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Welcoming a new baby can be a joyous time, but for between 10 and 15% of Canadian women, it can also be an extremely challenging time, as they struggle with postpartum depression. But how can you differentiate postpartum depression from the normal “baby blues”? We asked Dr. Sheila Wijayasinghe.
The difference between normal “baby blues” and postpartum depression
Approximately 70 per cent of new moms have mild depressive symptoms called baby blues, which peak between 2-5 days after delivery and can include weepiness, sadness, mood swings, and irritability. Blues generally do not seriously affect function – and resolve within 2-3 weeks. In some cases, symptoms persist and will progress to postpartum depression. Distinguishing between blues and depression can be difficult which why it’s important to assess mood and symptoms at multiple time points. Postpartum depression is a more serious condition which affects function/ability to bond and is longer lasting and can begin anytime in the first year after birth.
How to address it
Generally, at your postpartum visit with your doctor – we should be asking about mood. There is a questionnaire that you can do yourself called the Edinburgh Scale.
If you haven’t seen your doctor yet or they haven’t reviewed your mood (often mom’s mood is missed when the focus is on baby) please ask for help if you are experiencing the following:
- crying for no reason
- lack of feeling pleasure for activities you once enjoyed
- inability to sleep or nap– even when given the opportunity to sleep
- poor energy, concentration and appetite
- anxiety regarding baby’s health, breastfeeding, money, appearance
- thoughts of wishing you’d never had children
- thoughts of not wanting to live; thoughts of suicide
- thoughts of harming your baby (This is difficult to acknowledge as there is much pressure on what a mother should think/feel. It’s estimated that approx. 40% of women with postpartum depression report thoughts of harming baby.)
Are certain people pre-disposed to having postpartum depression?
Yes, there are certain risk factors that can pre-dispose you to developing PPD:
- Personal or family history of depression or anxiety (2x risk for PPD)
- Depressive or anxiety symptoms during pregnancy (prenatal depression)
- Prior diagnosis of postpartum depression
- Prior diagnosis of premenstrual dysphoric disorder
- Ambivalent feelings about pregnancy
- Limited social support (4xrisk)
- Marital conflict/interpersonal violence
- Stressful life events (2x as likely)
- Living alone
- Child-care stress
- History of childhood sexual abuse
- Infant irritability
- Low household income
If you are pre-disposed, work with your doctor to get help early and protect yourself by doing the following:
- Sleep and eat properly
- Avoid making major life changes during or right after childbirth
- Enlist household help during the postpartum period
- If marital issues – seek out counselling/support
Is the biological mother the only one at risk of developing postpartum depression?
We are learning more and more about how depression can occur for all parents – dads and partners included. For men, it is known as paternal postpartum depression and it’s estimated worldwide that approx. 1/10 men experience paternal postpartum depression. Postpartum support is available for men at postpartumdads.org. If can also happen with adoptive parents: similar to biological mothers during the postpartum period, women who adopt children experience increased stress and life changes that may put them at risk for developing depression and anxiety.
Early intervention is key:
- CBT: cognitive-behavioural therapy is a common treatment for postpartum depression.
- Support groups: Postpartum depression and new parenthood can both isolate you from others, and isolation can add to feelings of depression. Support groups are a safe place to share your experiences, learn from others, and connect with other parents who have similar experiences and understand what you’re going through.
- Enlist the support of others: take time/exercise/sleep – especially if vulnerable
- Medication in combination with counselling
HOW TO HELP
- Understand that people who experience postpartum depression may want to spend a lot of time alone. This can hurt, but try to remember that it isn’t about you. They are simply trying to cope with an illness.
- Offer help with daily responsibilities. It’s hard enough at the best of times to find time for daily chores when there’s a new baby. Often, offers of help from friends and neighbors are strong in the first month or two, but may be needed just as much, or more, in later months.
- Help with child care (including overnight help for feedings), or help finding a child care provider. A short break or a chance to get back into interests can make a big difference in anyone’s well-being. It can also create more opportunities for sleep.
- Managing postpartum depression can take a lot of hard work. Recognize a loved one’s efforts regardless of the outcome.
- Talk to your doctor or public health nurse, or accompany your loved one on appointments, if you’re concerned(especially if worried about baby/mom safety)
- Seek support for yourself, if needed. Support groups for loved ones can be a great resource and a great way to connect with others.
If women are taking medication to treat their depression, can they continue taking those anti-depressants during pregnancy?
Yes, there are specific types of antidepressants that have been found to be safe in pregnancy for those who have depression or anxiety. Important note: prior to becoming pregnant, if you are taking any medication (including anti-depressants) – it’s good to review with your doctor to ensure that they are safe to continue taking. If they are not studied or considered safe, you can be switched to an alternative option that is known to be ok to take in pregnancy. If you’re unsure about medication, Motherrisk.org is a resource that is very helpful for parents regarding what’s safe in pregnancy/breastfeeding.
It’s time we started talking openly about our mental health. Join the conversation on Bell Let’s Talk Day, January 30, and help end the stigma around mental illness. For every text message (not iMessage) sent and mobile or long-distance call made by Bell Canada, Bell Aliant and Bell MTS customers, Bell will donate five cents to Canadian mental health initiatives. The same goes for anyone sending a tweet using #BellLetsTalk, watching the Bell Let’s Talk Day video on Twitter, Instagram, Facebook or Snapchat, or using the Bell Let’s Talk Facebook frame or Snapchat filter. But talking about it is just the first step: Visit letstalk.bell.ca for more ways you can effect change and build awareness around mental health.