The Frequency of Postpartum Depression

When my son, Moses, came into the world in 2006, I expected to have another period of euphoria following his birth, much the way I had when my daughter was born two years earlier. Instead I was confronted with one of the darkest and most painfully debilitating chapters of my life. For about five months I had, what I can see in hindsight as postnatal depression, and since that time, I have wanted to know more about it. Not only from a hormonal and scientific standpoint, and why so many of us experience it, but from the perspective of other women who have gone through it. Below is advice from psychologist and frequent goop contributor (and mother of two) Dr. Karen Binder-Brynes.
Love, gp

Having a baby is supposed to be one of the most exciting joy-filled times in life for a woman. After waiting with rapt anticipation for nine months, your baby has arrived safely into this world and you should be filled with relief, unbridled joy, and happiness. It makes sense. However, 1 in 8 women suffer from mood disturbances after their delivery. Their mood swings can be caused by fluctuations in hormone levels, fatigue from the birth process or a wide variety of other life reasons, and usually go away on their own within a few weeks. This short-term state is usually described as “baby blues.” However, in 10% to 20% of all women, a longer lasting and more disturbing state of mood disorder develops which is labeled “postpartum depression.”

Recently, I worked with a patient who had happily anticipated the birth of her first child. She and her husband had waited years for this event and had gone through moderate infertility treatment. This baby was as wanted as any baby could be. The parents were emotionally stable and ready for a baby and finances were of no issue. They had familial support around them and wonderful medical attention. The baby girl arrived healthy and strong. My patient called me from the post-delivery room, ecstatic.

A week later, I encountered a very different new mother. Since arriving home from the hospital, my patient was tearful, had no energy, was feeling worthless and was not enjoying her baby at all. Worst of all, she felt terrible guilt about admitting to these feelings. I reassured her, that these mood states should pass and we agreed to keep in close touch. By a month after the baby’s birth, my patient was feeling worse and not better. At this point, I began to think of her troubling mood state as postpartum depression and we made plans to treat it aggressively. In this patient’s case, she had a familial history of clinical depressions (suggesting a possible biological predisposition) so we decided that a course of antidepressants as well as weekly phone sessions to talk about her feelings would be the best path.

Within a few weeks of this treatment, my patient’s mood began to improve and she was able to begin to enjoy her baby and new motherhood. As she felt better, she was able to join a new mother’s group and get social support from other new moms. After six months, she decided to go off the medication and has remained happily engaged with her baby ever since.

In this case, my patient had decided not to breast-feed her baby so taking the antidepressant did not pose a risk to her daughter. There are however, several antidepressants that can be used for breastfeeding moms. This should be discussed with the woman’s doctors. Not every woman who is suffering from postpartum depression will want to take medication. This, of course, is her right. However, she and her family members should be highly vigilant, that her mood state does not deteriorate in suicidal or homicidal feelings about herself and her baby and that she is capable of taking good care of the child. This is rare, but can be a possibility.

Besides professional help, the most important steps a woman can take is to:

• not be isolated
• find a support network
• ask for help from partner or friends and family when feeling overwhelmed
• not to be afraid to talk to her doctors.

There is absolutely, nothing to be ashamed of if a woman finds herself struggling with her mood state after giving birth. Most of us mothers today, especially in the Western World, live in a very different lifestyle than our ancestors. Typically, we are giving birth and raising our children away from our families, hometowns, or villages. We are often alone for the most part with our new family (except for when family members visit or move in with us temporarily). In the days of past, whole clans and the home-village helped with the childcare and a new mother was never isolated. Feeling depressed and moody after giving birth does not mean you are a bad mother or incapable of caring for a baby. What it means is that you are human and undergoing a huge transition in your life both psychologically and physically. Some of the best mothers I know today suffered from postpartum depression and got help and went on to love being moms who raised incredible kids!

Note: The American Journal of Medicine just released a new study which revealed that 10 percent of new fathers also suffer from postpartum depression before and after a birth and that by three months after the birth the rate rises to 26%.

– Dr. Karen Binder-Brynes is a leading psychologist with a private practice in New York City for the past 15 years.