Postpartum Depression Support on Long Island

What is Postpartum Depression?

Postpartum Depression, or PPD, is a medical problem that requires medical intervention. It is an illness just like diabetes or arthritis. It is not a moral weakness.

PPD is a very particular kind of depression that occurs after pregnancy (sometimes during pregnancy) and is triggered by the profound hormonal changes that you have undergone in pregnancy and the birth process. During the nine months of pregnancy, two female hormones, estrogen and progesterone, increase dramatically. In the twenty-four hours after the birth process, those hormones drop dramatically, to their normal, pre-pregnancy levels.

More than the change in the levels of those hormones in your body, researchers believe it is the dramatic drop in hormone levels that can contribute to PPD, in much the same way that smaller changes in hormones can affect your mood during your menstrual cycle.

In some women, thyroid hormones also drop after the birth process, diminishing your metabolism. Low thyroid levels have long been associated with the decreased interest, irritability, fatigue, difficulty in concentration, sleep problems and weight gain so commonly associated with depression. It is important to rule this out.

Of course, there are other, environmental triggers that contribute to PPD. After all, you have just had a baby! You are exhausted from labor and delivery. Your sleep patterns have been completely disrupted. You are tired!

There are personality traits to take into consideration, psychosocial impacts, physiological and general losses to consider, psychodynamic concerns and lack of social support. All of which are important risk factors for PPD, and can add up.

If you are like many new mothers, you feel overwhelmed with a new, or additional, baby to care for. You doubt your ability to be the kind of mother you want to be. Changes in your normal routines, at work and at home, are difficult to accommodate. You look in the mirror and you see someone you do not recognize. You feel alone. Remember, PPD is more common than you imagine.

PPD is a term that is used to describe six postpartum mood disorders. It is somewhat like an umbrella term. The six mood disorders have been given different names by different experts, but the general idea is the following:

1. Baby Blues / Adjustment
2. Postpartum Depression
3. Postpartum Obsessive Compulsive Disorder
4. Postpartum Panic or Anxiety Disorder
5. PTSD
6. Postpartum Psychosis

Could I have Postpartum Depression?

Do you:

• Cry over the slightest thing?
• No longer enjoy the things that you used to?
• Isolate yourself from friends and neighbors?
• Fear leaving the house or being alone?
• Have anxiety attacks?
• Have feelings of unexplained anger?
• Have difficulty concentrating?
• Think something else is wrong with you or your marriage?
• Feel like you will always feel this way and never get better?

Many new mothers will experience some of these feelings. If you answered yes to more than three of these questions, you may have postpartum depression. PPD affects 20% to 30% of all postpartum women. It is a real illness. It is very treatable. Do not deny yourself the opportunity to feel good again. Do not let misinformation, uncertainty, shame, finances, embarrassment, or denial get in the way of your getting the help you need. Talk to your doctor. Talk to your partner. Once you decide to seek treatment, you will be on the road to feeling better.

Courtesy of The Postpartum Stress Center, Karen Kleiman, Executive Director.

More Than the Baby Blues

Baby blues often occurs in the first few days immediately after childbirth. The symptoms, the blue feelings, generally disappear within a few days to a few weeks. However, during that time, you may have sudden mood swings (remember those hormonal changes) such as feelings of sadness, weepiness, difficulty sleeping (not associated with the baby), anxiousness, and a feeling of loneliness. However, these symptoms do not feel overwhelming to you. Napping when the baby naps, and getting help from your partner, family members, and friends can help get you through these days of transition and adjustment.

Unlike the baby blues, PPD can happen anytime during the first year, and some experts report up to two years, after the birth of your baby. The symptoms are very similar to those of the blues but are much more intense. They also include feeling guilty and worthless. You berate yourself: What kind of mom feels this way? What kind of mother has these thoughts? This is not what I had planned! The most significant differences between PPD and the baby blues are the feelings of being overwhelmed and the length of time the symptoms last, the intensity and duration. PPD compromises your sense of well-being.

Also unlike the baby blues, which can be addressed by some support from your loved ones and friends, PPD needs to be treated by a doctor. The key here is to remember that with the appropriate help and support from those who specialize in the treatment of PPD, it is very treatable.

Ultimately, the way to distinguish between the baby blues and PPD is to trust your instincts. You know when you feel something is very wrong, when you do not feel like you anymore.

If you feel you are struggling, if you feel you are losing ground, if you feel you are hurting, reach out and get help. Make the phone call!

Nutrition and Postpartum Depression

Postpartum depression is like almost every other example of depression and anxiety in at least one important respect: it makes you crave sweets and carbohydrates, the very foods that will make you feel worse.

Sweets and carbs only contribute to a roller-coaster blood sugar level. Keeping a balanced blood sugar level is very important in keeping a balanced emotional level as well.

Postpartum depression makes many things difficult, so it is important that you allow others, and guide others, to help you. Ask your partner, a friend, or a family member to shop for you and to stock your refrigerator with the kinds of healthy, easy-to-prepare foods that will help you, not just satisfy a momentary and destructive craving.

Here is a list of just a few of the things you might want to have available for meals and snacks:

• Yogurt
• Sliced low-sodium deli meats, such as roast turkey
• Cheese
• Hardboiled eggs
• Precut veggies such as carrots, broccoli and celery sticks, with a nice light dip
• Fruit, a good source of sweetness without the refined sugars

Of course, if you are looking at this and feeling a vague sense of nausea because you cannot even imagine putting a morsel of food in your mouth (lack of appetite is very common for women with PPD), consider drinking your nutrients. Protein drinks and unsweetened fruit drinks are great. Try to steer clear of caffeinated beverages, though.

Medication and Treatment

One of the ironies of struggling with PPD, and many other forms of depression and anxiety, is that you fear the very medications that might offer you the greatest relief. Although no one should take medication without having questions and concerns addressed, you need not fear taking the medicine if your PPD is disruptive enough to warrant it.

Bear in mind:

• Medication will not change your personality. It is the depression and anxiety that changes who you are, not the medication.
• You will not always be on medication. The medication is only to help you through a difficult period. Going off the meds is always a conversation to have with your therapist or doctor when the time is right. Some women decide to stay on medication.
• You will not become addicted to the medication. The medications commonly prescribed for most forms of depression and anxiety are not addictive or habit-forming, as long as you take the medication as prescribed by your physician.
• You will be able to manage side effects. Every medication, including aspirin, has side effects. Some are more significant than others. If you do experience unwanted side effects with one medication, you can try another. The bottom line is that concern about side effects should not keep you from the advantage of the relief and benefits that medication might bring you.
• It will take a few days, up to a couple of weeks, for you to experience the full benefit of some medications. However, there should be incremental improvement along the way.

Without even noticing it at first, you might suddenly realize that:

You are not crying all the time.

You are in the kitchen preparing meals for yourself and your family.

Someone comments on what a nice smile you have.

You feel a bit more patient than you have felt in a while.

You recognize the real you again.

The thoughts slowly diminish, and the anxiety and panicky feelings occur less frequently.

If you are concerned about breastfeeding and taking medications: this is a commonly felt dilemma that you and a trained professional will be able to talk through, to make the best informed decision for yourself and your baby.

Are there ways to treat PPD without taking medication?

Yes, there are other ways to treat PPD aside from medication. But this is something that should be explored with a trained professional who can recognize symptoms of PPD and how to manage your situation best, taking into account your history and severity.

Below are some alternate treatment methods:

• Hypnotherapy
• Omega-3
• Light therapy
• Massage, acupuncture, relaxation techniques
• Exercise
• EMDR, eye movement desensitization and reprocessing, an integrative psychotherapy approach
• ECT, electroconvulsive therapy, for more severe cases
• Support groups and psychoeducational groups
• Herbal supplements
• Psychotherapy

By no means is this an endorsement of any treatment. These are simply some alternative options to be explored. All have benefits and drawbacks that need to be addressed when deciding which treatment plan is best for you. Please have an evaluation or consultation with a trained professional.

If you have found that the insights and suggestions here have not fully answered your questions or helped you to feel better, please do not hesitate to contact me directly. Remember, you are not in this alone. You will not always feel this way. Everything will be all right.

Can My Loved Ones Help?

The long and short answer is yes. Your partner, loved ones or support person can:

• Take you and your concerns seriously.
• Encourage you, and help you, to rest as much as possible.
• Go to the doctor or therapist with you, and support you in returning to your sense of health and well-being.
• Help you set limits. No one is supermom.
• Help to set up a plan you are comfortable with.
• Sit and hold your hand when you are feeling bad.
• Tell you they love you.
• Reassure you that you will feel better, and that they are going to be with you all the way.
• Give you permission to take care of yourself.

Five Minutes Can Make All the Difference

Sure, a cruise to a beautiful tropical island might seem like the perfect antidote to your situation, but the fact is, you do not need a two-week vacation to experience a difference. Sometimes a few minutes of just being able to breathe is all it takes.

All new mothers, those with PPD and those who do not experience its symptoms, have been taught the myth that if we do not want to spend every moment with our babies, then we are somehow bad mothers who do not love our children as much as we should.

That is simply not true.

It is vitally important to take some time for yourself. And it is also important to be able to do so without guilt.

So, guilt-free, lean on your partner, your family, or your friends to give you at least three or four real breaks, a few hours at a time, each week. Even if you only sit in your room and listen to music, or walk through your backyard and let the sun shine on your face, take that time for yourself without having to worry about your baby or yourself. You will be glad you did.

Resources

My passion for perinatal mood disorders began after my own experience with perinatal and postpartum depression. Since that time I have dedicated myself to assisting families who are struggling with this illness and all of its complexities. I am a member of Postpartum Support International, and a member and volunteer for the Postpartum Resource Center of New York. I have been an active member of the mood disorder task force, bringing about awareness of PPD, antepartum depression, and the importance of prenatal care.

Below are some books and organizations you may find helpful.

• A Daughter’s Touch: A Journey of a Mother Trying to Come to Terms with Postpartum Depression, Sylvia Lasalandra
• The Stork’s Revenge: My Struggles and Triumphs Over Postpartum Depression, Geraldine O’Keeffe
• Lullabies and Alibis, Stephanie D. Lewis
• Stop Obsessing! How to Overcome Your Obsessions and Compulsions, Edna B. Foa
• Making the Prozac Decision: A Guide to Antidepressants, Carol Turkington
• Great Sex for Moms: Ten Steps to Nurturing Passion While Raising Kids, Valerie Davis Raskin

Organizations

• Postpartum Resource Center of New York
• Postpartum Support International
• The Postpartum Stress Center