Difficult Emotions & Postpartum Depression

I Have My “Bundle of Joy,” So Why Am I So Sad?

By Jill Brandl, Psychiatric Mental Health Nurse Practitioner at Bryan Heartland Psychiatry, part of Bryan Physician Network

There seems to be an expectation in our society that new mothers should be super happy with their little “bundle of joy,” yet this is not always the case. Fluctuating hormones and the stress of caring for a new life can leave a woman feeling drained and overwhelmed.

If you’re feeling sad, anxious or depressed either while pregnant or after having your baby, you are not alone! Nearly 1 in 7 women experience difficult emotions during pregnancy or after giving birth. It’s important to discuss this common yet treatable condition called postpartum depression.

What is Postpartum Depression?

The postpartum period is anytime in the first year after having a baby. Yet for nearly 50% of women identified with postpartum depression, these difficult mood symptoms were found to have started during their pregnancy. Mood or behavior changes lasting more than two weeks may indicate the presence of postpartum depression.

If at least five of the following symptoms have been present for two or more weeks, it’s time to seek help. Symptoms may include:

• Sadness or irritability
• Crying spells
• Not enjoying things you once enjoyed
• Feelings of worthlessness or not being good enough
• Blaming yourself unnecessarily when things go wrong
• Low motivation
• Trouble making decisions or concentrating
• Feeling anxious, worried, scared or panicked for no good reason
• Difficulty sleeping even when the baby is sleeping
• Thoughts of wanting to die or thoughts of harming others
• Excessive anxiety about the health of your baby or concern over your ability to care for your baby
• Increased use of alcohol, drugs or tobacco as a way to cope

Who is at risk for Postpartum Depression?

Women may be at risk if they have had:

• Depression in the past
• Postpartum depression with a previous pregnancy and birth
• A family history of postpartum depression
• Little social support from others
• Infants with health problems or infants born prematurely

How is Postpartum Depression treated?

A professional evaluation is important to determine what type of treatment is best, considering each woman’s unique circumstances and symptoms.

Common treatment options:

• Antidepressant medication can be very effective in helping a mom feel like “herself” again. Antidepressants can help decrease or eliminate postpartum depression symptoms, and many are considered safe for the breastfeeding infant.
• Psychotherapy can be very beneficial to provide emotional support and a neutral party to help problem-solve life’s difficulties. Therapy can help with learning healthier ways of thinking and can help one cope with stress.

Based on your symptoms and goals, you and your healthcare provider can determine the best plan for you.

What are the risks of untreated Postpartum Depression?

Left untreated, postpartum depression:

• Impairs a mother’s ability to function at her best
• Can have a negative impact on the mother-infant bonding process, which can have lifelong emotional and developmental consequences for the infant
• Can have a negative impact on the mother’s relationship with her significant other
• Can cause a mother to isolate and not seek out social support or help when it’s most needed

What can I do to feel better?

Balancing the many demands of motherhood is challenging for everyone. Your healthcare provider can offer treatment recommendations for your symptoms to get you feeling like “yourself” again.

Choosing to take good care of yourself is also important. If you aren’t taking care of your own basic needs first, it will be even more challenging to parent. Getting enough sleep, eating nutritious and nourishing foods, getting outside and moving your body in a way that feels good, and seeking out social support are all important.

I’m concerned about my wife or a woman I care about. What can I do to help?

The first step is to listen openly to what she is going through without judgment. Let her know her feelings and struggles are important and real. Gently share your observations, and ask what you can do to help rather than offering advice. Offer to care for the baby so she can take some time to care for herself.

If postpartum depression symptoms are present, reassure her there is no shame in seeking help. Encourage her to seek treatment if symptoms are present. Finally, if you are concerned about her safety or the safety of others, please seek immediate medical attention.

How can I get help for myself or someone I care about?

As a mental health practitioner, I know postpartum depression is real and have witnessed the effects it can have on a mother, her baby and her family if left untreated. I’ve also seen the positive outcomes when a woman seeks help to deal with difficult emotions. I encourage anyone who is experiencing symptoms to reach out for help. It is the first, and most important, step towards getting back to “you” and bringing joy back to your life.

Please consider the following resources if you or someone you know is struggling with postpartum depression: Postpartum Support International (PSI) and Suicide Prevention Hotline (1-800-273-8255).