Postpartum Depression: Understanding the Different Mood Disorders and Knowing When to Seek Help

Postpartum Mood Disorders: Understanding them and knowing when to seek help

About a week after my first baby was born, we were sitting on the couch in our living room and heard a loud noise from outside. Our second-floor apartment overlooked a busy street and when my husband got up to investigate, he saw that a dog had been hit by a car on the street below. He bounded downstairs to help. I stayed put; my newborn daughter resting skin-to-skin against my chest.

Within seconds, I began to shake and sob; my girl’s fuzzy head soaked in a shower of tears. I do love dogs, and it was a horrible scene, but my reaction that day was unusually intense. I was overcome with a flood of extreme emotion. I thought I might hyperventilate. I was in the throes of the baby blues – the most common postpartum mood condition, experienced by approximately 80 percent of mothers during the first two weeks after giving birth.

Symptoms of the baby blues include weepiness, mood swings and trouble sleeping, and usually dwindle after a couple of weeks. But, for as many as one in five women, these and other symptoms persist and become more severe.    

Olivia Scobie is a social work counsellor who specializes in perinatal mood, birth trauma, and maternal mental health. She’s also the founder and executive director of Postpartum Support Toronto, a not-for-profit that provides therapy and solidarity for new parents having a tough time adjusting to life with a baby.

“It's normal to feel exhausted, easily frustrated, overwhelmed, weepy and worried whether or not you are doing everything right in the first six weeks after having a baby,” Olivia says. “It's also normal to feel like your baby is a stranger and for it to take some time to feel bonded to them and confident in caring for them. But if this persists, and you are feeling hopeless or like your life is over, are sick with anxiety and racing thoughts, or are feeling ungrounded or having trouble distinguishing what is real and what is not, it's important to tell someone what you are going through.”

Postpartum depression (PPD) and postpartum anxiety (PPA) are the most common perinatal mood disorders, typically occurring in the early weeks and months after giving birth, though symptoms can begin anytime within the first year. As with many physical and mental illnesses, PPD and PPA symptoms can range from mild and manageable to debilitating.

But before we dive in, let’s first unpack ‘postpartum mood’ and get a good lay of the land – something many new parents, and even some healthcare practitioners, fail to do, simply because collectively we don’t talk about it enough. That’s where we need to start. 

Being a new mom is hard. Being a new parent is hard. Life with a newborn can be demanding beyond measure, when you feel like you’re running on empty. We often talk about the excitement and joy a new baby brings, with an assumption that the experience will be positive and fulfilling. The reality is that many new parents – birthing parents, in particular – feel isolated and overwhelmed, under the pressure of expectations to fall madly in love with their babies and carry on just fine, in a social system that doesn’t provide nearly enough support.

Don’t get me wrong – for many parents, having a baby is a magical, intimate, soul-shaking experience, wrapped up in a big ol’ blanket of love – but that doesn’t make it easy. The weeks and months after giving birth are a hormonal rollercoaster and we’re wading through a metamorphosis of the body, mind and spirit. For first-time moms, it’s stepping into a whole new identity.  

Acknowledging the normal challenges and transitions of postpartum life is vital to creating the safety nets and support new parents need in order to thrive. Though the two are used interchangeably, ‘postpartum’ does not mean ‘postpartum depression.’ All new parents have bad days. We need to be able to recognize when too many of those bad days are signalling something more troublesome.

“The biggest misconception is that feeling down, overwhelmed or anxious means that you’re weak or not a good parent. One in seven parents will struggle with a postpartum mood disorder and it has nothing to do with how good a parent you are - it just means you need more support than you currently have,” Olivia says. “It's also a misconception that only birth parents get postpartum mood disorders. Partners, adoptive and intended parents or surrogates are also at risk. It's often assumed that if you didn't have a postpartum mood disorder with previous children that you won't get it with subsequent children, but every postpartum experience is completely different.”

 

It can be hard to distinguish between Postpartum Depression and Postpartum Anxiety, as they often overlap or co-exist. The symptoms are many, but here's a brief overview of what these mood disorders typically look like:    

Postpartum Depression: You feel overwhelmed, like you can’t cope with motherhood, and guilty for not being good enough. You may feel like your baby would be better off without you. You feel sad, hopeless, disconnected and unable to focus. You may have thoughts of running away and leaving your family behind. You may have a loss of appetite and difficulty sleeping, even when you’re exhausted.

Postpartum Anxiety or Obsessive Compulsive Disorder: You are intensely worried, about all of the things, all of the time. You have frequent disturbing thoughts about ‘what-ifs’ and feel as though something terrible might happen. Your thoughts are racing and you can’t relax, even though you’re exhausted. You may have a loss of appetite and a constant need to be doing something. 

Postpartum Psychosis: If you feel like you’re seeing or hearing things that no one else does, are having thoughts of harming yourself or your baby, or feel like you and your baby are somehow cursed, it is very important to seek help immediately. Your illness can cause you to do to things you wouldn’t normally do, but you can get help. Speak to someone now, or reach free, 24/7 crisis support:

Anywhere in Canada: Call 1-833-456-4566 
Anywhere in the U.S.: Text HOME to 741741
If you need immediate help: Call 9-1-1

 

Thankfully, postpartum mood disorders are, for the most part, temporary and treatable. But asking for help isn’t always easy. “There is still a lot of stigma about having a mood disorder - and it's heartbreaking. There is nothing more innocent that having neurotransmitters that aren't working as effectively as they could be,” says Olivia. “Sometimes nursing parents are hesitant to seek help because they don't want to take medication. There is a lot of misunderstanding about depression and anxiety medication, and medication is only one way to treat a postpartum mood disorder. I encourage parents to seek help even if they are uncertain about the use of medication.

“It can be hard to know if you have a mood disorder or just need more sleep, and sometimes family and friends dismiss symptoms by telling parents to cheer up or think more positively,” she says. “It's really common for parents that waited to get help to say they wished they had reached out right away because they hadn't realized how much better they could feel.” 

Whether it’s your first baby or your fourth, we know that women are particularly vulnerable to mental health conditions during their reproductive years. More and more research shows that postpartum mental illness can persist well beyond one year. As a mother who has lived with mild to moderate postpartum anxiety off and on for more than seven years, I can attest to that.

It’s important to seek out help and find the supports that work best for you and your family, whatever that might look like. It’s naive to think that we can properly care for our kids if we don’t receive the support we need for our own mental health. The effects of untreated postpartum mood disorders can be devastating, not only for the individual experiencing them, but also for their partners and their children. Maternal mental well-being is the foundation of a much bigger picture: Healthy families.

 

Seeking Help:

“The first thing I would suggest is to tell someone you trust, such as a partner, doula, or friend how you have been feeling and ask them to help you get support. Together, you can talk to your family doctor, midwife or OB about how you have been feeling and get properly screened for a postpartum mood disorder,” says Olivia.

She also suggests connecting with your local hospital, as many have programs and services specifically for new parents. You might find support and connection in a community of other parents who have postpartum mood disorders, so search for online or local meet-ups.  

“Often you’ll find a ton of resources and ideas about how other people are managing and getting better, and it's hope-inspiring to hear from others who have come through it successfully,” Olivia says. “If you don't get the support you were hoping for from your medical doctor, book an appointment with a therapist who specializes in postpartum mood. They can help with coping strategies right away and can help you find and navigate local supports.”

 

New parenthood is a beautiful and tough gig. There’s no shame in not being able to do it alone. And there is so much power in letting go of what someone else might think and reaching out for the help you need.   

 

 

How Can I Help?
Here are some tips for supporting a loved one who is struggling with their postpartum mood.

  • Offer to help with household chores, including cooking, laundry and cleaning.
  • Help with childcare. This could include caring for a newborn, or taking older children out for play dates.
  • Check in and really listen to what the individual needs.
  • Acknowledge progress and successes, however small those might be.
  • Accompany them to appointments, and talk to your doctor if you are particularly concerned.
  • Get support for yourself, if needed.

 

LOCAL RESOURCES & SUPPORT:

In Canada: Canadian Mental Health Association

In the US: Mental Health America

  

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Picture of Lindsay Forsey

Author: Lindsay Forsey

Lindsay Forsey is the founder of Tenth Moon Mother Care and The Wellmama Project. She’s a postpartum wellness activist, a mom of two, and a former doula. When she’s not busy bundling up Tenth Moon postpartum care packages for new moms across Canada, you might spot her on TV talking about the fourth trimester, blogging about maternal health or perfecting her "padsicle" recipe.

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