Postpartum Depression: An In-Depth Look Part I

The Symptoms and the Statistics

Society has placed high expectations on motherhood. For 10-28% of new moms however, the birth or adoption of a baby marks a change in their lives which is quite distressing.

All mothers and families have anxieties and worries about bringing their new babe home, be it their first or fifteenth. For these 10-28% however, there are feelings of inadequacy coupled with numbness to sadness to irritability, confusion or anxiety. Nightmares and frightening thoughts can dominate the mama’s mind, leaving her hardly able to care for herself properly let alone a baby or family. Whether it is days, weeks or months after the new addition has arrived, the feelings are real and should not be taken lightly. She is not crazy, she is not a bad mother, she is not weak. She has postpartum depression (PPD).

'Tearfulness, despondency, feelings of inadequacy and inability to cope".* PPD is more than a depressed mood. It goes on for an extended period of time and it is disabling. The depression is often accompanied by anxiety, overwhelming feelings of guilt, shame, isolation, fatigue, a sense of loss and for a number of mothers, some very frightening fantasies. Be it one or more symptoms a woman struggles with, there is not one worse than another. They are all serious, real and debilitating.

Postpartum depression is not the "baby-blues", which is a very teary period in the first two to four weeks after the delivery of their baby. The "baby-blues" is reportedly experienced by approximately 80% of women, yet it is thought that every women has this period of tearfulness, only 80% have had it to a degree that they are concerned enough to report it to their care provider.

PPD is also not postpartum psychosis, which is vary rare, only affecting 0.1% of women. These women lose contact with reality for extended periods of time. In the media, we have all heard unbelievable stories of women who have had extraordinary postpartum psychosis. It is serious, severe and requires constant monitoring.

Postpartum depression very rarely requires that a mother be removed from the home or that she needs constant supervision like mothers with psychosis. Some women decide they need to remove themselves, or they need full time assistance, but it is rare for doctors or other healthcare providers to require this as part of their treatment and rehabilitation. Making the choice to remove oneself or ask for help is a huge struggle, but needs to be honored if it is requested.

The onset and symptoms of PPD vary immensely. The onset may start while a woman is still pregnant, or it may not set in until 18 months postpartum and sometimes even later. There is debate about when to stop calling these symptoms 'postpartum' depression and not 'depression' alone. Some care providers will say that postpartum depression occurs in the first 12 months. Anything after those first 12 months is postpartum affected depression, but treated like a depressive state unrelated to the postpartum period. There is also no rhyme or reason to which birth PPD could occur in. It could be the first, third or fifteenth. PPD is also experienced by adoptive mothers and looks remarkably the same as a mother who delivers a child after a pregnancy. No matter what the family unit is made up of, the feelings and experiences of PPD are unique to each woman.

* Pitt, B. (1968) "'Atypical' depression following childbirth".
British Journal of Psychiatry 144 (Nov. 1968): 1325-35


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About the Author Elizabeth is a 28 year old mother and wife living on beautiful Vancouver island. With aspirations toward Women's Health, Elizabeth worked in the Perinatal field (pre-conception, pregnancy, labor and delivery, postpartum) aiming for a degree in Midwifery, however school was eventually put on the back burner. These days, Elizabeth leads a very colourful, and happy life, which is accentuated by her writing, community service and a strong GLTB advocate.

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