Pregnancy, birth, and the early weeks of motherhood are cherished in our society. We see images of glowing women with child. We share the precious preparations of the nursery, complete with tiny socks and shoes. We adore those newborn photoshoots with soft props meant to highlight how new and how sweet the baby is.

We expect this image of perfection to become reality. Even during those challenging 40 weeks of pregnancy, the painful hours of childbirth, and the sleepless nights of new parenthood, we dream of the joy to come.

We know pregnancy takes its toll on our bodies, minds, and even our relationships. We know childbirth inevitably includes pain and fear. We know those first weeks or months will be trying. We also believe it will all be worth it, and we’ll make it through, stronger and better for it.

And that’s true. It’s a time to be cherished, even if it’s challenging. But what happens when the new mother’s experience is shaped by depression and anxiety?

Depression and Anxiety During and After Pregnancy

Commonly referred to as postpartum depression, this mood disorder can happen either during pregnancy (perinatal), after birth (postpartum), or both. A number of factors can lead to postpartum depression, but chief among them are “hormones, neurochemistry, and life history,” according to Everyday Health.

Another risk factor for postpartum depression is experiencing depression during pregnancy. I had brief periods of acute depression, during my first trimester. My midwife urged me to establish a relationship with a psychiatrist during my pregnancy, in the event that this arises after birth.

I’m not immune. None of us is immune, as perinatal and postpartum depression can affect any woman. It doesn’t discriminate based on race, culture, or economic factors.

However, some women are at higher risk, such as single mothers, low-income women, and those in cultures in which mental illness isn’t openly acknowledged. Additionally, women who have a history of mood disorders are at higher risk.

For mothers with a history of depression and other mood disorders, changes in antidepressants or other medication may intensify postpartum depression. Many mothers stop taking their medication or change medications during pregnancy, and change again after birth, or while breastfeeding. These changes can cause a mood roller coaster for moms.

It’s critical to tell your physician or mental health professional about medication changes changes and any effects on you. It’s also important to consider your own health and wellbeing, when making decisions about medications to continue or adjust during pregnancy and breastfeeding.   

How do you know if you have postpartum depression? Generally, the symptoms of postpartum depression may include:

  • Feelings of sadness, hopelessness, despair, or feeling overwhelmed and anxious
  • Extreme fatigue, or changes in sleeping and eating patterns (though some of this is simply part of being a new parent)
  • Feeling guilty, ashamed, and worthless, like your child or family might be better off without you
  • Loss of interest in activities
  • Withdrawing from your family and friends
  • Lack of interest in your baby, or trouble bonding with your baby
  • Thoughts of harming yourself or your baby (even if you don’t believe you’d ever take action on those thoughts, you still need help)

It’s always best to speak to your healthcare professional, if you’re experiencing changes in mood. Please get help if you need it.

A Mother’s Secret

Many of us don’t want to think about feeling incredible despair, instead of elation, after birth. It’s been ignored by our society and our families for centuries.      

Mothers living with it try to ignore it. But the fact is — perinatal and postpartum depression are very real, natural, and common. Postpartum depression occurs in 10-20 percent of women and can last from a few weeks up to two years.

It’s important to note that many more mothers experience postpartum depression and never seek help. It’s also important to know that most women (70-80 percent) experience the “baby blues” for a couple of weeks after birth.

This mild “baby blues” depression is due to drastic changes in hormones, lack of sleep, and other physical and emotional adjustments to childbirth and motherhood.

If a new mother’s depression continues after two weeks, or worsens significantly, it’s called postpartum depression. It’s absolutely heartbreaking for a mother, and can impact her relationships, and her child. But it’s often not discussed, let alone diagnosed and treated.

If postpartum depression is a common, risky, but treatable medical condition, why aren’t women getting help?

Women often feel ashamed of their feelings. A new mother expects to feel extreme joy. And when she doesn’t, she may feel abnormal, like she’s a “bad mother.” She may blame herself for her depression. She may not tell anyone how she’s feeling because she’s afraid of being hospitalized and not being able to care for her baby.

There’s a stigma around mental illness, including depression, in our society, and postpartum depression is no different. The stigma may in fact be worse because of our false expectations of perfection and overflowing joy with a new baby.

Here’s what a mother shared with me about her two-year battle with postpartum depression, and why she never asked for help, in her own words:

“I didn’t tell anyone until it had passed. I’m sure I gave numerous signs and signals, but I never directly said, ‘I need help.’ I think I was ashamed to say I was struggling. I didn’t want to ‘bother’ anyone with my troubles. And I was accustomed to handling my depression myself for the most part.”

This scenario is frighteningly common. Most women suffer in silence. Only in recent years, have we begun to bring postpartum depression to light, to have those sometimes uncomfortable conversations with other mothers, with our families, and with our healthcare professionals.

Within the last decade or so, we’ve heard celebrities and everyday moms share their stories of postpartum depression. The movement is gaining traction through public-service campaigns, such as Speak Up When You’re Down.   

We must have these conversations. The risk of keeping this secret, remaining silent, and suffering alone is far too great.

What’s at Risk?

Depression during and after pregnancy impacts both mother and child, the family, and society.

Depression affects the likelihood of a pregnant woman to seek proper prenatal care, puts her at increased risk of abusing substances, and can lead to suicidal thoughts, and tragically, suicidal actions. The fetus is at higher risk of preterm birth, low birthweight, and other negative effects, sometimes due to substance abuse or lack of prenatal care.  

Postpartum depression puts a woman at risk of suicide and of harming her baby through abuse or neglect. A mother’s depression can lead to difficulty bonding with her baby, which can lead to long-term developmental challenges in her child.

Children whose mothers had postpartum depression are more likely to have behavioral problems, cognitive development delays, social challenges, and emotional issues. Untreated postpartum depression can also place a burden on marriages, in some cases leading to separation or divorce.

You’re Not Alone

I want you to know you’re not alone. I’ve experienced perinatal depression firsthand and listened as other women shared their stories of courage and hope. There is help. Your child and family deserve a whole, healthy, and well version of you, and you deserve to feel better.

If you’re in the San Francisco area and need help managing your depression or other mood disorder during and after pregnancy, please reach out to us. We’d love to help. 

Please talk to your healthcare professional, if you think you might be experiencing depression or another mood disorder. If you’re having suicidal thoughts or feelings, get help immediately.

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