Apr 27, 2023
‘There should be no stigma or shame around postpartum depression’
The birth of a child brings joy, but can also bring unique strains, including potential postpartum depression — a common and treatable condition, clinicians say.
“There should be no stigma or shame around postpartum depression,” said Dr. Tracy Mullare, a psychiatrist and instructor in psychiatry at Harvard Medical School, and a member of the physician review team at Blue Cross Blue Shield of Massachusetts. “It’s a very natural response to the physical toll of childbirth, sleep deprivation, the pressures of caring for a newborn, and the sudden drop-off in pregnancy hormones. But help is available. It’s just important to reach out.”
The condition is so common that the American College of Obstetricians and Gynecologists recommends clinicians screen new moms for signs of postpartum depression around six weeks after childbirth.
What are the signs of postpartum depression?
“About half of new mothers experience ‘baby blues’ — short-lived worry and sadness in the days after having a baby,” Mullare said, “but postpartum depression is more intense and longer lasting.”
Recent research shows that about 1 in 8 women experience postpartum depression. Symptoms may include:
- A lasting sad, anxious, or “empty” mood.
- Feelings of hopelessness or pessimism.
- Feelings of guilt, worthlessness, or helplessness.
- Feelings of irritability or restlessness.
- Crying more often than usual.
- Withdrawing from loved ones.
- Feeling distant from your baby.
- Worrying or feeling overly anxious.
- Doubting your ability to care for your baby.
Anyone who is feeling isolated, depressed, and are having difficulty bonding with their baby should reach out for help immediately.
Dr. Tracy Mullare
About 1 in 1,000 new mothers experience a more serious condition known as postpartum psychosis, a medical emergency that may cause delusions, hallucinations, mania, paranoia, and confusion. Risk factors include a previous psychotic episode and personal or family history of bipolar disorder. Women experiencing postpartum psychosis may be at risk for harming themselves or their child and should receive help as soon as possible.
If you or a loved one are experiencing symptoms of postpartum psychosis, seek help immediately by calling 911 or going to the nearest emergency room.
“Postpartum depression is common and treatable, and postpartum psychosis is rare and treatable,” said Dr. Greg Harris, a practicing psychiatrist and senior medical director, behavioral health, at Blue Cross Blue Shield of Massachusetts. “In both cases, recovery is possible with professional help.”
How can postpartum depression be treated?
Treatment may include a combination of medication therapy and counseling, such as cognitive behavioral therapy, Harris said.
Parents also can find help through organizations like Postpartum Support International, Perinatal Mental Health Alliance for People of Color, LGBTQ Birth Project, Jewish Family & Children's Services and Group Peer Support. They offer support for partners, too.
Hotlines are available for anyone in crisis: Call the PSI Warmline at 1-800-944-4773 or text 503-894-9453 to get information, support and resources. The National Suicide Prevention Hotline number is 1-800-273-8255, and the Massachusetts Samaritans hotline for emotional support is 1-877-870-4673. Of course, 911 is available for anyone in immediate danger.
“It’s important for both parents to understand in advance how challenging the postpartum period can be,” said Dr. Monica Ruehli, an ob/gyn at Atrius Health’s Dedham Medical Associates and physician reviewer at Blue Cross Blue Shield of Massachusetts. “I recommend seeking out childbirth or parenting classes that include information on postpartum depression and how to be aware of mental health issues before childbirth.”
Postpartum mothers struggling with depression and anxiety also can get help by reaching out to their health insurer to find online tools or a therapist who has availability.
“Having a baby is challenging and every woman deserves support,” Ruehli said.
Don’t be afraid to lean on family and friends, and if you are feeling sad or anxious or overwhelmed, make an appointment to talk to your primary care provider or OB or your baby’s pediatrician as soon as possible. Getting help is the best thing you can do for yourself and your baby.
Dr. Monica Ruehli