Beyond the Baby Blues ~ An Overview of Postpartum Depression and Difficult Adjustment

The postpartum period is a time of significant change that can trigger mental and emotional imbalances. In the weeks and months after having a baby, women report feeling sad, lonely, overwhelmed, afraid, irritable, and tired. These feelings are a natural response to a new and demanding role. However, when your ability to function becomes impaired, it is time to reach out and seek help. This article, the first in a series of three profiling mental health issues, will focus on the signs and symptoms of postpartum depression, anxiety, and difficult adjustment.

Mental illness during pregnancy or postpartum has many possible causes, including a personal or family history of mental illness, a history of trauma, substance abuse, social isolation, lack of support, stress with your partner or spouse, an unwanted or accidental pregnancy, history of infertility or pregnancy loss, and stress related to a move, transition, job loss, divorce, or loss of a loved one. Physiological factors play an important role as well. It is important to rule out thyroid dysfunction, anemia, substance use, excess caffeine or alcohol, elevated cortisol, depleted serotonin, increased inflammation related to stress, disrupted sleep, and nutritional deficiencies.

Postpartum depression manifests as pervasive feelings of sadness and hopelessness, excessive crying, feeling overwhelmed, difficulty sleeping (even when the baby is sleeping), sleeping too much, low energy, agitation, irritability, panic, impaired concentration, guilt, intrusive scary thoughts, thought of harm, or thoughts of suicide.

Anxiety is considered a symptom of postpartum depression. Signs and symptoms to look for include pervasive worrying, feeling jittery, insomnia, stomach pain, nausea, gastrointestinal disturbances, or panic which is characterized by unexpected feelings of dread and terror. A panic attack can last anywhere from five to thirty minutes, with sensations such as heart palpitations, tight chest, chills, numbness, or feeling detached from your body.

Adjustment disorder is described as having difficulty adjusting to the demands of having a child. It may mean feeling moody, having an increased stress response, or a low threshold for feelings of frustration, anger, and irritability.

The onset of symptoms may occur right after the baby is born, or may surface a year or two later. Depending on the severity, some symptoms respond well to reassurance and short-term supportive therapy, while more critical cases of postpartum depression, especially if a woman has thoughts of harming herself or the baby, must be treated immediately with a combination of medication, therapy, diet and lifestyle modifications, and complementary medicine.

There are many barriers to seeking treatment. For instance, the denial or failure to recognize symptoms, fear of stigma or that the baby will be taken away, an unsupportive spouse or family, symptoms of depression (for example fatigue, apathy, lack of motivation) decrease the ability to mobilize for help, or help may be inaccessible due to wait-lists, cost, or geography.

Mental illness is prevalent across a lifespan. During pregnancy and postpartum, however, a woman must be able to take care of herself and the baby. Seeking support and treatment will enable a woman to recover so that she can be her best as a mom.

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Maya Hammer
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Maya Hammer is a psychotherapist specializing in prenatal and postpartum mental health, infertility support, and pregnancy loss or infant death bereavement. Maya’s approach to therapy is integrative, combining western psychology modalities with mindfulness meditation, yoga, and Ayurveda. Maya is passionate about promoting mental and emotional wellbeing during these significant life stages.
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