21 Nov Postpartum Depression Experienced By Birthing Individuals

What is Post Partum Depression?

Take a minute to think about what comes to your mind when you hear the word ‘depression’. Maybe – a person who is feeling chronic sadness, guilt, hopelessness, and helplessness. Even if two individuals are experiencing depression, their lived experience of depression may be different. For example, one may wake up on time, dress up and show up at work whereas the other person may face difficulty falling or staying asleep and waking up on time, and may not find the energy, interest, and motivation to carry out their daily tasks. No matter what the symptoms of depression are, their presentation may vary from person to person. 

There have been so many conversations around mental health in the last few years, especially around depression. But we have paid very little attention to an individual’s experience of depression at different developmental stages and role transitions – postpartum being one of them.       

What is postpartum depression?

Postpartum depression (PPD) is a mood disorder that affects both birthing and non-birthing partners. Some of the symptoms of PPD are similar to the symptoms of depression:

• Feelings of chronic sadness, emptiness, and guilt
• Feelings of worthlessness, hopelessness, and helplessness
• Feelings of irritability or restlessness
• Lack of energy to carry out daily tasks  
• Loss of interest in hobbies and activities that one was previously interested in  
• Changes in sleep – Difficulty falling asleep, staying asleep, and/or oversleeping
• Changes in appetite – Loss of appetite or overeating
• Problems in concentrating on tasks, recalling details, and making decisions 
• Recurrent thoughts of self-harm and suicide   

Other symptoms of Postpartum depression may also include:

• Thinking that ‘I am not a good parent’
• Excessive doubts about not being able to take care of the baby
• Feeling numb or disconnected from their own body 
• Feeling disconnected from the baby 
• Withdrawing from loved ones, including the partner and/or the baby  
• Increased somatic complaints – headaches, backaches, etc. 

How is postpartum depression different from ‘baby blues?

Baby blues can be a common experience of new mothers and birthing partners that can last between two days to two weeks after the birth. Birthing partners who experience baby blues may feel tearfulness, mood fluctuations, and increased irritability due to hormonal fluctuations at the time of birth and acute sleep deprivation. These symptoms peak usually around three to five days after delivery. Unlike the symptoms of PPD, birthing partners experiencing baby blues may still be able to emotionally connect with their baby and non-birthing partner. They may feel happy and their self-esteem may undergo only negligible changes.    

Yet, baby blues is not a psychological condition, and it affects around 60 to 80% of new mothers worldwide. The arrival of the baby may require parents to make major changes to their daily routine which may overwhelm them and exhaust them at times. Therefore, experiencing baby blues is a common experience as compared to PPD. Some of the major differences between baby blues and PPD include their severity/ intensity, timing/ onset, duration and chronicity. The symptoms of PPD are likely to be greater in intensity and continue beyond the first two weeks after birth which may require professional attention.      

Risk factors for developing postpartum depression

Postpartum depression can affect any new parent regardless of their age, gender identity, sexual orientation, race, caste, class, income, culture or level of education. Research has indicated that there are certain risk factors that may increase the likelihood of some birthing individuals and add to their vulnerability to experience PPD. These risk factors involve: 

• Personal history of depression or any other mood disorders 
• Family history of depression or any other mood disorders 
• Stressful and non-normative life events (e.g., unemployment, death of a loved one, relocation)
• Complications in pregnancy, birth, or breastfeeding
• Health challenges in baby or parents 
• Age-related stressors – Teenage pregnancy, perimenopause
• Reduced social support from family, friends, and significant others
• Interpersonal stress (e.g., domestic violence, emotional abuse, other relationship stress)
• Barriers to accessing care and support (e.g., unavailability, inaccessibility, and unaffordability of healthcare and other essential services) 
• Substance use 

Understanding postpartum depression through a systemic lens 

Mental health conditions such as PPD need to be seen not only from an individual-focused lens but also from a systemic lens. When a baby arrives, we often ask how the baby is doing. Some of us may also ask how the mother is after giving birth. But, very few of us ask about the emotional wellness of the new mother and the non-birthing partner. 

Pregnancy as well as the arrival of the baby require a lot of adjustment in the new parents’ daily routine including additional baby-care responsibilities, household chores, job commitments, etc. The postpartum period also includes periodic physical check-ups of the baby and the new mother. Yet, their emotional health remains unacknowledged. Traditionally, the arrival of the baby is often associated with the joy and bliss of parenthood. But we do not hold space for conversations around how overwhelming new parenthood can be. When new parents do have these conversations, their lived experiences are often ‘corrected’ by others around them by asking them to ‘look on the brighter side. 

Even when we visit new parents and the baby, we often tend to play with the baby only till they are happy. As soon as the baby starts crying, we tend to ask the parents to take care of the baby. What if we supported them in the baby-care while we visited them? What if we held space for new parents to have conversations around mental health? What if we asked them if they need any practical or emotional support? Research suggests that having practical and emotional support is a protective factor for PPD as it reduces burnout and increases the likelihood that the new parents will engage in self-care or other activities that reduce their stress. But sometimes, even having this support as a protective factor does not mean that the new parents would not experience PPD or any other mental health concerns at all. 

Some new parents may need professional support to adjust to this new chapter of life, especially when they feel disconnected from themselves, their partners, and their baby. Postpartum depression in parents not only affects their own mental health but also the baby’s mental, physical, emotional, cognitive, social, and behavioral development. If left untreated, PPD can also affect parent-child interactions including bonding and breastfeeding. Therefore, early detection of symptoms of PPD and treatment is necessary to improve parental and infant health outcomes. Treatment for PPD may include psychotherapy (e.g., Cognitive Behaviour Therapy, Interpersonal Therapy, Narrative Therapy) and sometimes, psychiatric medication prescribed by a perinatal psychiatrist. Regardless of the intensity of your mental health concerns, you deserve the best possible professional psychological support.

If you or any expectant individuals you know need support, you can reach out to an AtEase expert. You can book a session here.