Postpartum depression

About one in ten women are affected by some form of postpartum depression (PPD). Postpartum depression can set in after giving birth, as you are adjusting to your new life. A dramatic or traumatic birth experience can definitely be a strong contributing factor to poor mental health when your baby is an infant, but you don’t have to have gone through childbirth to develop depression. Even adoptive parents and co-parents of the person who gave birth can experience depression when they are new parents.
Here, you can learn more about what the symptoms look like, how depression is treated, and how to differentiate it from the baby blues.

What are the symptoms?

Most people experience low mood after childbirth; this is called the baby blues, and tends to arrive about three days after delivery. The baby blues should pass within two weeks. But if you experience a low mood that does not pass, but that actually gets worse every day, it may be depression, and you will need help to treat that. Common symptoms are:

• lack of energy and loss of interest in anything going on around you.
• difficulty feeling happy about anything, even things you enjoyed before.
• feeling like you don’t have the energy to take care of yourself or your baby.
• difficulty sleeping, sleeping poorly/anxiously and waking up early.
• comfort eating much of the time, or loss of appetite altogether.
• feeling guilty or hopeless.
• recurring panic, intense anger, or anxiety.
• being afraid that you might harm the baby or yourself.
• finding it difficult to be around others, even close friends and family.
• feeling like your low mood is constant, or moving in the wrong direction with each passing day.

These are just some of the symptoms; depression can look very different from one person to the next and it can also impact people with varying levels of severity. And of course, some symptoms, like uncertainty, being incredibly tired, and maybe even feelings of inadequacy, may just be about being a new parent. It isn’t always easy to determine what is normal and how you feel when your body and emotions are all different. But if you feel like it’s only getting worse by the day, and if you are sinking further and further into hopelessness or even having trouble getting through the day, then you should contact a doctor for help. It’s also good to know that feelings of guilt and shame are part of depression as an illness – but in fact, there isn’t anything shameful about experiencing depression as a new parent.
A minority of people may also experience something called postpartum psychosis, which should not be mistaken for depression. Psychosis usually occurs between two weeks and three months after childbirth. It can manifest as delusions, hearing voices or sounds that aren’t there, and being somewhat unresponsive to efforts to make contact. This is a serious condition that requires immediate medical attention.

Screening for depression after having a baby

About two months after giving birth, your doctor may give you a test to screen for signs of depression. Called the Edinburgh Postnatal Depression Scale (EPDS), this test is a form that you fill in that assesses your well-being through a number of different questions. You do not interpret the test yourself; rather, a doctor or psychologist will make a diagnosis based on your responses. The more honestly you answer the test, the better the chances are that you will get help quickly. When how you truly feel clashes with your expectations of yourself (or those you perceive others have of you), there is always a risk that you will tone things down and report feeling better than you actually feel. That is a natural reaction, but it could result in your condition going undetected. If either you or your partner are not doing well, don’t wait for your next visit to the clinic – contact your doctor earlier.

How is depression treated in new parents?

The first step might be talking to someone close to you, like a partner or friend. Putting your emotions into words will remove some of the drama surrounding the condition; that can feel good and it can help people help you. You should also make sure you do get help. Good treatment is available, primarily in the form of talk therapy. People are often surprised at how little it actually takes to become healthy. Usually, all you need is someone to listen and help you sort through your thoughts. The earlier you get help, the easier depression is to treat. It might also be preferable to go on short-term sick leave and have someone else, such as the other parent if there is one, help out with the baby during the day if possible. Treatment often includes antidepressants, which can be very good for helping you get through the hardest time.

What can you do yourself?

In addition to speaking openly about it, seeking out therapy, and possibly antidepressants, there are some other things you can do daily that might help you feel better, and that are often part of treatment, such as:

• getting help with practical tasks.
• fresh air and walks.
• sticking to hygiene routines, like showering, brushing your hair and changing your clothes.
• getting sleep and eating well – we know: sleeping well when you have a little one isn’t always easy, but consider whether you know anyone who can help out. You need the chance to sleep.
• see people regularly, even if it feels like a drag. You don’t have to see tons of people, but maybe a close friend or a relative you like.
• talk about your feelings with someone you trust. Depression is not your fault and it is incredibly difficult to carry this by yourself.

It can also be good to check that your thyroid is producing enough hormones, which is done through a blood test at a clinic.

How long does depression last?

This kind of depression usually passes within a few months; most people actually feel well within six months. For some, it may be more drawn out – especially if you’ve been very “good” at hiding it from the people around you, and only you know how you’ve really been feeling. But the longer you wait to seek help, the harder it can be to treat.
How long depression lasts depends on a variety of factors, such as intensity, how quickly you get help, and what support is available to you from the people you know, including opportunities to sleep and whether you have someone to talk to.

What causes it?

People with past experience of depression are at higher risk of developing it now, but it can often be prevented through talk therapy during pregnancy. There’s also a slightly higher risk if you had a difficult pregnancy and/or delivery, if your baby is particularly demanding (causing a lack of sleep), or if you don’t have a support network. But that really isn’t the full explanation; sometimes hormones play a role, and most of the time we don’t really know the cause. Meanwhile, your child’s earliest years are a challenging period (to say the least), with many emotions and very little sleep. When life is emotionally stressful, the risk of depression is generally higher.
Feelings of guilt when it comes to your baby are common if you were depressed during their infancy. But remember: your relationship with your child is lifelong! It doesn’t all hang upon what those first few months were like. After all, you will be with your child for life. There are lots of chances to repair a difficult start!

Please note that all information above is based on Swedish recommendations.