What you can do if you're at high risk for developing PPD.
While postpartum depression (PPD) could strike anyone, there are some factors that increase your risk. They include:
- History of mental illness: Women who have previously had clinical depression are seven times more likely to develop postpartum depression. Keep in mind that you may not have necessarily been aware of, or treated for, past episodes of depression. It's important to look at your life carefully -- your adolescence, your young adulthood, previous postpartum experiences -- and assess whether you have had any significant episodes of anxiety or depression that have hindered your ability to function.
- Severe PMS: Because postpartum depression seems to be triggered in part by hormonal changes that occur after childbirth (and possibly after weaning), many experts believe that previous hormonal sensitivity should raise a red flag. This includes women who have had a history of severe PMS or who experienced a negative mood change while taking birth control pills.
- A perfectionist personality: Women who are highly driven or who are not likely to admit when they need help may not adapt as successfully to the demands of new motherhood because their expectations are unrealistic. A partner who doesn't participate in parenting or emotionally support the mom can leave her feeling overwhelmed.
- Difficulties during pregnancy: Significant upheavals while expecting -- moving to a new home, a death or illness in the family, marital stress -- can make a woman more vulnerable to PPD. A growing body of evidence also shows that in many cases women begin to present symptoms of depression while they are pregnant. Many of these individuals continue to be depressed after they give birth.
If you are at risk, share as much information as possible with your partner (or a close friend). Help him learn the symptoms of PPD, and ask him to be on the lookout. It's also wise to reach out to a therapist while you're still pregnant. Then if you do become ill and need help, you won't have to waste time looking for treatment.
Postpartum Depression: "I couldn't even talk... without crying."
Being forewarned about this once-taboo topic allows you to create an environment that prevents or lessens the severity of postpartum depression. In fact, whether you're at risk for PPD or not, the following strategies will make the transition to motherhood easier.
- Join a support group. New-mommy groups offered by community organizations and hospitals provide relief from the social isolation that comes with having a new baby, as well as perspective, notes Meg Spinelli, MD, director of the maternal health program at the New York State Psychiatric Institute at Columbia University. A woman can hear whether new moms are feeling what she is feeling or not. There are also numerous Web sites where you can meet other women who are at different stages of parenthood. The Postpartum Stress Center's site, www.postpartumstress.com, is a good place to start.
- Talk to your pediatrician and ob-gyn. Because these health-care providers have frequent contact with expectant and new mothers, they are in an excellent position to detect signs of PPD. It's important that you choose people you can talk to, who are interested in your welfare, as well as the baby's, points out Karen Kleiman, author of This Isn't What I Expected: Overcoming Postpartum Depression (Bantam, 1994).
- Get help at home. If hiring help isn't economically feasible, ask friends, family members (as long as you get along well), or even volunteers from your church to lend a hand. If you're not nursing, plan for your partner to feed the baby during the night, if possible. If you are nursing, consider pumping for one of the night feedings once breastfeeding has been established so your partner can take a shift. Above all, don't avoid asking your partner for help.
Reviewed 11/02 by Elizabeth Stein, CNM
All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.