Know when—and how—to reach out.
By Rachel Grumman Bender, Self
Like a lot of women with postpartum depression, model and cookbook author Chrissy Teigen never thought it would happen to her.
[post_ads]But after her daughter Luna was born in April 2016, Teigen didn't feel like herself. "Getting out of bed to get to set on time was painful," she wrote in a candid essay she penned for Glamour. "My lower back throbbed; my shoulders—even my wrists—hurt. I didn’t have an appetite. I would go two days without a bite of food, and you know how big of a deal food is for me. One thing that really got me was just how short I was with people."
She added: "I couldn’t figure out why I was so unhappy."
After months of debilitating fatigue, crying jags, and not leaving her couch for days at a time, Teigen, with her husband John Legend by her side, went to her general practitioner, who diagnosed her with postpartum depression and anxiety.
Teigen is far from alone. About 9.8 percent of new mothers experience postpartum depression, according to the most recent data from the Centers for Disease Control and Prevention. The condition is hallmarked by anxiety, crying, irritability, loss of appetite, and withdrawing from family, friends, and activities you used to love.
Postpartum depression lasts longer than the baby blues (feeling teary or irritable during the first week or two after birth), and the symptoms are often more severe, Sue Varma, M.D., a psychiatrist practicing in Manhattan and clinical assistant professor of psychiatry at NYU Langone, explains to SELF. The mood disorder can start days or even months after having a baby, and if left untreated, it can last for several weeks or months, according to the American Psychological Association. (Some women experience depression during pregnancy, which is known as prenatal depression, notes Dr. Varma.) That's not only difficult for a new mom to endure, but in some—though not all—cases, postpartum depression can also affect mother-baby bonding.
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So how do you know if you're at risk for postpartum depression and what steps can you take to minimize the likelihood of having it? Dr. Varma, along with clinical social worker Karen Kleiman, the founder and director of The Postpartum Stress Center in Pennsylvania, share the best strategies for preventing the condition.
There’s no one sure way to prevent postpartum depression, but these steps might help. "Remember that even when women take steps to protect themselves, they can still experience depression and anxiety," Kleiman notes. "But preparing for it will likely reduce its impact and help them feel more in control if symptoms emerge."
Like a lot of women with postpartum depression, model and cookbook author Chrissy Teigen never thought it would happen to her.
[post_ads]But after her daughter Luna was born in April 2016, Teigen didn't feel like herself. "Getting out of bed to get to set on time was painful," she wrote in a candid essay she penned for Glamour. "My lower back throbbed; my shoulders—even my wrists—hurt. I didn’t have an appetite. I would go two days without a bite of food, and you know how big of a deal food is for me. One thing that really got me was just how short I was with people."
She added: "I couldn’t figure out why I was so unhappy."
After months of debilitating fatigue, crying jags, and not leaving her couch for days at a time, Teigen, with her husband John Legend by her side, went to her general practitioner, who diagnosed her with postpartum depression and anxiety.
Teigen is far from alone. About 9.8 percent of new mothers experience postpartum depression, according to the most recent data from the Centers for Disease Control and Prevention. The condition is hallmarked by anxiety, crying, irritability, loss of appetite, and withdrawing from family, friends, and activities you used to love.
Postpartum depression lasts longer than the baby blues (feeling teary or irritable during the first week or two after birth), and the symptoms are often more severe, Sue Varma, M.D., a psychiatrist practicing in Manhattan and clinical assistant professor of psychiatry at NYU Langone, explains to SELF. The mood disorder can start days or even months after having a baby, and if left untreated, it can last for several weeks or months, according to the American Psychological Association. (Some women experience depression during pregnancy, which is known as prenatal depression, notes Dr. Varma.) That's not only difficult for a new mom to endure, but in some—though not all—cases, postpartum depression can also affect mother-baby bonding.
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So how do you know if you're at risk for postpartum depression and what steps can you take to minimize the likelihood of having it? Dr. Varma, along with clinical social worker Karen Kleiman, the founder and director of The Postpartum Stress Center in Pennsylvania, share the best strategies for preventing the condition.
There’s no one sure way to prevent postpartum depression, but these steps might help. "Remember that even when women take steps to protect themselves, they can still experience depression and anxiety," Kleiman notes. "But preparing for it will likely reduce its impact and help them feel more in control if symptoms emerge."
If you have a history of depression or anxiety, you’re at a higher risk for postpartum depression. Make sure your ob/gyn knows about your mental health history so you can come up with a game plan together.
Any woman can develop postpartum depression, but there are some who are at a particularly increased risk both during and after pregnancy—namely, women who have a personal history of depression or anxiety, a family history of depression or anxiety, and a lack of support.
Dr. Varma explains that women with a history of depression are likely more at risk for postpartum depression because of their brain chemistry. "In depression, we have negative, pessimistic thinking," she says. "Depressed folks have a tendency to perceive things negatively, which can exacerbate conditions."
If you’re especially afraid of giving birth, it’s also a good idea to talk with your ob/gyn about postpartum depression. A 2014 study of more than 500,000 mothers published in BMJ also shows that women who don't have a history of depression but have fears about giving birth are about three times more likely to develop postpartum depression compared to women with no history of depression. "It could speak to a generalized anxiety a woman may have, which could put her at more risk for worsening anxiety later, and generalized anxiety disorder (GAD) is often co-occuring with depression," Dr. Varma says.
[post_ads]Dr. Varma notes that GAD is not to be confused with the normal anxiety that comes with being a brand-new parent and all of the responsibilities that go along with it. "With child care, going back to work, balancing it all—a normal level of anxiety is expected,” she explains. “But with GAD, there are six months or more of worrying about a wide range of things—motherhood wouldn't be the only issue—and it interferes with sleep, mood, and concentration."
If you have a history of depression or an anxiety disorder, make sure your ob/gyn knows about it. Also, let him or her know if you have close relatives such as your mother, father, or siblings, who have a history of depression or anxiety. By giving your doctor the head's up, your healthcare provider can help come up with an intervention plan ahead of time, such as counseling, cognitive behavioral therapy, or joining a support group.
Any woman can develop postpartum depression, but there are some who are at a particularly increased risk both during and after pregnancy—namely, women who have a personal history of depression or anxiety, a family history of depression or anxiety, and a lack of support.
Dr. Varma explains that women with a history of depression are likely more at risk for postpartum depression because of their brain chemistry. "In depression, we have negative, pessimistic thinking," she says. "Depressed folks have a tendency to perceive things negatively, which can exacerbate conditions."
If you’re especially afraid of giving birth, it’s also a good idea to talk with your ob/gyn about postpartum depression. A 2014 study of more than 500,000 mothers published in BMJ also shows that women who don't have a history of depression but have fears about giving birth are about three times more likely to develop postpartum depression compared to women with no history of depression. "It could speak to a generalized anxiety a woman may have, which could put her at more risk for worsening anxiety later, and generalized anxiety disorder (GAD) is often co-occuring with depression," Dr. Varma says.
[post_ads]Dr. Varma notes that GAD is not to be confused with the normal anxiety that comes with being a brand-new parent and all of the responsibilities that go along with it. "With child care, going back to work, balancing it all—a normal level of anxiety is expected,” she explains. “But with GAD, there are six months or more of worrying about a wide range of things—motherhood wouldn't be the only issue—and it interferes with sleep, mood, and concentration."
If you have a history of depression or an anxiety disorder, make sure your ob/gyn knows about it. Also, let him or her know if you have close relatives such as your mother, father, or siblings, who have a history of depression or anxiety. By giving your doctor the head's up, your healthcare provider can help come up with an intervention plan ahead of time, such as counseling, cognitive behavioral therapy, or joining a support group.
If you do start to notice symptoms of postpartum depression, tell your doctor. Don’t expect that it’ll just go away on its own after a few months.
If you notice that you're not feeling like yourself and are plagued with persistent mood swings, crying, and feeling like you're not bonding with your baby, say something to your doctor and get help. "The decision to reach out for help comes from strength, not weakness," says Kleiman, who is the author of an adult coloring book for postpartum moms called Moods in Motion. "Do not let the stigma of mental illness or asking for help interfere with you taking the necessary steps to get the help you need. Let your healthcare professional know how you are feeling and follow up with a treatment plan to help you get back on track as quickly as possible. The sooner you ask for help, the sooner you will start to feel like yourself again."
How do you know if you’re depressed or if it’s just the baby blues? The “baby blues” usually start shortly after you give birth and last up to two weeks, then go away on their own, Dr. Varma explains. If they don’t get better within this timeframe, it’s worth telling your doctor how you’re feeling.
If you notice that you're not feeling like yourself and are plagued with persistent mood swings, crying, and feeling like you're not bonding with your baby, say something to your doctor and get help. "The decision to reach out for help comes from strength, not weakness," says Kleiman, who is the author of an adult coloring book for postpartum moms called Moods in Motion. "Do not let the stigma of mental illness or asking for help interfere with you taking the necessary steps to get the help you need. Let your healthcare professional know how you are feeling and follow up with a treatment plan to help you get back on track as quickly as possible. The sooner you ask for help, the sooner you will start to feel like yourself again."
How do you know if you’re depressed or if it’s just the baby blues? The “baby blues” usually start shortly after you give birth and last up to two weeks, then go away on their own, Dr. Varma explains. If they don’t get better within this timeframe, it’s worth telling your doctor how you’re feeling.
Sleep as much as possible. Yes, we know that’s easier said than done.
With round-the-clock feedings and diaper changes, having a newborn often means that getting a good night's sleep is a genuine challenge. Try to make up for sleep loss by napping when the baby naps or asking relatives to pitch in so you can get some much-needed rest. "Sleep deprivation or irregular, unpredictable sleep patterns can lower your resistance to depression," says Kleiman.
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According to the National Sleep Foundation, "When you don't get the seven to nine hours of quality sleep you need, it can heavily influence your outlook on life, energy level, motivation, and emotions."
With round-the-clock feedings and diaper changes, having a newborn often means that getting a good night's sleep is a genuine challenge. Try to make up for sleep loss by napping when the baby naps or asking relatives to pitch in so you can get some much-needed rest. "Sleep deprivation or irregular, unpredictable sleep patterns can lower your resistance to depression," says Kleiman.
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According to the National Sleep Foundation, "When you don't get the seven to nine hours of quality sleep you need, it can heavily influence your outlook on life, energy level, motivation, and emotions."
Trouble with breastfeeding is linked to postpartum depression, so get help if you’re struggling with lactation. If you can't breastfeed, remember that you have other options.
Women who struggle with breastfeeding during the first two weeks after giving birth are more likely to suffer from postpartum depression two months later compared to women without any breastfeeding issues, according to a study of more than 2,500 women conducted by researchers at the University of North Carolina at Chapel Hill. The research revealed that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months after childbirth compared to others who had a positive breastfeeding experience. Women who had severe breast pain on the first day of breastfeeding and also two weeks after giving birth were twice as likely to have postpartum depression compared to women who didn't experience pain while nursing.
Although the researchers are still trying to understand the link between painful breastfeeding and depression, they note that previous studies shows feelings of pain and depression "share the same descending pathways in the central nervous system" and that "neurochemical imbalances in key neurotransmitters such as serotonin may contribute to feelings of pain as well as depression."
A 2013 review of studies on breastfeeding and postpartum depression also suggests that breastfeeding may be hormonally protective against postpartum depression to some extent: According to the study authors, breastfeeding can promote hormonal processes that help lower the cortisol response to stress, and that the hormones released during breastfeeding, oxytocin and prolactin, have an anti-depressant effect.
Women who struggle with breastfeeding during the first two weeks after giving birth are more likely to suffer from postpartum depression two months later compared to women without any breastfeeding issues, according to a study of more than 2,500 women conducted by researchers at the University of North Carolina at Chapel Hill. The research revealed that women who said they disliked breastfeeding were 42 percent more likely to experience postpartum depression at two months after childbirth compared to others who had a positive breastfeeding experience. Women who had severe breast pain on the first day of breastfeeding and also two weeks after giving birth were twice as likely to have postpartum depression compared to women who didn't experience pain while nursing.
Although the researchers are still trying to understand the link between painful breastfeeding and depression, they note that previous studies shows feelings of pain and depression "share the same descending pathways in the central nervous system" and that "neurochemical imbalances in key neurotransmitters such as serotonin may contribute to feelings of pain as well as depression."
A 2013 review of studies on breastfeeding and postpartum depression also suggests that breastfeeding may be hormonally protective against postpartum depression to some extent: According to the study authors, breastfeeding can promote hormonal processes that help lower the cortisol response to stress, and that the hormones released during breastfeeding, oxytocin and prolactin, have an anti-depressant effect.
[post_ads]The study authors recommend that women who are having trouble with breastfeeding should be screened for depressive symptoms so they can get help early on. You can also enlist the help of a lactation consultant, who can provide tips on how to make breastfeeding easier and more comfortable. And remember, formula is always an option. The American Academy of Pediatrics has many resources on which type of formula to choose and how to develop a formula feeding schedule.
If you can, put any big changes on hold for now.
External stressors, such as major changes or losses, ratchet up the risk of postpartum depression. Some factors, like the loss of a loved one, are clearly beyond anyone's control, but Kleiman recommends trying to avoid possible upheavals you may have a say in, such as job alterations or moving, if you can. "This is not a great time to make major life decisions or changes," she says. "Do your best to reduce added stress, when possible, and surround yourself with people and things that make you feel safe and cared for."
External stressors, such as major changes or losses, ratchet up the risk of postpartum depression. Some factors, like the loss of a loved one, are clearly beyond anyone's control, but Kleiman recommends trying to avoid possible upheavals you may have a say in, such as job alterations or moving, if you can. "This is not a great time to make major life decisions or changes," she says. "Do your best to reduce added stress, when possible, and surround yourself with people and things that make you feel safe and cared for."
Finally, don’t be afraid to ask for help. A lot of women have trouble talking about postpartum depression, but that’s one of the most important parts of the healing process.
Kleiman notes that, for many women, it’s difficult to open up and talk about how they're feeling when coping with postpartum depression. In fact, Teigen shared that she can't even say "postpartum depression"—she just tells friends she has "postpartum"—but says she is working on that.
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But it's important to share and confide in your loved ones about what you're going through and having that social support. "Be honest about how you are feeling and let others you trust know what they can do to help," Kleiman adds. "Remaining silent or isolated can increase symptoms and prolong suffering."
If you're not feeling good emotionally during or after your pregnancy, ask your partner, family, and friends for extra help rather than trying to trudge through. "Reach out for support from friends and family," suggests Kleiman. "Say yes when they offer to help."
If you’re feeling down after the birth of your baby, don’t let how you “should” feel get in the way of treatment. "[Women with postpartum depression] feel especially embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy," Kleiman says. Opening up—especially to your doctor—is the first step toward feeling better.
Kleiman notes that, for many women, it’s difficult to open up and talk about how they're feeling when coping with postpartum depression. In fact, Teigen shared that she can't even say "postpartum depression"—she just tells friends she has "postpartum"—but says she is working on that.
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But it's important to share and confide in your loved ones about what you're going through and having that social support. "Be honest about how you are feeling and let others you trust know what they can do to help," Kleiman adds. "Remaining silent or isolated can increase symptoms and prolong suffering."
If you're not feeling good emotionally during or after your pregnancy, ask your partner, family, and friends for extra help rather than trying to trudge through. "Reach out for support from friends and family," suggests Kleiman. "Say yes when they offer to help."
If you’re feeling down after the birth of your baby, don’t let how you “should” feel get in the way of treatment. "[Women with postpartum depression] feel especially embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy," Kleiman says. Opening up—especially to your doctor—is the first step toward feeling better.
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