Talk About Postpartum Depression

Pregnancy and having a baby may be the happiest times in a woman’s life. Celebrations, doting friends and family and the excitement of adding a sweet, cuddly tiny human to your household can launch you into a level of delight unmatched by anything else.

But what happens when you suddenly don’t feel so joyful? And loneliness, uncertainty and anxiety creep into your well-being? What is wrong with you? Why do you feel exhausted, helpless, guilty or just not yourself?

As part of its focus on Mental Health Awareness Month, Baptist Health South Florida hosted a Facebook Live discussion to talk about postpartum depression.

Prevalence of Postpartum Depression

Postpartum depression affects one in seven women, according to the American College of Obstetricians and Gynecologists. Alejandra Salazar, M.D., an obstetrician and gynecologist with Baptist Health Medical Group, says that while 14 percent of women experience varying levels of postpartum depression, only 10 percent report it to their doctor.

Dr. Salazar urges her patients and other women to speak up about their bothersome mental feelings, even if the baby hasn’t yet been born. Peripartum depression is less known about but almost always continues through the postpartum phase. If dealt with early, she says, postpartum depression can be managed, if not avoided altogether.

The American College of Obstetricians and Gynecologists issued its guidance on screening for postpartum depression in October 2018, recommending that all obstetric-care providers complete an assessment of mood and emotional well-being during the comprehensive postpartum visit for each patient, even if a patient has been screened for depression and anxiety during pregnancy.

Signs of Postpartum Depression

Those screenings will likely uncover potential problems and risks, but Grace Jimenez, a Behavioral Health manager at Baptist Health, says it can be up to the woman or her loved ones to alert her doctor to red flags. Some symptoms of peripartum and postpartum depression include:

• Physical fatigue or exhaustion
• Not wanting to do anything
• Feelings of guilt
• Sad thoughts
• A sense of not connecting with the baby
• Just not feeling right

Seek Help for Postpartum Depression Symptoms

While many of these symptoms mirror the normal stress signals associated with pregnancy and having a new baby, Ms. Jimenez says that when they become too much to handle, it’s important to talk with your doctor or seek the help of a therapist or behavioral health specialist.

Dr. Salazar adds that there are physiological reasons for experiencing some of the above signs. Progesterone and estrogen levels plummet in a short time following the birth of the baby to their pre-pregnancy levels, she says. But if these feelings last beyond the first two weeks after delivery, when hormones level off, she recommends speaking to your doctor.

If after two weeks, you can’t sleep, you’re eating too much or too little, experience anxiety that doesn’t go away or increases, or you consider harming yourself or your baby, Dr. Salazar urges you to seek professional help immediately. That help can come from your OB/GYN, a family doctor, or a mental health professional.

Ms. Jimenez says an online appointment with a behavioral health specialist through Baptist Health’s Care on Demand for Behavioral Health is also an option.

History of Mental Health Issues and Postpartum Depression

She says that for women who have a history of mental illness, anxiety or depression, discussing this history with your doctor at your first prenatal visit will help determine whether antidepressants or other medications should be changed, as it’s not always necessary to discontinue their use. 

Help for Postpartum Depression

Postpartum depression can be treated. Both Dr. Salazar and Ms. Jimenez say therapy is key, while medications can offer additional relief. Ms. Jimenez recommends involving the family in therapy as well, so they can learn how to support the person with postpartum depression.

Community Resources and Support Groups

Once the underlying depression is uncovered and managed through therapy or medication, or if you feel you need additional support to help you adjust to your role as a new parent – even if you have other children – community resources are available. Baptist Health offers new parent support groups and other groups, such as Postpartum Support International, exist.

Ms. Jimenez offers these words of advice to anyone hesitant to speak to someone about their postpartum depression: “Take care of yourself, so you can take care of your baby.”

Dr. Salazar echoes that sentiment and adds that you can give yourself permission to feel what you feel. “Don’t compare yourself to anyone else,” she said. “This is your journey.”

Watch our Facebook Live session on postpartum depression. 

Tags: Alejandra Salazar M.D., Graciela Jimenez, postpartum depression