This has been a post I’ve been meaning to write for a long time, I just haven’t known where to start. But sometimes starting a post is a matter of putting my butt in a chair and my hands on a keyboard.
We don’t like to talk about depression as a society. We talk about it in quiet places, in shadowy spaces and in clinic offices. We talk about it in shame and secrecy. And the shame and secrecy around depression is a significant contributor to the tragedy of suicide.
Postpartum depression (PPD) is a little different. We talk about postpartum depression but it’s a token effort. PPD screenings happen at your two and six week checkup, and if you have my daughter’s pediatrician you’ll be filling out a postpartum depression screening questionnaire up until her six month visit.
It’s great that society is taking it is trying, but for many women postpartum depression doesn’t even begin until six months after the birth. Some women don’t experience symptoms until late into the first year. This is well after screening has ended.
There is a significant difference between the “baby blues” and postpartum depression and knowing the difference can be a matter of saving your life.
The Baby Blues
The period immediately after birth is a hurricane of hormonal changes, and with that comes the potential of emotional instability. The American Pregnancy Association states that up to 75% of mothers experience baby blues. Some estimates are as high as 80%.
The Baby Blues are characterized by:
- mood swings (“I’m so happy to be a mother” levels of elation to “I don’t think I can to this, I’m a terrible mother” levels of depression in the blink of an eye)
- feelings of frustration, irritability and anxiousness
- feelings of being overwhelmed
- feelings of sadness or weepiness
- difficulty sleeping (beyond having a new baby)
- loss of appetite
- changes to eating or sleeping patterns
These things are all incredibly common. You just went through a huge change and your body and brain are adapting. Make sure to talk to your friends, your family, your care providers and your partner. They’re all there to help you through this and they all understand.
Coping with the baby blues is a matter of having patience with yourself, utilizing your care team and taking things one step at a time. Eat well, rest up and spend some time bonding. You can do this!
Would you like specialized support? Postpartum Support International offers a “warmline”. Get more information through the button below.
Postpartum depression (sometimes called postnatal depression) is less common than the baby blues and in many cases more serious.
Postpartum depression can occur for up to one entire year after the birth of your baby but the most basic postpartum depression screening in the US ends at your baby’s six month checkup. Your postpartum depression screening ends at your six week checkup.
What this system communicates to women is that their risk for postpartum depression ends at six months (or even six weeks) after the birth and that’s just not true. In fact, postpartum depression can be defined as any depression symptoms that begin up to one year after the birth.
Here’s another surprising fact about postpartum depression – it occurs in men at the same rates as in women. And dads aren’t getting screened at all.
Symptoms of postpartum depression include many of the same symptoms of baby blues but continue past two weeks postpartum. They also include more severe symptoms such as:
- having absolutely no interest in the baby
- feelings of sadness and hopelessness
- trouble eating or sleeping that interferes with your quality of life
- withdrawing from friends and family
- loss of interests in things you used to enjoy
- lack of energy
- low self-esteem
- thinking you’re not cut out to be a parent/won’t be able to properly care for the baby
- thoughts of harming the baby*
- thoughts of harming yourself*
These last two are emergency situations. Call 911 or the National Suicide Lifeline. You can get help.
All of these symptoms are things that should be discussed with your midwife, your primary care provider or a therapist.
One of the best coping mechanisms for postpartum depression is to talk with your partner, because chances are you’re not alone in this. And having a partner who gets it will get you both through this better.
You do not need to be on the verge of suicide to ask for help. Call your midwife, your therapist, your doctor, your friends or click the link below to talk to a crisis management volunteer.
Postpartum psychosis (or puerperal psychosis) is a relatively rare but serious condition. It only occurs in 1-2 out of every 1,000 pregnancies, but unlike the baby blues or postpartum depression, PPP or postpartum psychosis requires an immediate intervention by your care team. You can’t white knuckle your way through PPP.
Unlike with the baby blues or postpartum depression, PPP comes on like a lightning strike. Within the two to three weeks after a birth a mother begins experiencing:
- laughing and crying abnormally
- being unable to calm or an inability to be reasoned with
- loss of inhibitions
- bizarre behaviors
- hallucinations or delusions
- rapid mood swings
- suicidal thoughts
- thoughts of harming the baby
- loss of consciousness*
* These conditions are part of the Traditional Chinese Medical pattern diagnosis, which include all other symptoms as well
The treatment for PPP is psychiatric care. Full stop. End of story. PPP is an emergency condition and unless an acupuncturist is part of your care team and you have already started your care plan with your primary care providers, it is outside our scope of practice.
PPP is an emergency condition and very serious. If you or your partner are showing any signs of PPP contact your medical team immediately.
If you are having thoughts of harming yourself call 911 or click below to immediately contact the suicide prevention lifeline.
It’s not you, it’s your brain
I’ve talked before about internalization versus externalization. In my process praise blog post I talk about the difference between shame and guilt being “I am” versus “I did” (thank you, Brenee Brown). That same process of externalization is applicable here.
You are you. You are your consciousness. We don’t have to get super metaphysical here but depending on your philosophy, you are your soul, you are the sum of your thoughts, or maybe you’re part of a greater consciousness. You exist in your body, but your body is separate.
You are not your neurochemicals or hormones.
Your neurochemicals are what causes the baby blues, the depression, or the psychosis. You are not depression, you have depression. You are not bad, you are not wrong and you are not broken. You have a neurochemical or hormonal imbalance and this differentiation is key. It’s a lot easier to face fixing a physical problem than to attempt to fix You.
Find someone to talk to about this. Talk to your doctor. Talk to your midwife. Talk to your friend. Heck, talk to me.
There are so many other people on this planet who understand. They’ve been through it, seen friends or patients through it, or are going through it themselves.
So wherever you are on your journey, always remember:
You don’t have to do it alone.
Disclaimer: I am an acupuncturist in the state of Minnesota, and the information falls within my scope of practice in my state. However, unless I have directed you here as your homework I am probably not your acupuncturist. The information in this post is for general purposes only and does not constitute medical advice. As always, check with your own acupuncturist or primary care provider before making any lifestyle changes. This post does not create a patient-practitioner relationship and I am not liable for any losses or damages resulting or relating to the content in this post.
Resources and links
National Suicide Lifeline or call 1-800-273-8255
Postpartum Support International – Warmlime
American Pregnancy Association – Postpartum depression
The National Institute of Mental Health’s Postpartum Depression Facts
A study on Paternal Postpartum Depression
Jessica Gustafson is a licensed acupuncturist in St Paul, MN specializing in women’s health and fertility. She loves working with patients through the Health Foundations Birth Center on Grand Avenue in St Paul as well as doing home visits in the Twin Cities area. Check out the services page for more information!
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