Perinatal Mood and Anxiety Disorder
The range of emotional challenges experienced during pregnancy and after birth is extensive. The emotional issues previously referred to as Postpartum Depression (PPD) are now assessed under the framework of Perinatal Mood And Anxiety Disorder (PMAD).
“Postpartum” means the time after childbirth. You are home and everyone is celebrating the birth of your adorable baby. You must be so so happy right?
Its not that simple: Feeling hopeless or empty after childbirth is not what anyone talked to you about, and certainly not what you expected to be a part of being a new parent. Most new parents get the “baby blues” within the first week after giving birth: hormones are raging, exhaustion like never before experienced, and a feeling of emptiness that is hard to pinpoint.
For many, these baby blues go away after a week or so of getting settled into the “ new normal”. However, some more than they may admit, continue to feel sad, hopeless, or empty for longer. If these symptoms persist for more than 2 weeks, you may have postpartum depression.
PMAD is a potentially serious condition that is not your fault, and is nothing to be ashamed about, but it does require attention. It can lead not only to feeling sad and apathetic, but also unconnected to your baby, as if you are not the baby’s parent. Sometimes it can seem hard to love and care properly for your baby.
PMAD affects 1 in 9 people after giving birth. But remember that not everything you feel is worrisome: Most parents feel overwhelmed when a new baby comes home. Feeling exhausted and less attractive than they used to be before the pregnancy, feeling the stress from changes in work and home routines, and, most intensely feeling an unrealistic need to be a perfect parent. But more significant symptoms such as feeling hopeless, and crying a lot, not having any interest in the baby, or feeling as if your baby is someone else’s baby are important symptoms to seek attention for.
Other signs of PMAD include feeling worthless, guilty, or withdrawing from friends and family. And If you ever have thoughts of hurting yourself or of hurting the baby this is an emergency that requires immediate intervention.
Unfortunately, some new parents are ashamed to admit these thoughts and feelings when they are expected to be so happy. They worry they will be judged, and feel guilty that they are not overjoyed all the time.
It is critical to ask for help, and to remember that anyone can become depressed during pregnancy or after having a baby. The hormonal changes that occur during pregnancy produce estrogen and progesterone levels that are the highest your body has ever felt! Then, in the first 24 hours after childbirth, hormone levels drop dramatically to almost pre-pregnancy levels. This hormonal roller-coaster ride is implicated in the triggering of PMAD. Add to this, levels of thyroid hormones may also drop after giving birth which can also cause symptoms of depression (fatigue, appetite changes, irritability)
What is the best way to manage your feelings? Ask for help from your partner or loved one and call your doctor, nurse, midwife, or pediatrician if:
Your “baby blues” haven’t improved after 2 weeks
Your symptoms of depression get worse
You cannot really take care for yourself or your baby (e.g., eating, sleeping, bathing)
You have thoughts about hurting yourself or your baby
Along with getting professional help, remember that taking care of yourself is important too: Especially sleeping and eating well. But also get some help with the baby’s daily care and take some time out for yourself and with your partner. And try to avoid making any other major life changes right after giving birth.
PMAD is recognized as a serious health condition and can be treated with therapy as well as anti-depressant medicine some of which are safe to take while breastfeeding. However, remember that Antidepressants may take several weeks to start working so you will need to have people around you to support you during this interval. Remember that getting help is a sign of strength.
