I was recently asked to put together a list of things women should know about postpartum depression. I thought a lot about what I went through in 2001 with postpartum OCD, and the things I wish I had known that I believe would have lessened the severity of my experience. While the list below certainly doesn't cover everything, I think it's a good start and I hope it will help many women in their journey as new mothers.
PPD can and often does happen.
Many pregnancy books and childbirth educators gloss over postpartum mood disorders. They minimally describe the symptoms and emphasize how rare it is. Actually, 10-15% of new moms experience these illnesses, and some studies report it may be as high as 25%. My childbirth educator told our class that we really needn't spend too much time worrying about it, so I didn't, and thus I was completely unprepared for what hit me.
Postpartum depression is only one in a spectrum of postpartum illnesses.
Postpartum mood disorders include postpartum depression (PPD), postpartum obsessive compulsive disorder (PPOCD), postpartum psychosis (PPP) and postpartum post-traumatic stress disorder. PPOCD is often characterized by intrusive thoughts, which are disturbing unwanted thoughts. When I experienced my first intrusive thoughts -- about smothering my infant son with the burpcloth -- I had never heard of such things. No one ever told me they were possible. I was convinced I had just gone permanently crazy, and it never occurred to me that I had PPOCD. If I had been better informed, I would have felt comfort in knowing what was wrong and that immediate treatment was available. Instead I kept quiet for weeks because I was afraid I'd be locked up forever and lose my family. (For more information on each illness and its symptoms, visit the Postpartum Support International website at http://www.postpartum.net/brief.html )
Symptoms can appear anytime during the first year after birth.
Many women think that if they start feeling bad when their child is 3 or 4 months old, or even older, that it can't be related to postpartum depression. Apparently, even the DSM-IV, the manual that psychiatric professionals use to diagnose psychiatric illnesses, states that your illness can only be diagnosed as postpartum if the symptoms show up within the first four weeks after birth. This isn't necessarily true. Postpartum mood disorders can occur any time within the first year after the birth of your baby, though it is true that most are diagnosed within 2 to 4 months postpartum.
Ask your friends and family to be prepared.
It's important to talk about the possibility that you might experience some form of postpartum mood disorder with the people closest to you. Ask them to educate themselves. Sometimes we can't see that we're acting differently, or we try to convince ourselves we're fine and purposefully ignore our symptoms. In that case, it often takes someone close to us to point out that we might need help. Neither my husband nor my mother knew about what to look for or what to do about it, which made it harder on all of us.
The sooner you get treatment the better.
Many recent studies show that children of mothers with postpartum mood disorders who go untreated for long periods can be negatively impacted over the long term with behavioral problems. A study published in 2006 in the Journal of the American Medical Association (http://jama.ama-assn.org/cgi/content/short/295/12/1389), for instance, found that children of mothers who have received treatment via medication for major depression or anxiety are less likely to be diagnosed with anxiety, disruptive and depressive disorders themselves, compared to children of women who remain untreated. You MUST push past the fear and speak up to lessen the impact of these illnesses on yourself and your children. You must be willing to say how you are feeling and seek treatment so that not only you, but your whole family can heal.
