Postpartum depression

One in seven mothers will develop a postpartum mood disorder, a condition associated with new moms during pregnancy or after delivering a baby. Recently the U.S. Preventive Services Task Force updated their recommendation that all women who are pregnant or have recently given birth should be screened. In this article, The Polyclinic behavioral health providers and Dr. Kristen Johnson share what you should know about postpartum mood disorder that can cripple new moms and families.

Sometimes a major life change that is supposed to feel happy can disrupt your mood in ways you never imagined. Such is the case with the mood disorder formerly known as postpartum depression that affects pregnant women and new mothers -- postpartum mood disorder.

What is Postpartum Mood Disorder?

Postpartum mood disorder describes any mood disorder that occurs during pregnancy and up to 18 months after giving birth.

Postpartum mood disorder is described by its impact across the span of new motherhood: peripartum mood disorder, which means “across pregnancy.” Physicians have broadened the definition of peripartum mood disorder to refer to the range of mood disorders that impact a woman at any point during or after pregnancy. However, for this article we will refer to the condition by “postpartum mood disorder.”

Women in their childbearing years are the largest group of Americans with depression, according to the American College of Obstetrics and Gynecologists.

What are the symptoms of a postpartum mood disorder?

  • Depression
  • Anxiety
  • Obsessive compulsive behavior
  • Apathy
  • Intrusive thoughts or images
  • Psychosis, in rare cases

A Struggle with Intrusive Thoughts

Women with postpartum mood disorder might have intrusive thoughts or images about harming their baby. These thoughts often reflect the mother’s anxieties about being “a bad mother.” She experiences fear that something bad will happen to the infant. These images are often incongruent with the mother’s intentions. She will rarely act upon them. The incongruent and intrusive thoughts do not necessarily indicate a risk to the child.

However, these thoughts can be frightening.

One patient shared that she would think of stabbing her infant whenever she caught sight of a knife. Another mother imagined dropping her baby from a balcony. Both mothers had no intention of harming their children but felt the horror and shame of having such thoughts, and the fear of admitting to them. Once they learned to acknowledge the thoughts for what they were – symptoms of anxiety – they were able to remain calm and continue with parenting activities without becoming distressed. They sought prompt assessment and treatment for these thoughts. This is important because these intrusive thoughts can cause prolonged distress, disrupt sleep patterns, interfere with daily functioning and impact caring for a new baby.

What are the risk factors of Postpartum Mood Disorder?

  • History of depression, mild or severe
  • Marital strife
  • Domestic violence
  • Poverty
  • Lack of family or social support

How Postpartum Mood Disorder Impacts Children, Family and Society

Postpartum mood disorders also pose risks for the fetus, according to a Harvard study. A depressed woman produces higher levels of stress chemicals. These stress chemicals can reduce fetal growth and compromise the genes that create a child’s own stress and immune response system.

A woman suffering from depression while pregnant can find it hard to fulfill daily activities, let alone support a growing baby. Possible risks to the depressed pregnant mother can include:

  • Higher possibility of substance abuse
  • Poor prenatal care
  • Relationship stress
  • Obstetrical complications

After a baby is born, maternal depression can impact bonding. Poor mother-infant attachment can lead to delayed cognitive linguistic skills and impaired emotional behavioral development. A distressed mother is at risk for abuse or neglect of her child, difficulty sustaining primary relationships and in the worst case, suicide, according to the same Harvard study.

Maternal depression can negatively influence family dynamics and child development. The annual cost of not treating a mother with depression (in lost income and productivity) is $7,200, according to the National Business Group on Health. Children of depressed mothers are often depressed themselves later in life. They suffer greater incidence of illness, visit medical office and emergency departments more frequently, and utilize health care services more than children of mothers who are not depressed.

Getting Help for Postpartum Mood Disorder at the Right Time

Time is crucial in treating postpartum mood disorder, says Dr. Kristen Johnson, family medicine physician at The Polyclinic Northgate. Dr. Johnson regularly screens all new expectant mothers through pregnancy and childbirth and beyond.

This care model aligns with the U.S. Preventive Task Force’s recently amended screening guidelines. “I’ve taken different approaches to treating postpartum mood disorder: seeing mom and baby back more frequently to check in, encouraging them to join support groups, encouraging counseling, and if appropriate, I’ll also manage medication,” she says.

Don’t Let Shame Prevent Treatment

Many new moms feel guilty or ashamed for experiencing symptoms or intrusive thoughts. According to The Polyclinic Behavioral Health providers, moms with postpartum mood disorder shouldn’t let shame get in the way of seeking treatment, but should treat it like any other medical condition.

How to Fight Postpartum Mood Disorder

Treatment can combine multiple approaches including:

  • Psychotherapy
  • Medication
  • Regular self-care
  • Enhanced social support

“In addition to psychiatric care, recovery from postpartum mood disorder often involves maintaining regular physical self-care routines such as sleep, diet, and exercise. Staying socially engaged is an important part of depression recovery, as it helps counter the sense of isolation that often accompanies depression,” says Miles.

Talk therapy helps normalize the experience for a distressed new mother. For mothers-to-be or a new mother, the time frame is short and the stakes are potentially high. The advantage at The Polyclinic is that the Behavioral Health Department is embedded in primary care.

Dr. Johnson indicates that the care of the mother rests ultimately in the hands of her primary care provider, who can manage medication and oversee therapy over the long run.

The Polyclinic is committed to helping women seek help for every aspect of new motherhood. If you feel you may be suffering from postpartum mood disorder, please contact your primary care physician at The Polyclinic to talk about what you are going through. We’re here to provide the support, resources, or referral you need to get back to health.


Suicide Prevention

If you are in crisis, call 1-800-273-TALK (8255).

February 22, 2016 | by The Polyclinic