Post Partum Depression and the Effects on Motherhood

According to research compiled by John W. Santrock, there are three categories that women fall into after giving birth. The first category is made up of 20% of United States women, and that is those who have no symptoms at all after giving birth. The second category, postpartum blues, describes the 70% of United States women who experience symptoms of depression, anxiety and being easily upset within two to three days after giving birth. The women in this category usually notice that symptoms dissipate over the course of a week or two. The last category, postpartum depression, is made up of 10% of United States women who experience the same symptoms as those with postpartum blues, except that the symptoms last for weeks or months and interfere with the functions of daily life. The major depressive state kicks in around four weeks after delivery. Of the 10% of women who fall into the category of those with postpartum depression, between 25 and 50 percent of those women have depressive episodes lasting six months or more. Gone untreated, roughly 25 percent of these women are still depressed a year later (Santrock, 2008).

Causes

It is believed that there are a number of reasons that women experience symptoms of depression during and after pregnancy. Hormone changes or other stressful events in a person's life can lead to chemical changes in the brain that can lead to depression. Depression is also an illness that can run in the family. Other times, it is not abundantly clear what causes depression.

Pregnant women may be more susceptible to postpartum depression if they find any of the following factors to be true during their pregnancy: "history of depression or substance abuse, family history of medical illness, little support from family and friends, anxiety about the fetus, problems with previous pregnancy or birth, marital or financial problems, young age of the mother" (Roca, 2005). Hormonal changes in the mother's body after birth can trigger symptoms of depression. Estrogen and progesterone, two female hormones, increase greatly during pregnancy and within twenty-four hours after giving birth the amount of these hormones drops drastically to their normal levels. Some researchers believe that the rapid drop in the hormone levels may lead to depression in some women (Roca, 2005).

Another possible cause of postpartum depression is the level of thyroid hormones present in the mother's body after birth. The levels of thyroid hormones sometimes drop after giving birth, which can lead to "depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain" (Roca, 2005). Luckily, a blood test is all that is needed to tell whether the thyroid hormone levels are too low and medication can be prescribed to easily fix the problem.

A lot of simple, every day type things can lead to symptoms of postpartum depression. The mother is often very tired and fatigued after giving birth, and this situation is not helped by the fact that having a newborn means broken sleep patterns and lack of adequate rest. A new mother can often go weeks before regaining her full strength. Some women stress over whether or not they are a good mother, and can get overwhelmed with a new baby in the house or feel the need to be the perfect mother, which adds even more stress to the mix. A newborn also takes a lot of the spare time the mother may have had before giving birth, and this could mean less time with family and less one on one time with their spouse. The loss of control over their daily life and even the fear of not getting back to their pre-pregnancy weight and/or figure contribute added stress and feelings of inadequacy. All of these factors can contribute to postpartum depression.

Symptoms

Women with postpartum depression are described as those who have any of the following symptoms during and/or after pregnancy that last two weeks or more: "feeling restless or irritable, feeling sad, hopeless, and overwhelmed, crying a lot, having no energy or motivation, eating too little or too much, sleeping too little or too much, trouble focusing, remembering or making decisions, feeling worthless and guilty, loss of interest or pleasure in activities, withdrawal from friends and family, having headaches, chest pains, heart palpitations (the heart beating fast and feeling like it is skipping beats), or hyperventilation (fast and shallow breathing)" (Roca, 2005).

Postpartum depression does not necessarily occur right after giving birth. Postpartum depression can actually occur anytime within the first year after childbirth, and the mother often has a number of the symptoms listed above. Postpartum depression differs from the baby blues in that it interferes with the mother's daily life and well being and keeps her from functioning normally for a longer period of time (Roca, 2005). Postpartum depression should not be left untreated.

Treatments

Many women are often guilty or ashamed of feeling the way they do if they are experiencing symptoms of postpartum depression, which can lead to a longer diagnosis time if she does not seek help at first sight of the symptoms. Women should not feel guilty, as postpartum depression can happen to any woman. There are many treatments and different types of therapy that can help women suffering from postpartum depression.

Some women find group or individual talk therapy very helpful. This type of therapy can encourage the mother to see that she is not alone and show her how to feel and do better as a mom and as a person (Roca, 2005). Doctors can also prescribe anti-depressant medication, which research has shown is helpful in improving the symptoms of postpartum depression in many women (Roca, 2005).

The most important thing for a woman to remember if she is experiencing symptoms of postpartum depression is that she is not alone and the best thing to do is to talk to her doctor. Left untreated it could last years and can be unhealthy for the mother and child both. Some women find it helpful to get rest as much as possible, or to nap when the baby naps. Having a network of support to help take some of the pressure and daily duties off the mother's shoulders is also very helpful in keeping stress levels down. Spending a lot of time alone can be worse, so having the mother get out of the house or being around family and friends can improve the mother's mood and feelings of happiness. These are many little things the mother can do to help improve the quality of her daily life if she is suffering from postpartum depression.

News Coverage

Women all over the world are blindsided by postpartum depression and not always aware of what they are going through. They are also not always aware that they are not alone. There have been many women who have come forward to tell their story in hopes that it would help even one other mother out there to know she is not alone. There have also been the sad stories of women who did not get the help they needed and in turn ended up harming their children. The most well-known instance of the latter is the story of Andrea Yates who killed her five children while suffering from postpartum depression.

On June 20, 2001, Andrea Yates called her local police to inform them that she had drowned her five children, ranging in age from six months to seven years, one by one in the family bathtub (Sweetingham, 2006). In Texas, where Yates lived, any defendant who used insanity as a defense must be able to prove that they were both mentally ill and did not know that their actions were wrong at the time of the crime. The officers who responded to the 911 call placed by Yates told the courtroom that she appeared "unemotional, unkempt, and soaking wet" as she calmly stated, "I killed my kids" (Sweetingham, 2006). Even Yates best friend testified that although she was a sweet friend and loving mother, she became zombie-like after the birth of her fourth son and could not even finish sentences at times. Apparently Yates had a long medical history of mental illness, suicide attempts, and recurrent postpartum depression and had even been hospitalized several times for psychiatric care. Her physician had gradually taken her off her antipsychotic medication just weeks before she killed her children (Sweetingham, 2006).

In 2002, Yates was sentenced to life in prison after the jury found her guilty of capital murder. The decision was thrown out and she was granted a new trial due to the flawed testimony of a prosecution medical expert. After her new trial, the jury of six men and six women rejected the state's theory that Yates knew what she was doing was wrong when she drowned her children and she was only charged in the deaths of three of the five. One representative of the jury panel explained that it was clear that she had psychosis before, during, and after the pregnancy. She escaped spending her life behind bars, but will most likely spend it in a psychiatric ward (Sweetingham, 2006).

Not all cases of postpartum depression end as badly as the case of Andrea Yates. Postpartum depression even befell the celebrated actress Brooke Shields. On the outside, she had it all, but after her daughter was born, she suffered a horrible bout of postpartum depression. In 2003 when Brooke gave birth, she found herself on the verge of putting an end to it all. She was not happily adoring her new baby, but rather suffering on the inside and not sure where to turn. She admits to wanting to jump out and end her life every time she passed a window. After struggling to get pregnant, and then falling into a deep depression, she claims this time as "the most tumultuous time in her life" (Mann, 2004).

Brooke claims that she had no motherly instincts, which she thought would just appear once she gave birth. Her husband was extremely supportive and concerned for his wife, and yet Brooke still had no motivation to help care for their newborn daughter. The thought never crossed her mind that the thoughts and feelings she was experiencing were those of postpartum depression. She admits to having visions of her daughter flying through the air and hitting a wall, although Brooke was never the person throwing her (Mann, 2004).

For some women, the reasons behind why they become depressed after childbirth are unknown. For Brooke, the complications of getting pregnant through in vitro fertilization and actually giving birth should have been red flags. Her daughter was delivered by emergency C-section, and Brooke's uterus herniated during the surgery and she lost a lot of blood. Her father also passed away from prostate cancer just three weeks before she gave birth and she was also mourning the death of her best friend who committed suicide in 1999 (Mann, 2004). All of these factors most likely contributed to the extreme case of postpartum depression that Brooke experienced almost immediately after giving birth.

Brooke entered therapy and ended up writing a book titled Down Came the Rain telling all about her ups and downs of becoming a mother. Postpartum depression is not a topic talked about openly amongst most people, and she felt that putting her personal story out there for everyone to see might help more women come forward or at least seek help if they were feeling the symptoms of postpartum depression. Brooke sums it up beautifully when she said, "Postpartum depression takes certain truths and turns them into the worst version of the truth. The truth is, your life is changed forever when you have a child, but what you don't factor in is that it might be better and it might be more enriched" (Mann, 2004).

Bibliography

Mann, Denise (2004, March, 24). Out of the Blue. Web MD the Magazine, Retrieved November

24, 2007, from http://www.webmd.com/depression/guide/brooke-shields-depression-struggle

Roca, C (2005, April). Postpartum Depression. Retrieved November 24, 2007, from Depression

During and After Pregnancy Web site: http://www.4woman.gov/faq/postpartum.htm

Santrock, J. W. (2008). Life-Span Development. New York, NY: McGraw Hill.

Sweetingham, Lisa (2006, July, 26). Andrea Yates found not guilty by reason of insanity in

children's deaths. Court TV News, Retrieved November 24, 2007, from http://www.courttv.com/trials/yates/072606_verdict2_ctv.html