Motherhood – we romanticize it and expect each new mother and baby to bask in its golden glow. But for one in seven mothers, depression and anxiety during pregnancy or baby’s first year are an unexpected and unwelcome part of becoming a mom.
What are postpartum depression and anxiety? What are the symptoms and causes? How are they different from the “baby blues”?
While approximately 80 percent of moms experience the blues during the first two to three weeks after birth, the mood swings, crying spells, general sadness, irritability, appetite problems, anxiety or difficulty sleeping that are part of this normal adjustment period generally resolve without any medical assistance.
Telling the difference between the natural overwhelming feelings that come with motherhood and symptoms of depression or anxiety that require intervention is tricky. Many women try to ignore or hide their feelings. They may feel ashamed or guilty, not understanding that they are going through the most common complication of pregnancy. Not knowing this is highly treatable, new moms suffering from a perinatal mood and anxiety disorder may be tormented by thoughts such as “I’m weak,” “I’m going crazy,” “I’m not a good mother,” or “Seeking help is a sign of failure.”
Another complication is that no two situations look alike. Some new moms may feel irritable and overwhelmed; some bond with their babies while others feel distant or even fearful; some moms are sad and teary; some may sleep more than usual, while others struggle with insomnia.
Pediatricians are now encouraged to routinely screen moms for perinatal mood and anxiety disorder during well-baby checks at two, six and 12 months post-delivery. A useful online self-diagnosis tool can be accessed at psychology-tools.com/epds.
Symptoms of depression and anxiety
Depression symptoms can start anytime during pregnancy or the first year following birth and may include:
• Feelings of anger or irritability
• Lack of interest in the baby
• Appetite and sleep disturbances
• Crying and sadness
• Feelings of guilt, shame or hopelessness
• Loss of interest, joy or pleasure in things you used to enjoy
• Possible thoughts of harming the baby or yourself
If untreated, postpartum depression can last for months or even longer.
Symptoms of anxiety during or after pregnancy include:
• Constant worry
• Feeling that something bad is going to happen
• Racing thoughts
• Disturbances of sleep or appetite
• Inability to sit still
• Physical symptoms such as dizziness, hot flashes and nausea
Sometimes symptoms of anxiety are experienced alone, and sometimes they occur along with depression.
What causes these illnesses? There is no single cause, and symptoms result from a combination of psychological, social and biological stressors.
Risk factors include:
• A personal or family history of depression, anxiety or postpartum depression
• Lack of support in caring for the baby
• Financial or marital stress
• Complications in pregnancy, birth or breastfeeding
• A major life event such as loss of a loved one, moving, job loss or an unplanned pregnancy
Also at risk are women who give birth to multiple children, have a thyroid imbalance or form of diabetes, undergo infertility treatments or whose babies spend time in a neonatal intensive care unit.
What to do? If after two weeks the symptoms do not subside, seek help and support.
Ante- and postpartum depression and anxiety are temporary and treatable with professional help. Talk to your personal physician or pediatrician. Ask for a referral or seek out a therapist who is familiar with perinatal mood and anxiety disorder, because talk therapy is effective on an individual or group basis.Medication that doesn’t interfere with breastfeeding is available.
Support groups focused on helping women cope with postpartum difficulties may reduce feelings of isolation and shame, normalizing this common experience. El Camino Hospital’s Maternal Outreach Mood Services program is a local resource for expectant and new mothers.
If you suspect that you may be suffering from one of these common complications of child bearing, know that it is not your fault and you are not to blame. Admitting that there may be a problem is the most important step a mother can take for herself and her family.
Nancy Andersen, a licensed Marriage and Family Therapist, helps individuals and couples using emotionally focused therapy in her Loyola Corners office in Los Altos. For more information, call 833-9574 or visit nancyandersenmft.com.