Postpartum Depression and The Working Mother
Postpartum Depression can be difficult to diagnose after having a baby, especially since giving birth to and nurturing a newborn is a time of great upheaval already. It presents mental and physical challenges that no one can prepare you for. Physical pain from the trauma of birth and possible surgery, sleep deprivation, isolation, and extreme stress, all as you try to understand this new, incoherent human being! And in this period, the "baby blues" is quite common, with 50-80% of women suffering bouts of emotional episodes, crying easily, and quite stressed about their new identity. The "Baby Blues" peaks by 3-5 days postpartum and usually goes away within the days and weeks following birth. Theories suggest that this period is hormone driven.
Postpartum Depression, on the other hand, only occurs in 5-25% of women (American College of OB-Gyns) and tends to be diagnosed after 3-6 months postpartum and could last for weeks to months. The symptoms of postpartum depression are a bit more extreme; insomnia or hyper-somnia, suicidal thoughts, excessive guilt or feelings of worthlessness, decreased energy, poor concentration are but a few.
The outcomes of untreated postpartum Depression are grave; poor bonding with baby, neonatal abnormalities and cognitive problems with the child, marital tensions, suicide, and homicide. If you suspect you may have postpartum depression I beg you to call a doctor immediately. There are many forms of treatment for this suffering. The Edinburg Postpartum Depression Scale is a tool available in many languages that doctors use to diagnose Postpartum Depression. It should not be used in the absence of seeing a doctor. I can't say enough, if you are suffering, please see a doctor for help. The Edinburg Postpartum Depression Scale takes about five minutes to do, and with careful clinical assessment from a doctor, can be an effective way to identify this problem. (Some information from Perinatal Depression: Current Concepts, Nelda Scott MD.)
GOING BACK TO WORK - ON EMPTY
7-26% of women are already depressed during pregnancy. A study involving incarcerated mothers revealed that anticipation of separation changes bonding with baby during pregnancy. It is an extreme leap, but not outside the realm of possibility that a pregnant woman anticipating going back to work soon after birth could be feeling the same type of loss and dread. Stress effects your unborn child as well. Women with depression have twice the risk of preterm labor. When I was pregnant, I lived in dread of returning to work and obsessed about every moment with my baby.
Two risks factors for Postpartum Depression include life stress and poor social support. For some, returning to work is a huge life stress, and if you have no support from a spouse or family, you've got an instant recipe for Postpartum Depression. This also makes the timing of diagnosis for Postpartum Depression critical. Since most cases don't get diagnosed until 3-6 months (a lot longer than most American maternity leaves), you're already managing your baby, your work, and your life in an impaired state. If you know you are going back to work, the earlier after birth you get help for your postpartum depression, the better. The sooner you'll be able to cope with your return to working.
POSTPARTUM ANXIETY
Postpartum Anxiety is something we don't hear enough about. Two studies in the US and Germany have found that women are two to three times as likely to suffer from anxiety disorders after giving birth as from depression (from Living on the Edge, Cookie Magazine Article, November 09). Symptoms include a crippling fear of doing the day-to-day, heart-palpitations, trouble breathing, diarrea, and obsessive thoughts about extreme events are common with Postpartum Anxiety. If you feel like you need help, call your doctor to seek treatment.
POSTPARTUM DEPRESSION AND YOUR HUSBAND
The LaTimes just published an article on a study published in the Journal of the American Medical Assn. that reveals that 10% of men also suffer depression somewhere between your first trimester and one year after birth, and America men experiencing it at even higher rates: 14.1% versus 8.2% internationally. Men can become irritable and angry, detached from the family as a result of the stress, sleep deprivation, your own postpartum depression, or feeling overwhelmed by their new responsibilities as father. Men had a higher risk of depression if it was seen in their partner.
Although it states that sleep deprivation is the likely the biggest factor, financial difficulties, marital problems, and a sick or colicky baby can increase the risk in both partners. Once again, the going back to work period and financial disagreements around this choice could present a very stressful time for the family. It's important to seek help if you feel that this is causing you to be depressed.
IMPORTANT RESOURCES FOR POSTPARTUM DEPRESSION
Postpartum Support International - (800) 944-4773 or postpartum.net
Anxiety Disorders Association of America - adaa
Postpartum Progress - a blog - postpartumprogress
Motherisk at Toronto's Hospital for Sick Children - motherisk
The Pregnancy & Postpartum Anxiety Workbook by Pamela Wiegartz and Kevin L. Gyoerkoe
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