Depression (PPD) has been increasingly studied, and new treatments have been developed in recent years. However, it still remains stigmatized and under-recognized given the incorrect assumption that parents should be happy following the birth of a healthy baby. Postpartum depression can impact anyone, and can be exacerbated by a variety of factors, including hormonal changes, sleep deprivation, stressors that accompany life with a newborn, pre-existing mental illness, among other factors. This article will define what postpartum depression is, who it impacts, common misconceptions, and resources/treatment options for postpartum depression. If you or a loved one is struggling with symptoms of postpartum depression or anxiety, there is hope.
What is Postpartum Depression?
Baby Blues vs PPD
“Baby blues” is estimated to impact up to 80% of women in the first two weeks following birth, and typically presents as mild mood swings, anxiety, and weepiness. Symptoms often peak 4-5 days postpartum and resolve within two weeks (3). Rapid hormone shifts associated with birth and other life changes related to taking care of a newborn can contribute to “the baby blues”. This phenomenon does not affect a parent’s ability to function and resolves on its own without medical interventions.
Postpartum depression occurs up to one year following birth and impacts around 15% of child-bearing persons (while around 10% can become depressed during pregnancy) (1). However, the prevalence of PPD in developed countries did increase during the pandemic, according to some studies. Notable features of PPD might include feeling sad or tearful, feelings of guilt or shame, low interest in activities that were previously enjoyable, feelings of worthlessness, sleep disruption, increase or decrease in appetite, feeling easily irritable or angry, difficulty bonding with the baby/lack of interest in the baby, thoughts of harming the baby or thoughts of harming oneself. (1) Postpartum depression also can frequently present with anxious, intrusive thoughts of something bad happening to the baby (or a parent may be separately diagnosed with a postpartum anxiety disorder).
Who Does Postpartum Depression Affect?
Contrary to popular belief, postpartum depression can impact not only the mother/ child-bearing individual, but there have also been studies demonstrating postpartum depression in 1 in 10 fathers and postpartum anxiety disorders in almost 1 in 5 fathers (1). Queer and trans families are also at risk for perinatal mood struggles, and may be at higher risk due to stigma, discrimination, complications with conception/ adoption, and other factors (1). In addition, adoptive parents are not immune to development of depression, and rates are similar to those in birth parents (1).
How to Treat Postpartum Depression
Many OB and pediatrician offices now screen all women for signs of postpartum depression with a simple questionnaire called the EPDS or Edinburgh Perinatal Depression Screen.
What is the Best Treatment for Postpartum Depression?
The most appropriate treatment plan will be individualized and discussed with a healthcare provider, but may include options including therapy (Interpersonal Therapy and Cognitive Behavioral Therapy have been shown to be effective in treating PPD), medications (such as antidepressants, anti-anxiety agents, mood stabilizers), or a combination of both therapy and medication. For appropriate patients, a newer 60-hour infusion treatment called “Zulresso” has been approved for the rapid treatment of postpartum depression. Other forms of treatment may be appropriate depending on symptom severity.
Who to See For Postpartum Depression
It is important to know when and how to seek treatment when you or a loved one may need it. You should schedule an appointment with a psychiatrist, primary care doctor or OB-GYN when symptoms/ the “baby blues” have lasted more than 2 weeks, when the symptoms are so disruptive the parent is unable to fully function in their daily tasks or when the EPDS score is greater than 10 - 12 points.
If a parent is having thoughts of harming them self or anyone else, including the baby, or there are any signs of postpartum psychosis (symptoms of which may include hearing voices or developing abnormal beliefs, sometimes about the baby), it is important to seek emergency treatment by calling 911 or going to the Emergency Department. Postpartum psychosis is a rare condition but typically occurs within the first 2 weeks postpartum and can be more common in women with a history of bipolar disorder.
Knowing the signs and symptoms of postpartum depression can be the first step in healing. If you or someone you love is struggling, it is vital to remember you are not alone, there is help and asking for help is okay and most importantly you can get better.
Common Misconceptions of PPD
Pregnancy is protective against development of mood disorders.FALSE - studies have demonstrated that pregnancy and the postpartum period do not show a decrease in frequency of mood disorders compared to other times in a parent’s life, and depending on several factors, may be a time of higher risk for new onset or relapse of psychiatric illness. (2)
Using medications or other treatments in pregnancy is unsafe.FALSE - though this should always be an individualized risk-benefit discussion between a patient and their physician (usually a Psychiatrist or OB-GYN), many treatments are considered safe during both pregnancy and breastfeeding. For some parents, the risks of untreated depression and anxiety during pregnancy and postpartum can far outweigh potential risks associated with treatment.
If I develop postpartum depression or anxiety, I am not a ‘good enough’ parent.FALSE - the development of mood symptoms is not a sign of “weakness” nor evidence of one’s ability to parent. Most importantly, postpartum depression is very treatable.
Postpartum Depression Resources
• Any OB-GYN, Psychiatrist or Primary Care Provider
HopeWay Psychiatry & Associates also plans to start a postpartum support group in the upcoming year! More information to come.
2. Mood and Anxiety Disorders During Pregnancy and Postpartum by Lee S. Cohen, M.D. and Rita M Nonas, PH.D.
3. MGH (womensmentalhealth.org)
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