“Postpartum depression isn’t your fault and doesn’t make you a bad Mom or Dad.”

Introduction

You’ve gone through your pregnancy, the pain and joy of childbirth, and now you’ve got a new baby at home. Shouldn’t you be bursting with happiness? Many new parents come home from the hospital to find that the postpartum period isn’t pure bliss like they’d been told. Postpartum depression is more common than you think. But why does it happen? Let’s talk about where postpartum depression comes from.

More Normal Than You Think

The time around having a baby can feel chaotic, happy, and stressful. You’re figuring out how to take care of your new little person. Your body is adjusting to post-pregnancy. You and your partner may be re-orienting your relationship around caring for your baby. And you’re probably sleeping and showering less than you’d like.

Yet movies and social media make us think new parents are all smiles, all the time. So if you’re not feeling that way, you may wonder if you’re doing something wrong. The first thing you should know about feeling out-of-whack after having a baby is that it’s normal.

Baby blues happen, and they’re pretty common. These initial feelings typically resolve on their own once you’ve adjusted physically and mentally to your new life.

But if these feelings persist, they may be a sign of postpartum depression.

Postpartum Depression vs. Baby Blues

Postpartum Depression (PPD) is a treatable psychiatric condition you’ll want to get help for. About one in seven women develop PPD, yet experts think half of these women go undiagnosed because they don’t want to tell anyone about their feelings. PPD can happen in any trimester, not just after you’ve had your baby.

How do you know if what you’re feeling is normal baby blues or postpartum depression? Here’s a chart to help you tell the difference between baby blues and postpartum depression, or PPD:

Baby Blues	PPD
Mood swings, including sadness, feeling overwhelmed, and crying	Depressed mood, and more severe mood swings. This may include excessive crying and anger
Anxiety, especially around caring for your baby and keeping your infant safe	Overwhelming anxiety, which may lead to panic attacks and overwhelming feelings of inadequacy
Appetite fluctuations	Loss of appetite
Trouble sleeping	Insomnia
Problems with concentration	Problems with thinking clearly, making decisions, and concentrating
Typically lasts about two weeks	Lasts two weeks or longer

As you can see, PPD is more severe and lasts longer than typical baby blues. And even though its symptoms are painful, many new moms feel so shameful that they suffer in silence. Dads can experience PPD as well. This condition is stressful for parents and painful for their kids and families.

At KarmaDocs, we help people with postpartum depression by creating custom integrative treatment plans. We offer medication management that considers breastfeeding and pregnancy, as well as supportive psychotherapy that fits your schedule.

Moms and Dads deserve to feel better. Our team helps them feel whole again.

Postpartum depression is a common mental health problem. Yet the lack of public support and knowledge about it can be frustrating. And more often, family members tend to shame women rather than support them. This leads to more isolation and guilt. And you might wonder why you’re dealing with these symptoms while no one else seems to be.

Postpartum depression isn’t your fault and doesn’t make you a bad Mom or Dad.

Causes of Postpartum Depression

Let’s dive a little deeper and talk about what is known about the root causes of PPD. Where Does Postpartum Depression Come From? Experts are still not exactly sure where PPD comes from or why it happens to some people and not others. Here are the main causes of postpartum depression that we know about so far:

Disruptions in reproductive hormones from pregnancy may cause other body processes to dysregulate. For example, the Hypothalamic-Pituitary-Adrenal (HPA) axis is involved in PPD and causes the release of stress hormones. This axis may be thrown off by hormonal changes during pregnancy, causing cortisol imbalances in pregnant women. These imbalances can remain for up to 12 weeks after childbirth.

Reproductive hormones themselves may be stressors, leading to depressive symptoms. Oxytocin and prolactin play important roles in PPD. They also regulate milk production and the milk let-down reflex. Women often experience the onset of PPD symptoms at the same time as lactation problems. Low oxytocin levels are associated with symptoms of depression during and after pregnancy.

Hormones can also play a role in mental health in women who aren’t pregnant. Learn how on our blog.

But these hormonal changes aren’t the whole picture. Like with other mental health conditions, genetics, hormones, and psychological stressors combine to make some women more at risk for PPD. Let’s talk about the factors that can put some women at higher risk for postpartum depression. What Factors Can Increase Someone’s Risk of Postpartum Depression? A few things may increase a person’s risk of developing postpartum depression. Some of them may surprise you. Take a look at these risk factors for PPD, which are similar for men and women:

• First pregnancy
• Unintended pregnancy
• History of previous mental health problems, like depression and anxiety
• History of premenstrual syndrome (PMS)
• Negative feelings about the baby or their gender
• History of sexual abuse
• Risky pregnancy, including cesarean (C-section) birth and multiple hospitalizations
• Birth complications like umbilical cord prolapse, preterm or low birth weight pregnancies, and blood loss during birth
• Lack of social support and/or partner support
• Domestic abuse
• Smoking during pregnancy
• Previous problems with sleep
• Low physical activity
• Low socioeconomic status

It may come as no surprise that having higher stress levels before and during pregnancy can lead to depression and stress after birth. Parents who lead more stressful lives, like those in an abusive relationship and who may have financial anxiety, are more at risk.

Most of the risk factors for PPD are outside of your control. Postpartum depression is no one’s fault.

But is it possible to reduce your risk for postpartum depression? Let’s talk about prevention.

How Can You Prevent Postpartum Depression?

There’s still no proven way to entirely prevent postpartum depression. Many of the biggest risk factors for postpartum depression are ones that people can’t control. If it were possible for parents to pull themselves out of poverty, for instance, they would have done that before pregnancy. But if you or your partner are pregnant, there are some things you can do to reduce your risk of postpartum depression.

Get exercise, even when you’re pregnant. Many women think they shouldn’t or don’t need to exercise when they’re pregnant, but it’s actually great for balancing your hormones and making you feel good. Even a quick 20-minute walk a few days a week can improve your life and your risk for PPD.

Seek education. Some research has shown that parents who feel more confident in caring for their baby tend to have less risk of PPD. Simply reading this article and learning about the symptoms can help you feel more equipped.

Quit smoking. This can reduce your risk for postpartum depression and other risks during pregnancy. Women who smoke during pregnancy are twice as likely to have complications like placenta problems, premature birth, hypertension, and more.

Let your OB/Gyn or primary care provider know if you have a history of depression or anxiety. They should be able to refer you to a psychiatrist or mental health provider. You can also call our office if you believe you’re at risk or experiencing PPD.

Treatment for Postpartum Depression

If you’re noticing symptoms of postpartum depression, it may be too late to prevent it from happening. But the good news is there is treatment for PPD. Treatment for Postpartum Depression PPD treatment is typically a combination of antidepressant medications and psychotherapy. New Moms are often worried about taking medications while breastfeeding. A few new treatments are specifically helpful for Moms with PPD. Let’s talk about them:

Zulresso (brexanolone) is the first medication that was made specifically to treat postpartum depression in women. Zulresso is given via IV infusion by a licensed medical provider.

Transcranial Magnetic Stimulation (TMS) is a cutting-edge treatment method that doesn’t require anesthesia or medications. Learn about TMS on our KarmaTMS site.

Postpartum depression is painful, but there are more treatment options available than ever. It wasn’t that long ago that women with PPD had to learn to live with their symptoms because medications could get into breastmilk. But with new treatment options, women have more access to care than in the past.

If you think you or your partner may have postpartum depression, contact our office for help. PPD is painful for individuals and families, and treatment is out there. Our team is experienced in helping parents heal from postpartum depression.

During your first visit, our compassionate psychiatric staff will take the time to hear your story and understand what you’re going through. We combine modern medical treatments with integrative lifestyle strategies, so you get the best care for postpartum depression. Contact our KarmaDocs office to get your symptoms evaluated and get treatment for postpartum depression.

Resources

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2) Mayo Foundation for Medical Education and Research. (2022, May 24). Postpartum depression. Mayo Clinic. Retrieved November 1, 2022, from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

3) Scarff JR. Postpartum Depression in Men. Innov Clin Neurosci. 2019 May 1;16(5-6):11-14. PMID: 31440396; PMCID: PMC6659987.

4) Barber, G. A., & Steinberg, J. R. (2022). The association between pregnancy intention, fertility treatment use, and postpartum depression. Social Science & Medicine, 314, 115439. https://doi.org/10.1016/j.socscimed.2022.115439

5) Shimpuku, Y., Iida, M., Hirose, N., Tada, K., Tsuji, T., Kubota, A., Senba, Y., Nagamori, K., & Horiuchi, S. (2022). Prenatal education program decreases postpartum depression and increases maternal confidence: A longitudinal quasi-experimental study in urban Japan. Women and Birth, 35(5). https://doi.org/10.1016/j.wombi.2021.11.004

6)Chen, H.-L., Cai, J.-Y., Zha, M.-L., & Shen, W.-Q. (2018). Prenatal smoking and postpartum depression: A meta-analysis. Journal of Psychosomatic Obstetrics & Gynecology, 40(2), 97–105. https://doi.org/10.1080/0167482x.2017.1415881

7) Commissioner, O. of the. (2019, March 19). FDA approves first treatment for post-partum depression. U.S. Food and Drug Administration. Retrieved November 1, 2022, from https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-post-partum-depression