Women who have recently given birth are at a higher risk for developing depression and generally need to look out for the same warning signs as they might outside of pregnancy and the postpartum period, although depression postpartum can play off of different or additional worries and stressors.
There are a few factors that can make women more likely to experience depression during the postpartum period. These factors include:
- Life stressors, including stress at work, financial stress, housing instability, familial stress, or anything else that’s adding extra emotional strain throughout pregnancy and early parenting
- A history of depression or other mood disorders
- A lack of social support, which can happen to single parents or parents parenting with partners, if they’re far from extended family, don’t have friends who are familiar with or supportive of pregnancy and young children, or a workplace that doesn’t offer strong support to parents
- Unintended pregnancy, since parents who don’t feel like they’ve prepared a plan for parenting ahead of time can feel extra stress
- Intimate partner violence
Staying ahead of the curve
Women who are at a higher risk of developing depression after pregnancy can do a few things to start to get ahead of mood disorders, so that if they do appear, they’re already ready to deal with them. When it’s possible, one great way to start is by entering talk therapy – while it’s often a treatment for depression and PPD, it’s also a great way for women in the postpartum period who don’t have depression to stay tuned in to changes in their moods, and to identify types and sources of stress as they emerge. And if depression does emerge, women who have already sought talk therapy will already have trust-based relationships with therapists to draw on.
Another way to keep an eye out for mood changes, and the possibility of mood disorders, is for women in the postpartum period to keep track of their sleep patterns, to make note of any changes, and to make sure they’re getting plenty of rest. Although a solid eight hours of sleep may not seem possible with your newborn, it’s a good idea to make a plan for getting enough rest after delivery. This is helpful both because changes in sleep patterns, including sharp increases and decreases in sleep, are signs of depression, but also because lack of sleep has been suggested as a contributing factor in postpartum depression.
Women who have had depression or other mood disorders in the past should keep an eye out for symptoms they’ve experienced before, but there’s no guarantee that depression after pregnancy will look exactly the same as depression that the same person has experienced at other points in time. However, there’s an increased chance that women who have experienced postpartum depression in the past will experience it again.
Many doctors recommend that women who are already being treated for depression before pregnancy continue that treatment throughout pregnancy. For women who have discontinued treatment during pregnancy, if depression returns, it’s a good time to talk through the risks and benefits of returning to the pre-pregnancy treatment plan. Even when there are risks associated with certain medications, in many cases, the risk to mom and baby or untreated depression may be considered more risky.
What depression looks like
Signs of depression include:
- Excessive anxiety about the baby
- Low self esteem about motherhood, or feeling especially unprepared for parenthood
- Having trouble enjoying the things you usually like to do
- Not responding well or feeling comforted when the people in your life try to reassure you
- More frequent drinking, smoking, or use of illicit drugs
- Changes in eating or sleeping patterns, or trouble sleeping or eating healthily
- Thoughts of suicide
Women who notice one or more of these symptoms, or feel like these symptoms are starting to get in the way of their health, should talk to their healthcare providers about the possibility of depression.
- What every mom with a history of depression should know
- What every mom with a history of anxiety should know
- Lori L. Altshuler, Victoria Hendrick, Lee S. Cohen. “An update on mood and anxiety disorders during pregnancy and the postpartum period.” The Primary Care Companion to the Journal of Clinical Psychiatry. 2(6): 217-222. December 2000. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181144/.
- Mayo Clinic Staff. “Depression during pregnancy: you’re not alone.” Mayo Clinic. Mayo Clinic, November 24 2016. Retrieved July 9 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/depression-during-pregnancy/art-20237875.
- Marie-Louise H. Rasmussen, et al. “Risk, treatment duration, and recurrence risk of postpartum affective disorder in women with no prior psychiatric history: a population-based cohort study.” PLoS Medicine. 14(9). September 2017. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614423/.
- Linda Weinreb, et al. “What happens to mental health during pregnancy? Women’s experience with prescribing providers.” Psychiatric Quarterly. 85(3): 349-355. September 2014. Retrieved July 9 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399820/.
- “Postpartum depression risk, duration, and recurrence.” EurekAlert! American Association for the Advancement of Science, September 26 2017. Retrieved July 9 2018. https://www.eurekalert.org/pub_releases/2017-09/p-pdr091917.php.