By Dr. Ryan Harris and Dr. Joanna Chambers.
The month of May is the time of the year when we pause to celebrate mothers. Being a mother requires extending oneself for the sake of others, and, despite its rewards, it can prove to be taxing on a mother’s mental, physical, and emotional wellbeing. Becoming a mother changes one’s biology, mentality, and lifestyle. While mothers may welcome this change overall, these changes often require them to mourn the loss of the person they were before having children. This aspect of becoming a mother is seldom discussed, but it is very real.
“Baby blues” are a common experience for many people in the month following the birth of a baby. Moms find themselves feeling tearful and generally more emotional, and this can be made worse by the poor sleep associated with life with a newborn. Oftentimes, mothers experience anxiety about their new responsibility and a sense of being overwhelmed. These emotional shifts are often influenced by hormonal changes and the adjustment to motherhood. For many mothers, relief comes after several weeks. The intensity of emotions wanes, the body heals, and they settle into their new role.
Postpartum depression (PPD) is characterized by persistent sadness, decreased interest in previously enjoyable activities, crying spells, and, at times, a lack of interest in the baby. The disinterest in the baby may feel frightening or unnerving and can result in feelings of intense guilt. Some women notice a significant increase in worries about the baby’s care and safety. One of the most significant risk factors for PPD is a history of depression, including depression during pregnancy. One study estimated the risk of PPD for those with a history of depression is 20 times higher than for moms without a history of depression. Even in the absence of a history of depression, research suggests an increased risk of PPD for women younger than age 24. Risk of PPD is also increased by gestational diabetes, preterm delivery, and maternal age over 35.
One notable difference between baby blues and PPD is that with baby blues, despite feeling more tearful or emotional at times, moms are still able to experience joy and remain engaged in the care of their baby. This differs for the 10-20 percent of women who experience PPD, according to psychology researchers Susanne Brummelte and Liisa Galea.
Depression and anxiety affect mothers of all socioeconomic levels, all ages, and all races. Mothers who do not have support from their families or from the father of the baby may be at increased risk for depression and anxiety. If a woman has a history of trauma (including child abuse or neglect) from her own childhood, she may be more likely to feel depressed when she becomes a mother.
Increasingly, the medical community understands the importance of treating women with PPD. Research suggests children of women with untreated PPD have an increased risk of developmental delays and more ER visits and hospitalizations in the first two years of life. Untreated depression can also compromise the ability of mom and baby to form a healthy attachment. The attachment between a mother and her infant is the cornerstone of the infant’s ability to develop strong, nurturing relationships throughout the lifespan.
Moms who are in need of support and treatment can talk to their ob-gyn, primary care doctor, or their baby’s pediatrician about their symptoms to get a referral to a psychiatric provider. In some cases, PPD can lead to thoughts about self-harm or harming others. If this happens, it’s important to get emergency psychiatric help.
There is hope for women experiencing symptoms of postpartum depression. Effective treatments that are safe for both the mother and infant are available. Many women benefit from a combination of medication and therapy; safe medication options exist for moms who are breastfeeding. The types of therapy are varied but include supportive therapy, cognitive behavioral therapy, psychodynamic psychotherapy, and attachment-based approaches. Moms do not have to suffer in silence. There is a community of care providers ready and willing to help them recover.