Tips on Postpartum Depression Adjustment

Many women experience postpartum depression after having a baby. The adjustment to postpartum can become physically and emotional difficult. To help understand what makes it challenging for someone people to adjust to postpartum depression and for tips on adjusting to postpartum depression, I have interviewed psychologist Sanjay R. Nath, Ph.D.

Tell me a little bit about yourself.
"My training is as a clinical psychologist. I work as a professor at Widener University 's Institute for Graduate Clinical Psychology (a graduate school training program for those who want to become clinical psychologists ), and also have a part-time psychotherapy private practice in Philadelphia, Pennsylvania. My doctoral thesis was about the causes of postpartum depression , and involved interviewing fifty women prior to birth and several months postpartum about their experiences of the transition to motherhood. I have also seen women in my private practice who have struggled with postpartum adjustment."

What makes it challenging for some people to adjust postpartum depression?
"The postpartum period is a time of major adjustment to a new care-taking role, to new responsibilities among partners and family members, as well as a time to form a unique bond between parent and child. In addition to changes in these core social relationships, many women and families experience justifiable concern about the economic realities of having a new child. Given the psychological, physical, social, and economic demands placed on a new mother , the postpartum period is often challenging and stressful even under the best of circumstances.

A significant percentage of mothers experience postpartum changes in their psychological functioning. Most common is the experience of the 'postpartum blues,' defined as mild dysphoria and crying spells in the first week after birth. It occurs in about 40% of women. Postpartum blues are characterized by crying spells, irritability, anxiety, mood shifts, and changes in sleep and eating patterns, peaking three to five days after birth. They are a transitory side effect of the birthing process, usually considered related to the dramatic hormonal changes occurring in the body immediately after birth, and these blues usually go away after the first week or two.

In contrast to the blues, approximately 10 to 15% of women experience major depression in the months following the birth. These women meet diagnostic criteria for a depressive episode (at least two weeks of significant symptoms such as changes in eating, sleeping, mood, lack of energy or lack of pleasure in usual activities, etc.). Such symptoms are significant in that they last most of the day every day for a minimum of two weeks. They are very difficult symptoms to handle alone, given the stressors of caring for a newborn and worries about the changing roles in work and family responsibilities.

The cause of postpartum depression is multi-determined and complex, and in past research, has been linked to biology, stressful life events, a history of past depression (many women also suffer from depression while pregnant and this may continue postpartum), lack of social or marital support, difficulties transitioning back to work, and inner conflicts over the transition to motherhood."

Do fathers or non-biological parents have postpartum depression adjustment issues?
"One of the most interesting aspects of postpartum adjustment is that research studies have established that adopting mothers, non-biological parents in same-sex families, and fathers all experience some of the difficulties described above with postpartum adjustment. This is part of the evidence that the postpartum period is a difficult and stressful adjustment period that impacts individuals deeply given the dramatic changes in roles and family life. It also means that such issues cannot be explained solely as a biological or hormonal response (in fact, the research on biological causes of postpartum depression has not found strong evidence to support this idea, despite its popularity). Lastly, it also means that getting support and finding professional help may be necessary not only for biological mothers, but also for others in the family system as well."

What are some tips on postpartum depression adjustment?
"One of the biggest hurdles to adjusting is acknowledging that one is having difficulty and asking for help. Because of the social pressure to be 'happy' as a new mother, many women feel guilty and ashamed of any difficulties they are having and may work to hide such issues from others or to downplay the extent of the adjustment issue. If one can admit to oneself and others that something doesn't feel right, and not simply explain it away as 'hormones,' that is the first step to coping better with one's situation.

An additional tip is not to isolate oneself. Join a parenting or mother's group. Spend the day with a friend or family member. Ask for help from someone you know to take a morning or afternoon off. Taking care of oneself is very important in being able to take care of others.

Tell someone that you are struggling and getting support from others is also a major protective factor for developing post-partum depression. Depression is related to not feeling like there is anyone you can turn to in a time of need and not feeling satisfied with the help or support around you '" anything that increases your support system is positive and protective in terms of postpartum depression.

Finally, talk with others about the experience of becoming a mother and what it feels like, what are you scared about, hopeful for, and anticipate as the best and worst aspects of the experience. Checking in and sharing your hopes and expectations as well as your fears and ambivalence can be an important aspect of coping with what is all too often a challenging, and sometimes overwhelming, period of one's life."

What type of professional help is available for someone that is having a difficult time adjusting to postpartum depression?
"If you have had prior problems with major depression before becoming pregnant or in a previous postpartum period, it makes sense to seek out professional support early in the process, anticipating possible problems and putting support in place early. Once you have a helpful professional relationship in place, it is often easier to prevent problems from developing and to make use of that individual as an additional support.

Types of help available vary. In addition to parenting and mothering support groups, there are also mental health professionals who have specialized in working with women and mothers (and partners when needed) on post-partum issues. Psychotherapists may be trained as psychologists, social workers, psychiatrists, or counselors. Make sure that the individual is licensed to practice in your state, and you may want to check on their ability to take your insurance or work on a sliding scale fee. Also ask your primary care doctor or obstetrician/gynecologist for a referral. They should be experienced in referring women with post-partum issues to reputable and experienced psychotherapists.

Many women who are at high risk for postpartum depression or even depression during pregnancy take antidepressant medication (some of the new SSRIs are classified as safe during pregnancy ). This practice has been encouraged in part because of the well-documented negative effects on infants when a mother is severely depressed postpartum. This is something also worth exploring with your primary care doctor or obstetrician/gynecologist.

There are also a growing number of mental health professionals who have become trained in a growing sub-specialty area called ' Infant Mental Health '. These individuals can help women with postpartum issues, and also often include young infants in the treatment as well (we offer this area of post-graduate study at Widener as a certificate program for professionals who are interested). Related to the focus on infant mental health, there is a national non-profit organization called 'Zero to Three' that also has a library of handouts for parents that is worth looking at ( zerotothree.org )."

Thank you Dr. Nath for doing the interview on postpartum depression adjustment. For more information on Dr. Nath or his work you can check out his website on www.centercitytherapy.com .

Recommended Readings:
http://www.associatedcontent.com/article/5674574/how_to_overcome_depression.html?cat=5">How to Overcome Depression

http://www.associatedcontent.com/article/5441884/postpartum_depression_an_interview.html?cat=70">Postpartum Depression\

http://www.associatedcontent.com/article/2944934/treatment_for_depression.html?cat=70">Treatment for Depression