I’m guessing you’ve heard of postpartum depression. Or you’ve at least heard people talk about “postpartum” — as in, “I had postpartum after my second baby” (usually shared in hushed tones — and often not shared at all).
Maybe news broadcasts about people like Andrea Yates have shaped your ideas about postpartum depression — you can’t imagine how someone could get to a place where they’d hurt their children, and that experience feels so far from what you or anyone you know went through after having a baby.
In fact, maybe you even struggled a little — or a lot! — after having your baby, but you didn’t think it was at a level that warranted support. (If that’s you, mama, you’re in really good company.) Here’s the thing: There’s a whole lot most of us don’t know about postpartum depression. Let’s change that! Here are ten lesser-known facts:
1. It’s more than just depression.
What we tend to think of as “postpartum depression” is actually a group of mental health issues called Perinatal Mood and Anxiety Disorders (PMAD’s), which include perinatal depression, perinatal anxiety, perinatal obsessive-compulsive disorder (OCD), perinatal bipolar disorder and perinatal psychosis.
Please know that perinatal psychosis — Andrea Yates’ diagnosis — is extremely rare (affecting one to two out of one thousand perinatal women).
And it’s always an emergency. This is a situation where mom doesn’t seem like herself at all; she’s doing and saying things that are out of character for her, and her reality seems “off” from what’s actually happening around her. She might be having thoughts of harming her baby or herself, and because of the psychosis, these thoughts aren’t troubling to her, and she’s likely to act on them. If this sounds like someone you know, please seek help for them immediately; call 911 or go to your nearest emergency room.
2. You can get it while pregnant.
PMAD’s can affect women at any time during the perinatal period — which begins at conception and lasts through baby’s first birthday — and without appropriate treatment and support, they may persist well beyond the perinatal period. PMAD’s often don’t get better on their own, so even if you’re three years postpartum, if you’re still struggling, please seek help! You don’t have to keep feeling this way.
3. It’s really common.
PMAD’s affect one out of every five to seven women. That’s a whole lot of us suffering — often in silence, and often while feeling very alone, watching all the other moms seemingly making it work and doing just fine. (Hint: Appearances can be deceiving — plenty of people are struggling, but you’d never know it by looking at them.)
4. Partners can get it too.
It’s not just moms who are vulnerable during the perinatal period; partners can get PMAD’s too. One in ten partners will suffer from a PMAD, and a partner’s chances of struggling increase if mom is struggling too. Adoptive parents are also vulnerable to PMAD’s.
5. You can get it with any pregnancy.
Even if you’ve been pregnant and/or given birth before without any difficulties, you’re vulnerable to PMAD’s with each pregnancy. Some people struggle for the first time with their fourth child!
6. You can get it after a miscarriage.
In fact, women are even more vulnerable to PMAD’s after a miscarriage or stillbirth because the hormonal shifts associated with pregnancy and postpartum are exacerbated by grief, which in and of itself is often intense and overwhelming.
7. It can be life-threatening.
Untreated PMAD’s can leave a person vulnerable to suicide. And given the nature of PMAD’s and the frequent and sometimes intense hormonal shifts associated with the perinatal period, a person can shift into dangerous territory quickly, and sometimes without a lot of warning. Please always take it seriously if a new parent talks about self-harm, even in a more off-handed way, like saying “my family would be better off without me” (which is absolutely untrue!).
If you’re having thoughts of harming yourself — or if someone you know is having thoughts of harming themselves — please get help: Call 911, go to your nearest emergency room, or call the National Suicide Prevention Lifeline at 1-800-273-8255.
8. It’s not your fault.
You didn’t do anything wrong, and you’re not a bad parent. Let me repeat that: PMAD’s aren’t your fault, and you’re a good parent — the absolute right parent for your baby. And while there are risk factors (like a personal or family history of depression or anxiety) that increase your chances of developing a PMAD, please know that PMAD’s don’t discriminate; they occur across cultural, socioeconomic, educational, and racial groups.
9. You might feel okay some of the time and still have it.
PMAD’s can look and feel different from person to person — and even from day to day. Some days you might feel okay, and other days the anxiety or sadness or upsetting thoughts might feel completely overwhelming, like you’re drowning. Please know that you don’t have to be in complete despair to get help! It’s okay to reach out, even if you feel fine some days.
10. There IS help, and you CAN feel better!
The good news is that PMAD’s are so very treatable! With therapy, social support, and sometimes medication, you can feel better. If you’re struggling, even some of the time, please reach out to your provider (your OB, midwife, family practitioner, or your baby’s pediatrician) or a therapist near you. Check out Postpartum Support International (PSI) for a list of PMAD-trained therapists near you, or call PSI’s help line at 1-800-944-4773, and someone will get back to you within 24 hours.
PLEASE SEEK HELP for any of the following symptoms:
anxiety and/or panic
difficulty sleeping when baby sleeps
upsetting thoughts that you can’t get out of your mind
changes in appetite
regrets about becoming a parent
difficulty bonding with your baby
feeling as if you’re “going crazy”
thoughts of hurting yourself or others
Some of these symptoms can be normal in the first two weeks after baby’s birth (i.e., the “baby blues”), but after that, they signify a problem for which help is warranted. (ALWAYS seek help if you have thoughts of hurting yourself or your baby, even in the first two weeks.)
Dr. Hilary Mandzik is a Licensed Psychologist serving Cary, NC and the Triangle area. She provides therapy and support for new parents who are struggling and offers flexible scheduling options — including in-office therapy sessions in Cary, in-home therapy, online therapy throughout NC and VA, and walk-and-talk therapy — to make it easier for new parents to get the help they need. Click here or call 919-344-1296 to schedule a free 15-minute phone consultation to see if working together is a good fit for your needs.