Understanding and Treating Postpartum Depression (PPD)

image of a woman holding a baby looking stressed, suffering from PPD
by Daniel

Welcoming a new life into the world is a joyous occasion, but for some mothers, the postpartum period can bring unexpected challenges, including postpartum depression (PPD). It’s essential to recognize the signs and seek help early on to ensure the well-being of both mother and child. 

Understanding Postpartum Depression

Most new mothers will experience postpartum ‘baby blues’ after giving birth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues usually begin within the first 2 to 3 days after delivery and may last for up to two weeks. Crucially, postpartum depression is more than the baby blues.

Some new mothers go through a more intense and prolonged type of depression termed postpartum depression. It is occasionally referred to as peripartum depression, as it may onset during pregnancy and persist after childbirth. In rare cases, an acute mood disorder known as postpartum psychosis may emerge after giving birth.

It’s crucial to understand that postpartum depression is not a sign of weakness or failure as a mother. Sometimes, it is a complication associated with giving birth. If you find yourself experiencing postpartum depression, seeking timely treatment can aid in symptom management and support the development of a strong bond with your baby.

Recognizing Postpartum Depression and Postpartum Psychosis Symptoms

Postpartum depression symptoms may initially be mistaken for the baby blues, but the symptoms are more intense and persistent. These symptoms can impact your ability to care for your baby and handle daily tasks. They typically emerge within the first few weeks after childbirth, although onset may occur during pregnancy or up to a year postpartum. Untreated postpartum depression can persist for several months or longer.

Common postpartum depression (PPD) symptoms include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawal from family and friends
  • Changes in appetite
  • Insomnia or excessive sleep
  • Overwhelming fatigue or loss of energy
  • Reduced interest in previously enjoyed activities
  • Intense irritability and anger
  • Feelings of inadequacy or worthlessness
  • Difficulty concentrating and making decisions
  • Restlessness
  • Severe anxiety, panic attacks
  • Thoughts of harming yourself or your baby
  • Recurring thoughts of death or suicide

In rare cases, postpartum psychosis may develop within the first week after delivery, with severe symptoms such as:

  • Confusion and feeling lost
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Increased energy with emotional distress
  • Paranoia
  • Attempts to harm yourself or your baby

Postpartum psychosis requires immediate treatment due to the potential for life-threatening thoughts or behaviors.

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Potential Causes of PPD

Postpartum depression (PPD) is a complex condition with various contributing factors. It’s likely caused by a combination of physical and emotional factors, including:

  • Hormonal Changes: After childbirth, there’s a rapid drop in estrogen and progesterone levels, which can contribute to mood swings and depression.
  • Physical Changes: Giving birth is physically demanding and can lead to exhaustion and stress, which can contribute to feelings of depression.
  • Emotional Factors: The adjustment to motherhood, changes in relationships, and feelings of isolation or inadequacy can all play a role in PPD.
  • Personal History: Women with a history of depression or other mental health issues are at a higher risk of developing PPD.
  • Stressful Life Events: Stressful events during pregnancy or after childbirth, such as financial problems or a difficult birth, can increase the risk of PPD.
  • Lack of Support: A lack of support from partner, family, or friends can contribute to feelings of loneliness and depression.
  • Biological Factors: Some women may be more biologically susceptible to developing PPD due to differences in brain chemistry or genetic predisposition.

Postpartum Depression in Fathers

Studies have shown that new fathers can also experience postpartum depression, exhibiting symptoms such as sadness, fatigue, becoming overwhelmed, anxiety, and changes in eating and sleeping patterns—like those experienced by mothers.

Factors that may increase the risk of postpartum depression in fathers include youth, a history of depression, relationship difficulties, or financial struggles. Termed paternal postpartum depression, these symptoms can have negative effects on partner relationships and child development.

If you are a partner of a new mother and are experiencing depression or anxiety symptoms during your partner’s pregnancy or after childbirth, it is essential to speak with your healthcare provider. Similar treatments and support provided to mothers with postpartum depression can be effective in addressing postpartum depression in the other parent. Early intervention and open communication can play a vital role in fostering a healthy family environment.

Treatment Options for Postpartum Depression

Medication Management

Antidepressant Medications: medication may be recommended to help regulate mood and alleviate symptoms. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed and considered safe for breastfeeding mothers.

Therapy and therapeutic activities

Counseling and Supportive Therapy: One-on-one counseling sessions, such as cognitive-behavioral therapy (CBT) or interpersonal therapy, provide a safe space for mothers to express their emotions, learn coping strategies, and build a support network.

Group Therapy: Joining a support group with other mothers experiencing similar challenges fosters a sense of community and reduces feelings of isolation. Group therapy provides a platform to share experiences, exchange advice, and gain insights from others on the same journey.

Postpartum Support Groups: Local and online support groups specifically designed for postpartum mothers can offer a sense of camaraderie and understanding. Connecting with other moms who are navigating similar experiences helps create a supportive community.

Educational Programs: Participating in postpartum education programs provides valuable information on self-care, baby care, and mental health during the postpartum period. Knowledge is a powerful tool in managing the challenges that may arise.

Mindfulness and Yoga: Incorporating mindfulness practices and gentle yoga into the postpartum routine can promote relaxation and reduce stress. These practices focus on being present in the moment, fostering a sense of calm and balance.

Advanced treatment options

Transcranial Magnetic Stimulation (TMS or rTMS): TMS is a non-invasive, FDA-approved procedure that uses a magnetic field to stimulate nerve cells in the brain, particularly in areas associated with mood regulation. TMS has shown effectiveness in treating postpartum depression medications and psychotherapy have not achieved a satisfactory result. It is covered by most insurance plans.

Esketamine (Spravato): Esketamine, marketed under the brand Spravato, is a nasal spray that is administered under the supervision of a physician in Aster Mental Health’s offices. Each treatment session lasts approximately 2 hours. Like TMS, Spravato has proven effective at treating depression. The treatment is FDA approved and covered by insurance.

Can PPD be Prevented?

While it’s not always possible to prevent PPD, there are steps you can take to reduce your risk and promote emotional well-being during and after pregnancy:

  • Prenatal Care: Attend all prenatal appointments and discuss any concerns about mood changes with your healthcare provider.
  • Healthy Lifestyle: Maintain a healthy diet, get regular exercise (if approved by your healthcare provider), and get enough sleep.
  • Social Support: Build a support network of family, friends, and other new mothers. Joining a support group for new mothers can be particularly helpful.
  • Education: Learn about PPD and its symptoms so you can recognize them early.
  • Communication: Talk openly with your partner, family, and friends about your feelings and any challenges you’re facing.
  • Postpartum Plan: Develop a plan for the postpartum period, including childcare, household responsibilities, and self-care.
  • Professional Help: If you have a history of depression or other mental health issues, talk to your healthcare provider about a plan to manage your mental health during and after pregnancy.
  • Mindfulness and Stress Reduction: Practice relaxation techniques such as yoga, meditation, or deep breathing exercises to reduce stress.
  • Avoid Isolation: Stay connected with others and seek help if you’re feeling overwhelmed or isolated.

When to Get Emergency Help for PPD

If you think you may hurt yourself, someone else, or attempt suicide, call 911 in the U.S. or your local emergency number immediately. 

Also consider these options if you’re having suicidal thoughts: 

  • Visit the nearest emergency room or urgent care facility.
  • Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
  • U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

When to Seek Professional Help for Postpartum Depression

Postpartum depression is a medical condition that requires attention and care. Seeking professional help ensures an accurate diagnosis and the development of an effective treatment plan. The combination of medication, therapy, and additional support options can significantly improve the well-being of mothers and fathers struggling with postpartum depression.

Remember, reaching out for help is a sign of strength, not weakness. If you or someone you know is experiencing symptoms of postpartum depression, consult with a healthcare professional to explore the most appropriate treatment options and embark on the journey toward healing.

At Aster Mental Health, we specialize in supporting parents of newborns through the challenges of postpartum depression. We are in-network with most commercial insurance companies in Massachusetts and offer appointments in our offices or via telehealth. Our team of compassionate physicians, physician assistants, nurse practitioners, mental health counselors, and social workers offers personalized treatment plans, combining medication management, therapy, and supportive interventions to help you regain their emotional well-being.

Start by scheduling a consultation and take the first step towards a brighter postpartum experience.