How huge is the number? It could be about one in seven new moms, according to Aimee Danielson, director of the Women’s Mental Health Program in the department of psychiatry at MedStar Georgetown University Hospital. However, she added, we need to think even wider than just postpartum depression, because many women actually start to become depressed during pregnancy. And depression is often only a part of it. What many call the joy of pregnancy and new motherhood can also be a time for obsessive-compulsive disorder and anxiety and panic disorders for many mothers and mothers-to-be.
About 50 percent of postpartum depression cases go untreated and unrecognized, Danielson said. “There’s a tendency for mothers to suffer in silence. Mothers dismiss and minimize the difficulty . . . There’s shame and stigma — it seems like everyone else is doing okay,” she said.
And so seeing a celebrity suffer from and talking about postpartum depression makes it less stigmatized.
Many women suffer from some variation of what is referred to as baby blues. And no wonder: you get home from the hospital, you’re exhausted, overwhelmed, feel horrible and this new little being keeps waking you up, needing to feed, crying. You’ve never been so emotionally or physically challenged, and you can’t just take a day off. No wonder we cry and feel hopeless or anxious at times.
But the difference between baby blues and depression is stark. The blues strike about 85 percent of new moms, Danielson said, but women get better in two to three weeks. Postpartum depression continues — and gets worse.
Symptoms for postpartum depression include depressed mood, anxiety and mournful feelings. Some women will say they don’t feel depressed, they feel terrified. The disorder can be a clustering of “mood instability,” Danielson said. Women may have a diminished or absent bond with their baby. There might be thoughts of death or intrusive images hurting themselves or their baby. They may have sleep problems where, even though they are exhausted, they can’t fall into a deep sleep. They may have difficulty breastfeeding or connecting with their partner.
(Also to note: Postpartum psychosis is another very dangerous issue, but thankfully much less prevalent. “It’s extraordinarily rare, but extraordinarily dangerous,” Danielson said. Most episodes begin 48 to 72 hours after giving birth and can include hallucinations, sleeplessness, profound guilt and feelings of worthlessness. If there is any thought that this might be going on, it’s important to get the mother immediate hospitalization.)
Untreated postpartum depression can last for months or even longer. It can start right after birth, or may begin later, like 6 months after birth.
Luckily, many doctors now ask about moods and feelings at the first check up to see if there might be anything to be concerned about. But that typically only happens at the six-week appointment, and “if we don’t catch her and refer her for treatment then, that opportunity is lost,” Danielson said.
Treatment typically includes medication or therapy, and is often successful, which is the key message to get across to new moms and their partners. “One of the reasons I love this work,” Danielson said, “is that there’s a lot we can do about this, and women get better.”
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