Type A, perfectionist, go-getter, independent, and capable. Confident baby can fit in. Unwilling to update expectations for life, house, and career for anything. It might not sound like you, but it was me. And, without knowing it, all of these things - in combination with hormones and brain chemistry - set me up for postpartum depression in the months after my daughter was born.
Every parent, birthing partner or not, should be aware of the spectrum of postpartum mood disorders, risk factors, and the steps to take if you experience difficulties yourself.
What are postpartum mood disorders?
While conversation around postpartum depression has become more common, there is a range of disorders that can impact the birthing parent or support parent in the year after baby’s birth. These include:
Postpartum post-traumatic stress disorder
Postpartum obsessive-compulsive disorder
Bipolar mood disorder
Each of these can look and feel very different from what you may imagine. I encourage you to read Postpartum Support International’s overview here: https://www.postpartum.net/learn-more/ Roughly 1 in 7 birthing parents will experience a postpartum mood disorder.
Baby Blues: It’s important to mention the baby blues. Up to 80% of birthing parents express some amount of emotional upheaval in the 2-3 weeks after the birth of a child due to huge hormonal shifts. This is normal! The postpartum mood disorders listed above can surface any time in the year after the birth of a baby.
What are the risk factors for postpartum mood disorders?
Studies have shown that there are 9 predictors that can impact the development of postpartum mood disorders.
Mental health struggles during pregnancy
Self-esteem, including but not limited to:
history of eating disorders or abuse
3. Childcare stress
4. Life stress, like:
Traumatic or disappointing childbirth experience
Unresolved losses, particularly reproductive in nature
Illness in self/family
Change in jobs
Change in financial status
5. Social support (or lack thereof, due to family relationships, isolation, or having few or no peers or friends with children)
6. Relationship with your co-parent
7. History of previous mental health diagnoses (in self or family)
8. Infant temperament - colicky, high needs, illness/injury, developmental delays, multiples
9. Baby, or maternity, blues
How can you prepare during pregnancy?
Ask your medical provider what resources might be available that are affiliated with their practice.
Research other local postpartum mood disorder providers (psychologytoday.com is a great resource) and support groups.
Bookmark Postpartum Support International and put their Helpline (available for call or text!) in your phone.
If you’re experiencing symptoms, how do you seek help?
Start with one call. Call the medical provider who oversaw your pregnancy and delivery and see if they can connect you to a mental health professional. If they can’t, call Postpartum Support International at 1-800-944-4773.
Work with a confidant (or reach out to me for a free meeting) to develop a plan to get your basic needs met easily - meals and sleep. A postpartum doula or postpartum volunteer organization can help you here, but - if that doesn’t work for you - this is a time to lean on your partner or call in favors with friends, acquaintances, or your network.
How did my postpartum depression surface?
I didn’t cry in bed all day or sit around, I didn’t want to hurt myself or my baby. I was angry and annoyed. I couldn’t sleep when my daughter slept, or even when I was supposed to. I wanted to be replaced with the old version of myself - she who was not hormonal, sleep deprived, and utterly necessary to a small human. She would have been able to cope with my baby’s crying and nursing difficulties. I didn’t feel this way immediately postpartum, but I felt my lowest, and knew I needed to seek help, when my daughter was 4 months, after I had returned to work.
What were my risk factors?
Looking at the research now, I was a mess of contributing factors! We were isolated from friends and family, having moved cities for my husband’s career. My husband had limited time off and a demanding work schedule. I had been treated for generalized anxiety a few times. We’d been monitored extensively in the third trimester for a potential health issue, and my daughter was taken to the NICU at birth. Last, my daughter had tongue and lip ties (like her dad) and significant feeding difficulties that lasted for 8 weeks.
How did I get help?
Because of my medical history, I anticipated postpartum depression, but I didn’t look into any services before my daughter’s birthday. After I put the pieces together and determined that I needed help, I called my OB/GYN who put me in touch with the hospital’s women’s mental health team. I met with a psychiatrist for therapy, and she prescribed me Zoloft, which allowed me to keep breastfeeding. It was absolutely the right decision for me and my family.
I share my story not as a roadmap, but as one anecdote in case it helps you.
Because so many families I work with have unexpectedly experienced postpartum mood disorders, I've put together a planner to use both before and after birth to prepare for difficulties and help decide when to seek help.
It's something I hope you never need, but it's a must for your fridge.
Get access to the worksheet now!
DONA International https://www.dona.org/
Rai S, Pathak A, Sharma I. Postpartum psychiatric disorders: Early diagnosis and management. Indian J Psychiatry. 2015 Jul;57(Suppl 2):S216-21. doi: 10.4103/0019-5545.161481. PMID: 26330638; PMCID: PMC4539865. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539865/
Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001 Sep-Oct;50(5):275-85. doi: 10.1097/00006199-200109000-00004. PMID: 11570712.