Beyond the baby blues: navigating postpartum depression myths

Silhouette of a woman pushing a stroller in a city tunnel

When a newborn is brought into the world, mothers often experience a floodgate of emotions: excitement, jitters, joy. But, the beautiful milestone of a birth may trigger other feelings for new moms: isolation, numbness, hopelessness. There is a deepening silence around these feelings and a generalized stigma surrounding a prevalent maternal mental illness called postpartum depression (PPD).

You’ve probably heard the term at some point in your lifetime. You might even know a mother who has experienced it. Each year, hundreds of thousands of women suffer in silence from postpartum depression and we need to do more. Now.

Nationally, postpartum depression (PPD) is one of the most common maternal mental illnesses, affecting one in every seven mothers.

Celebrities like Chrissy Teigen, Serena Williams and Adele have opened up about their battle with postpartum depression, encouraging new mothers to reach out to get their mental health back on track.

Despite its prevalence, and the fact that it is highly treatable, postpartum depression is one of the most misunderstood mental illnesses.

Lack of knowledge and acceptance has created powerful myths about postpartum depression that impact families nationwide. Most mothers aren’t getting the help they desperately need due to misconceptions about what postpartum depression really is.

Woman in a black top. Headshot of Robin Bershader.

Psychiatrist Robin Bershader treats adults, children and adolescents at HCA Healthcare’s HealthONE’s The Medical Center of Aurora’s Behavioral Health & Wellness Center, specializing in reproductive psychiatry.

Psychiatrist Robin Bershader with affiliate HealthONE’s The Medical Center of Aurora’s Behavioral Health & Wellness Center helps us separate fact from fiction when it comes to postpartum depression.

Here are five common myths debunked by our expert.

MYTH #1:

Postpartum depression is the “baby blues” and will go away on its own over time.

“Postpartum depression” and what is referred to as the “baby blues” are very distinct entities. Often times, postpartum depression presents very similarly to baby blues, but transitions in an extreme fashion, interfering with a woman’s ability to care for herself or her family.

Baby blues generally starts roughly two days after giving birth, characterized by mood swings, possible decreased appetite, irritability and anxiousness.  There are many items that contribute to the natural development of the baby blues, which is seen in up to 80 percent of mothers. Contributing factors of the baby blues are massive hormonal shifts postpartum, sleep deprivation and an overall restructuring of a mother’s entire life. Generally, we expect the baby blues to resolve within two weeks.

In comparison, with postpartum depression, rather than seeing an improvement in these symptoms over that two week period, we see a progression and worsening.

Beyond the mood swings, other intense symptoms appear with postpartum depression.

Postpartum depression symptoms may include:

  • Hopelessness
  • Worthlessness or feelings of guilt and inadequacy
  • Difficulty bonding with your newborn
  • Anxiety and panic attacks
  • Excessive crying
  • Irritability or anger
  • Withdrawing from friends and family
  • Loss of appetite
  • Sleeplessness or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Restlessness
  • Recurrent suicidal thoughts
  • Thoughts of harming yourself or your newborn

It is so important for new mothers to talk about their feelings at all stages of postpartum. New moms often put on a cape and think, “I must have baby blues, and it will go away.” That mentality can have a detrimental consequence in preventing people from seeking help. Mothers should never feel hindered from seeking mental health care.

MYTH #2:

Postpartum depression occurs within the first few weeks of childbirth.

Postpartum depression may present immediately after giving birth, but it doesn’t always materialize within that time period. Experts have seen a huge spike in postpartum depression prevalence later in the postpartum period, with an onset and worsening of symptoms between the six and nine month mark.

If mothers have any risk factors, a close eye should be kept up until the 12 month mark. Mothers should always relay any risk factors to their obstetrician, nurse or midwife.

Risk factors for postpartum depression can include:

  • A previous history of depression outside the perinatal period
  • Prior history of depression during or after a previous pregnancy
  • Psychosocial stressors such as a strained marriage, a financially strained household, a special needs or medically complex child, returning to work after maternity leave or stopping breastfeeding

Postpartum depression can affect any woman regardless of age, ethnicity, or economic status.

An exhausted woman with her hand on forehead holding a sleeping baby

MYTH #3:

Mothers with postpartum depression cry often.

Often, when people think of a woman with postpartum depression, they’re thinking of a very specific picture of a woman crying and avoiding her life around her. But, often postpartum depression can present very differently.

Sometimes it is not the outward image of crying, but rather holding everything in, feel inadequate inside and putting on an external front that everything is okay. For the new parents around us, we need to look a little deeper about what they are really going through. Family and friends may be the first line of defense to recognize symptoms of postpartum depression in a new mother. If you recognize signs or symptoms, encourage her to talk to her health care provider.

MYTH #4:

Only birth mothers are at risk for postpartum depression

With the concept of postpartum depression, all of the focus tends to be on the biological mother.

There is also post-adoption depression syndrome (PADS) that presents in adoptive parents. Biological or not, all new parents have disruptions in their life. The inherent stress of parenting can cause disturbances in your relationships and bring out feelings of “this is harder than I thought it was going to be.”

Bringing an adopted child home can also ignite feelings of grief, loss, guilt and unresolved fertility issues, all of which can contribute to depression. The symptoms and risk factors of PADS are very similar to the signs of postpartum depression.

Fathers can also suffer from paternal postnatal depression (PPPD). Men, and partners in general, are often neglected when we think about depression associated with bringing a new child into the fold. This type of depression can be related to feeling excluded from the bonding process, a huge shift in the relationship with their partner, financial or work stress and even hormonal changes. There is a potential for drops in testosterone, estrogen prolactin and other hormones.

All parents (both moms and dads) deserve the chance to enjoy their life and their new baby. Don’t suffer alone. If you are a parent that is depressed, tell a loved one and reach out to your doctor immediately.

MYTH #5:

Mothers can’t take antidepressants while breastfeeding.

Many antidepressants, which are the mainstay treatment at this point in time for postpartum depression, are not harmful to infants who are nursing.

What we look at is the relative infant dose, or the amount of medication that will reach the infant. Generally, a number under ten percent is considered safe for a nursing mother and her baby. And, most antidepressants prescribed for postpartum depression have relative infant doses under three percent. There is a lot of literature to support that antidepressant medication for breastfeeding mothers is not detrimental.

Untreated postpartum depression poses a much higher detriment to the child.

Final takeaways

In today’s society, postpartum is portrayed as a happy time with picture-perfect images flooding social media. Comparatively, women experiencing both the baby blues and postpartum depression feel a lot of shame about their mental health. There is a lot of pressure to succeed at a being a mother, which is supposed to be the pinnacle of womanhood. When you are in the trenches of balancing motherhood with a career, and not succeeding at 100 percent capacity in either role, that feeling of inadequacy can be devastating.

We all need to be more open and candid with one other about the emotional experiences that we are having. Sharing the truth about postpartum depression is what is going to turn the associated-stigma around.

A woman looking down at a sleeping baby in her arms

Postpartum Support International (PSI) declared May Maternal Mental Health Month to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum.

Postpartum Support International offers a HelpLine at 1-800-944-4773 or via TEXT at 503-894-9453. *The PSI HelpLine does not handle emergencies. People in crisis should call their local emergency number or the National Suicide Prevention Hotline at 1-800-273-TALK (8255).

About HCA Healthcare

HCA Healthcare, one of the nation's leading providers of healthcare services, is comprised of 183 hospitals and more than 2,300 sites of care, in 20 states and the United Kingdom. Our more than 283,000 colleagues are connected by a single purpose — to give patients healthier tomorrows.

As an enterprise, we recognize the significant responsibility we have as a leading healthcare provider within each of the communities we serve, as well as the opportunity we have to improve the lives of the patients for whom we are entrusted to care. Through the compassion, knowledge and skill of our caregivers, and our ability to leverage our scale and innovative capabilities, HCA Healthcare is in a unique position to play a leading role in the transformation of care.

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