Are You a New Mom? You Might Be Depressed
Stronger postpartum screening guidelines benefit mother and baby
“If testing would have prevented the experience I had, absolutely. Bring me any test they’ve got,” Kristina Dulaney told LifeZette.
The Jonesborough, Tennessee, mother is an advocate and ambassador for Postpartum Progress, which encourages women to get screenings, medical help and any other psychotherapy they might need after having a baby.
“I had to be hospitalized in a psychiatric facility for two weeks and treated with medication and psychotherapy,” Dulaney said of her experience with postpartum depression, or PPD.
Prayer, in addition to medication, helped her through her “significant experience” with postpartum psychosis, she said.
Delaney is far from alone. This is precisely why the United States Preventive Services Task Force has issued a strong recommendation that all adults be screened for depression, specifically pregnant women and new mothers, so they may receive the right treatment sooner, rather than later.
"Previous task forces have recommended screening for depression, but this is the first time recommendations have been made to screen during pregnancy and postpartum," said Sarah Allen of the Postpartum Depression Alliance of Illinois.
"This reflects the increase in research and public awareness that up to 20 percent of postpartum and 15 percent of pregnant women experience a mood disorder such as anxiety and/or depression."
The high prevalence among new mothers has a simple explanation: After a baby is born and the placenta is delivered, estrogen levels drop rapidly. This affects brain serotonin levels and parts of the frontal cortex. On top of that, many new mothers are sleep deprived, which can lead to the production of fewer necessary brain chemicals used to cope with a newborn, stress and other psychosocial issues.
While PPD is largely due to chemical imbalances and hormones, other risk factors are at play, including prior experience with an anxiety disorder or the trauma of the birth process. Experts also point to financial stress, lack of emotional support, and the overall newness and physical and emotional upheaval of having a new baby in one's care.
"PPD is an umbrella, and underneath that umbrella there is panic and anxiety, obsessive-compulsive disorder and depression," said Kelley Kitley of Chicago-Based Serendipitous Psychotherapy LLC. "These are also experienced at different levels — mild, moderate and severe."
"I wanted them so badly to ask me more questions (about my postpartum symptoms), but it seemed like they didn't think it was necessary," said one new mother.
"What people need to understand is how many women are struggling with this, and how underdiagnosed it is," said Katherine Stone, founder and executive director of Postpartum Progress, a national organization aimed at helping moms with PPD. "While screening is not going to fix all of the problems, and they are numerous, it is a step forward."
Mothers such as Katy Reeve, a public relations professional in Phoenix, Arizona, said she didn’t know what to say when her doctor asked about any postpartum symptoms after the birth of her first child.
"I didn't know what the symptoms were, what was normal, what wasn't — and I am the type who can do it all. So I said, ‘I don't think so,’" Reeve told LifeZette. "I wanted them so badly to ask me more questions, but it seemed like they didn't think it was necessary."
This is why mental health experts say they have been clamoring for this announcement, so that more questions are asked and more is done for mothers who need help.
"Perinatal mood disorders have effects on the mother and on the baby, and the more severe and prolonged the symptoms and condition are, the higher likelihood of having a potential impact on the growth and development of the baby," Katayune Kaeni, a Southern California-based psychologist specializing in material mental health, told LifeZette.
Medical professionals say mothers are not alone in the fight against PPD. Even dads are at risk. Some 10 percent of fathers will experience significant mood changes related to postpartum.
But more likely, experts say, fathers play an integral role in helping mothers cope and ultimately receive the necessary treatment.
"A mother doesn't need anyone telling her to toughen up, or to wait it out, or to do this, but not that. She just needs love, support and validation," said Stone.
"A dad should also be aware of the potential changes in the mother, as he can be a source of support and change if he knows what is going on or what to look for," said Kaeni. "Having a partner who is educated can be very beneficial to mother and baby."
"It takes a lot of bravery to reach out in times of need, especially during pregnancy, where one might feel like a ‘bad mom’ for needing help," said Dr. Tamar Gur, a reproductive psychiatrist at the Ohio State University Wexner Medical Center. "This cannot be farther from the truth."