Pregnancy/Baby
Postpartum Depression Can Affect Any New Mother
By Susan Detrick-Atchley
June/July 2002

I seemed OK, despite being sleep deprived and having some seriously bad hair days. The baby was about six weeks old, sweet and calm, unlike my first child. I was holding my son on my lap when my husband looked in my eyes and said "Something's wrong." He was right. Everything was fine, and I loved our new baby fiercely, but the rest of the world had gone completely flat. It was as if someone had turned off a switch in my heart, and while I knew what I should be feeling, I wasn't actually feeling much besides sadness.

I think I knew, before my husband spoke up, what was wrong. I had postpartum depression (PPD), and as it turns out I was a textbook case. The depression hit suddenly, without an identifiable cause, and within my son's first year. It was my second experience with motherhood, which, according to some, is actually the more common time to get depressed.

Of course I've had the "baby blues" as they call it, the tears bursting forth at the sight of a tiny sock or at the improper loading of the dishwasher. The baby blues is a relatively brief reaction that occurs usually within a few days of giving birth and hits from 50 to 80 percent of all mothers. It is the most common form of postpartum reaction, causing sudden crying, irritability, restlessness and anxiety. This period of emotional hyperarousal is thought nowadays to be an essential component of mother-child bonding, not a mood disorder. It usually departs as quickly as it comes.

What I was experiencing after the birth of my son went deeper than baby blues. Postpartum depression is indeed a profound disorder, with symptoms such as fatigue and exhaustion, sadness, appetite and sleep disturbances, poor concentration, memory loss, overconcern for the baby, uncontrollable crying, guilt, lack of interest in the baby, fear of harming the baby or yourself, exaggerated highs and/or lows, lack of interest in sex, and intrusive thoughts. For me, the problem was plain old sadness, but a sadness that seemed to stand between me and the world and set me far apart. It was a sadness that brought tremendous guilt - guilt that I was unhappy although our baby was healthy, guilt over what my sadness could do to our children.

Postpartum depression can look different from one woman to the next, and from one day to the next. Women with a previous history of depression are more at risk for PPD than those without this history, but any woman who is pregnant, has had a baby within the past year or miscarried, had an abortion or interrupted pregnancy, or recently weaned a child from nursing can experience a postpartum disorder regardless of how many uncomplicated pregnancies she has had in the past. The common theme among women who have this sort of depression is the sense that it is a feeling unlike anything they have had before, and it makes it difficult for them to function.

Tracy Harper, an area mom, shared her experience with me: "In the beginning, I didn't want my baby. I cried all the time. I didn't want to eat. I lost a lot of weight really fast. I wanted to go back to being pregnant, not being a new mom. The responsibility was so overwhelming. My husband and I both knew it was PPD."

Another Athens mom recalls her depression setting in before her child was born: "I remember just being so alone. I know pregnant women cry a lot, but it seemed I cried A LOT." Her depression went away, but returned after the baby was born, and she remembers, "I couldn't keep up with the house. When the baby was crying (which seemed like always), I couldn't deal with that. My husband did nothing the way I wanted him to. I felt horrible bodywise. I couldn't stop crying. Nothing I did was right, and I could do nothing."

It is worth mentioning that postpartum reactions can take other forms than depression. Some women with PPD have feelings of anxiety that amount to a panic disorder, characterized by intense fear, rapid breathing, palpitations, hot or cold flashes, shaking, dizziness, chest pains, insomnia, and feelings of wanting to "run away." Others may even show signs of postpartum obsessive-compulsive disorder, with intrusive or repetitive thoughts and anxiety. A very small number of women, about one in one thousand, experience the exaggerated and severe symptoms of postpartum psychosis and require immediate treatment.

The good news about the baby blues and postpartum depression is that both have relatively high rates of successful treatment. For a simple case of baby blues, all you may need is time and sleep to get past the feeling and put it behind you. For more serious postpartum reactions, the best treatment plan begins with a medical evaluation. Dr. Margaret Cramer of Athens Women's Clinic notes that PPD is "more common than most people think," and if you even suspect there is depression beyond baby blues, it is best to check with your doctor right away. She reports that in many cases, a mother's response to simple questions at the follow-up visit gives her an idea of whether or not her patient is depressed. Dr. Cramer explains that the postpartum period is a time of "incredible disruption," physically and emotionally. Hormones are unbalanced, neurotransmitters are in flux, and seratonin levels are unstable as well. Add to this the adjustment of a new child and the lack of sleep, and it is not hard to understand why PPD is a part of life for some women.

Some women I spoke with said they just "snapped out of it" at some point during their baby's first year. Others sought medical help and some of those began taking antidepressants like Prozac, Zoloft, Paxil or Celexa (SSRIs) and found it really helped. Some turned to a group of fellow mothers at the Athens Mother's Center.

My own treatment plan consisted of an appointment with a counselor, which turned into regular sessions that helped me to talk through my feelings and reframe them. The depression waned and left me after two months, but I liked the counseling and stayed on a while (what new mom turns down someone who will listen to her complain?). Angel Davis, a counselor familiar with PPD, stresses that postpartum reactions have "no reflection on who [women] are, their capability as mothers, or how much they love their children." Rather, seeking help can be the best act of mothering a woman can perform. Davis agrees that "a lot of it is just having an objective person looking at things, someone whose feelings they don't have to worry about hurting."

All the women I spoke with for this article, doctors, counselors and moms alike, stressed the importance of taking postpartum depression seriously Each one also wanted to emphasize that PPD is, as Dr. Cramer puts it, "a real thing, a legitimate thing."

I found that once I began to talk about the experience, the PPD support group was all around me in the women I knew. Some friends had experienced postpartum depression and encouraged me greatly with their ways of coping. I realized then that I was neither more nor less than normal, and that having gone through PPD did not exclude me from being a cool mom.

I know that some people will read this article and remark to me that I don't seem "the sort of person to get depressed." Of course that would be wrong. No one can predict exactly who will end up with PPD. It does not indicate weakness or point out unfit mothers. I can only describe it as a condition that comes with the territory for some of us. Ultimately we handle it as best we can, and then hopefully wave goodbye to it and move on.

Susan Detrick-Atchley is a mother of two living in Watkinsville.