For the past decade, public awareness of postpartum depression (PPD) has dramatically increased, thanks largely to the testimony of numerous celebrities and countless others.
But PPD is not a new problem. In fact, PPD was first recognized nearly 2,500 years ago by the father of modern medicine, Hippocrates.
For some women, PPD may be caused by rapidly falling estrogen levels, which naturally occur following delivery. Occasionally, inflammation of the thyroid gland following delivery, called postpartum thyroiditis, may cause PPD.
There is often no clear hormonal cause of PPD. Instead, PPD may be triggered by stressors that frequently accompany childbearing, including unplanned or unwanted pregnancy, poor social support, severe sleep deprivation, difficulties in breastfeeding and other parenting issues.
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There is, in fact, no time in a woman’s life when she is at higher risk for depression than the postpartum period. PPD affects 10 to 20 percent of adult women and one-fourth of teen mothers. Among women who become depressed, about one-half experience their first episode during the year following delivery of a child.
PPD is not only common, but it takes a tremendous toll on both mother and child. Besides the symptoms of depression, women with PPD suffer from greater social isolation and marital discord, and have poorer bonding with their infants. As early as 3 months, the babies of depressed mothers are fussier yet less responsive to their mothers. As they age, children of depressed mothers are more vulnerable to anxiety, depression and low self-esteem. They struggle with poor self-control and may have difficulty maintaining friendships with other children.
Fortunately, there is help for women suffering from PPD. The first line of defense is peer support, provided by Postpartum Support International and similar organizations offering support groups and educational resources. In addition, psychotherapy, especially interpersonal therapy and cognitive-behavioral therapy, offer reliable relief from mild to moderate PPD. These therapies may be provided to the new mother alone or as couple’s therapy.
Finally, when the symptoms of PPD are more severe, antidepressant medicines may be considered. Several antidepressants have been shown to be effective and reasonably safe during the postpartum period, even when taken by breastfeeding mothers.
If you suspect you or a loved one are suffering from postpartum depression, contact your doctor. With the right medical support, you can more fully enjoy the early days of motherhood, as well as create a healthier long-term environment for your whole family.
Dr. Jeff Newport is a psychiatrist and director of Women’s Reproductive Mental Health at the University of Miami Health System. To learn more, visit umiamihospital.com/specialties/psychiatry.