By Dr. Mercola
The video above shares a tragic story of a new mother, Allison Goldstein, with a seemingly picture-perfect life, who took her own life after losing a battle with postpartum depression. The story is particularly poignant because she was otherwise a happy, normal and healthy woman, one who gave her family and friends no red flags or cause for concern after her daughter was born.
While regularly checking in with her parents and sister, and showing no outward signs of her inner turmoil, she checked her 4-month-old daughter into day care and then committed suicide — the No. 1 cause of death among women in the first year postpartum, according to an NBC 12 News report.
If it could happen to Allison, her mother said, it could happen to anyone, which is why it's so important to be aware of postpartum depression and what to do if you or a loved one is struggling.
What Is Postpartum Depression?
While up to 80 percent of new moms experience what's known as the "baby blues" postpartum, some experience a more debilitating and longer lasting form of depression known as postpartum depression or PPD. While the postpartum blues may involve mood swings, anxiety, irritability, crying and sadness, the feelings are self-limiting and typically resolve after a few weeks.
The feelings of anxiety, guilt, fatigue and inadequacy that come along with PPD, however, may persist for a year or more. The symptoms may include some or all of the following:1
Depressed mood or severe mood swings
Difficulty bonding with your baby
Withdrawing from family and friends
Loss of appetite or eating much more than usual
Inability to sleep (insomnia) or sleeping too much
Overwhelming fatigue or loss of energy
Reduced interest and pleasure in activities you used to enjoy
Intense irritability and anger
Fear that you're not a good mother
Feelings of worthlessness, shame, guilt or inadequacy
Diminished ability to think clearly, concentrate or make decisions
Severe anxiety and panic attacks
Thoughts of harming yourself or your baby
Recurrent thoughts of death or suicide
As noted by the Postpartum Depression Alliance of Illinois (PPD IL), "A lack of feeling for the baby is of special concern. These feelings can appear any time during the first few months to one year after the birth. Unfortunately, women experiencing this form of depression rarely seek treatment although almost all respond well."2
In some women, a traumatic childbirth experience may also trigger post-traumatic stress disorder (PTSD), which can carry some of the same symptoms as PPD. In addition, rarely new mothers may suffer from postpartum psychosis, which usually develops within two weeks of delivery. This requires immediate medical attention and involves the following symptoms:
Confusion and disorientation
Obsessive thoughts about your baby
Hallucinations and delusions
Attempts to harm yourself or your baby
How Common Is PPD?
Sadly, Allison's story is not unique. It's estimated that up to 22 percent of women may suffer from depression during their first year postpartum, but recognition and treatment rates are lower among this population than in the general population. According to a study published in JAMA Psychiatry:3
"Low treatment rates are juxtaposed against mounting evidence that antenatal and postpartum depression (PPD) increase the risk for multiple adverse outcomes among women and their offspring. Maternal depression interferes with child development and increases the rates of insecure attachment and poor cognitive performance."
The researchers noted that suicide accounts for 20 percent of postpartum deaths and found that, in a screening of 10,000 new mothers for PPD, 14 percent were positive for PPD.
Of these, more than 19 percent had self-harm ideation, all of whom scored 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS), the most common tool used to screen for PPD. When and where to screen for PPD is an ongoing debate, with some experts suggesting universal screening for all new moms and others recommending against it. As the JAMA Psychiatry study explained:4
"Childbearing is an opportune time for intervention because women have contact with health care professionals, have access to health insurance and are motivated toward positive behaviors to invest in their offspring's welfare.
Identification of PPD through universal screening has been recommended (and is mandated in several states); however, screening without system enhancements, such as diagnostic evaluation with intervention implementation, is not currently justifiable or cost-effective and may incur ethical and liability concerns."
As far as risk factors, women who have had previous episodes of major depression, a family history of PPD, pregnancy complications or difficult deliveries may be at increased risk, as may young or older mothers, particularly after unplanned pregnancies.5 Stress, sleep deprivation and financial and relationship troubles, along with feeling a loss of identity, lack of support or social isolation, may also play a role.
Dr. Helen Chen, head of the department of psychological medicine at KK Women's and Children's Hospital in Singapore, further told Channel NewsAsia, "There are usually many factors that contribute to the development of postnatal depression in women: hormonal, biological, psychosocial and emotional changes."6
What Postpartum Depression Feels Like
The National Coalition for Maternal Mental Health (MMH) estimates that, conservatively, more than 600,000 U.S. women suffer from maternal mental health disorders each year.7 Their online suicide memorial wall is a tragic display of the many families torn apart by PPD and related conditions.8
In many cases, women may feel unhappy after giving birth, which amplifies feelings of guilt or thought of being a "bad" mom. Many do not realize they're actually suffering with PPD. Maureen Fura, who faced her own struggle with PPD, created the above video to share with others how she felt. She told the Huffington Post that she experienced feelings of shame, anxiety, insomnia, intrusive thoughts and sadness, noting:9
"It's not uncommon for many mothers to experience intrusive thoughts. Like a boomerang, these bothersome ideas may seem to pop up out of nowhere. Often, they are scary and include fantasies of 'worst' case scenarios. For Maureen, this worry included: 'What if I let go of the stroller?'"
Another woman, Mary O'Malley, shared her own story of PPD with Care.com. She felt she was spiraling out of control until she talked with a therapist who specializes in postnatal issues, who let her know her feelings did not make her a bad mom.
"Months of mental and emotional distress continued, exacerbated by feeding and nursing issues, a baby with colic and reflux, and so little sleep I'm not sure how I survived. Every day felt relentless and exhausting. I could feel myself pulling away from everyone and everything that mattered to me. I was numb and desperate to get out of this cycle before it got worse."10
Upon talking to the therapist and learning her feelings were hallmark signs of PPD, she wrote, "Relief flooded my body. For the first time in almost a year, I had hope. I wasn't damaged goods. I wasn't alone and I could get better."
What to Do if You're Struggling With PPD
If you're a new mom and are having suicidal thoughts or thoughts of harming your baby, seek help immediately. If you're in the U.S., call 911 or the National Suicide Prevention Lifeline at (800) 273-TALK or (800) 273-8255. You should also talk to your health care provider, a mental health specialist, a family member or friend, a spiritual leader or all of the above.
If you're feeling depressed and aren't sure if it's PPD or postpartum baby blues, talk with your family, therapist and your doctor as soon as possible. It's important not to suffer in silence. As you seek help from a mental health professional, you can also support your recovery using the following natural strategies:
- Increase your omega-3 intake. A study has shown that insufficient dietary intake of omega-3s may increase a woman's risk of postpartum depression.11 You can get omega-3s from foods like wild Alaskan salmon and small fish such as sardines and anchovies. Supplementing with high-quality krill oil is also recommended.
- Exercise. Exercise is known to help relieve depression, and research also shows that light-to-moderate intensity exercise improves mild-to-moderate depressive symptoms and increases the likelihood that the depression will resolve during the postpartum period.12
- Practice mindfulness before and during birth. Research suggests mindfulness training that's tailored to address the fear and pain of childbirth offers many mental health benefits to new moms, including the prevention of PPD.13
- Get vitamin B2. It may decrease your risk of PPD if consumed in moderation.14
- Breastfeed your baby. There is some research linking the discontinuation of breastfeeding and formula feeding with PPD,15 while women who breastfeed their infants reduce their risk of developing PPD.16
If you feel yourself slipping into a dark place after childbirth, do not let the stigma of your feelings stop you from seeking help. Connect with your friends, partner and family and let them know you need their support. In the meantime, accept help from others and make time for yourself.
Continue to do the things you enjoy and take time for stress-relieving activities like going for walks, meditating or listening to music. Rest as much as possible, even if it means enlisting help so you can get some sleep. Finally, nourish yourself with real, whole food, keeping simple, quick whole-food snacks on hand so you can grab a healthy bite when you need to.