The birth of a baby is generally considered a joyous event. However, for many mothers the experience can be overshadowed by postpartum blues, postpartum depression or postpartum psychosis.

I suffered from postpartum depression (PPD) many years ago, and the experience was one of great suffering. I had a C-section so I was trying to attend to a newborn while also recovering from major surgery. If my husband hadn't been there, and been so capable, I don't know how my son would have been well cared for during that time. I was inconsolably sad. Even worse, I was ashamed to be sad when I had just been given such a beautiful gift. A friend called me daily, saving my sanity in those early days. I worried I wasn't caring properly for my baby, I cried, I couldn't sleep and I had dark thoughts of just getting in the car and driving away without him. His crying and constant neediness was completely overwhelming, and I felt unequal to the task. I tried going to my OB-GYN for help, but in those days very little was known about PPD and he was no help. I knew this was more than the "baby blues."

My saving grace came with a newsletter from a local hospital which included a notice about a support group for women with PPD. I called the number right away and found the therapist, Ann Dunnewold (subsequently an author of several books on PPD and mothering), was on maternity leave but that the group was meeting informally without her. After one phone call to a complete stranger, I grabbed my baby, hopped in her mini-van and headed off to a local mall where the women were meeting that day. Eventually the therapist returned, more formal support was offered and I was given a prescription for antidepressant medication. By the time my son was six months old I was well on the road to recovery.

What I was experiencing was not the "baby blues," which may affect as many as 80 percent of women. The "baby blues" typically happens soon after birth and is short-lived, usually lasting several days to a couple of weeks. According to the Mayo Clinic, symptoms of the postpartum blues include mood swings, anxiety, sadness, irritability, crying, decreased concentration and trouble sleeping.

I realized I had PPD, which affects 11-16 percent of women and presents itself usually several weeks after delivery. The Mayo Clinic says, "Postpartum depression may appear to be the "baby blues" at first - but the signs and symptoms are more intense and longer lasting, eventually interfering with your ability to care for your baby and handle other daily tasks." Left untreated it can last several months or more.

How do you tell if you have postpartum depression?

Postpartum Depression Symptoms May Include:

  • Loss of appetite

  • Insomnia

  • Intense irritability and anger

  • Overwhelming fatigue

  • Loss of interest in sex

  • Lack of joy in life

  • Feelings of shame, guilt or inadequacy

  • Severe mood swings

  • Difficulty bonding with your baby

  • Withdrawal from family and friends

  • Thoughts of harming yourself or your baby

The Mayo Clinic explains that with postpartum psychosis - a rare condition that typically develops within the first two weeks after delivery - the signs and symptoms are even more severe. Signs and symptoms of postpartum psychosis may include confusion and disorientation, hallucinations and delusions, paranoia and attempts to harm yourself or your baby. If you are experiencing these symptoms call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

What causes postpartum depression? Medical professionals still do not know, but it is believed that hormonal changes are responsible. Levels of estrogen and progesterone increase dramatically during pregnancy, then after delivery they - as well as other hormones - drop significantly. The intense stress of caring for a new infant may play a role, and women who suffered from depression are at higher risk.

It is critical to begin treatment for PPD as soon as possible not only for the mother's sake, but for the baby, too. Left untreated, postpartum depression can have an impact on infants' social-emotional and other growth areas. According to the PBS documentary "This Emotional Life," "Several studies suggest that babies of mothers with untreated postpartum depression are more likely to be slow in developing motor skills. (Those are activities such as lifting the head, rolling over, sitting up, crawling and walking.) These children also tend to show delayed development in cognitive skills-the mental skills that guide how knowledge is obtained. When mom has postpartum depression, the infant may withdraw. The baby may be more irritable and difficult to soothe. Studies show that by age 4 or 5, some of these children show impaired cognitive and intellectual performance. By age 11, children of mothers who had untreated postpartum depression had lower IQ scores than the youngsters of mothers without postpartum depression. The children also had greater problems with attention and had a tougher time with mathematical reasoning." Children of moms with untreated PPD can also show signs of conduct and mood disorders.

Don't let embarrassment about your symptoms stop you from reaching out - there is help out there and you are not alone! Treatment for postpartum depression can include talk therapy and medication. Reach out to your OB-GYN, psychiatrist or therapist as soon as you recognize that you are experiencing symptoms of PPD. Peer-to-peer groups can be very helpful, and there are numerous groups that meet around the D.C. metro area as well as online communities. Additional resources, including access to local support groups, are available through the list of resources at the end of this article.

Healthy Mothers, Healthy Babies: Help for Low-Income Women

One local organization has been helping low-income women with maternal depression for over 12 years. Aspire Counseling, a non-profit mental health organization in Montgomery County, runs the Healthy Mothers, Healthy Babies program, which provides free home-based therapy and counseling for mothers suffering from pre-natal and postpartum depression regardless of their income or insurance.

According to Aspire Counseling's Development Associate, Fleur Gedamke, the impetus for the program was the realization that there are a lot of programs available for serious mental illnesses in Montgomery County, but no free short-term therapy available for low-income women with maternal depression.

Aspire Counseling's bilingual therapists often travel to meet the women for therapy - to their homes, community centers and even car parks - "or wherever works," says Gedamke. Most women prefer home visits since getting out of the house is difficult with a new baby. The possibility of additional children requiring child care, no money for child care, a lack of a support network and the inability to travel to the office are the most common reasons for a home visit. "This is too overwhelming for a depressed and anxious mother," says Gedamke. If the first visit indicates the woman needs treatment, Healthy Mothers, Healthy Babies provides 12 free treatment sessions. If necessary, the therapists can extend therapy to ensure that the mother and baby are stable and safe. They also have a Patient Care Monitor, which links women to community resources and makes social service referrals, e.g. English classes, domestic violence assistance, diaper bank, etc.

Healthy Mothers, Healthy Babies serves more than 100 women each year. Gedamke notes that the actual demand is a lot higher. Unfortunately, they receive more referrals than what they can accommodate.

For more information on Healthy Mothers, Healthy Babies, visit we-aspire.org or call 301-978-9750 and ask for program manager, America Caballero, MS; LCPC.

Resources:

  • National Institutes of Mental Health

  • nimh.nih.gov

  • Office on Women's Health, U.S. Department of Health and Human Services

  • womenshealth.gov

  • Postpartum Education for Parents

  • sbpep.org

  • Online support groups

  • Warmline, a free 24-hour phone service which provides confidential one-on-one support from trained parent volunteers; 805-564-3888; En Espanol 805-852-1595.

  • Postpartum Progress

  • postpartumprogress.com

  • Geographic list of support groups in Maryland, Virginia and Washington, D.C.

  • Postpartum Support International

  • postpartum.net

  • State and local support resources

  • Warmline, a toll-free telephone number anyone can call to get basic information, support and resources; 1-800-944-4773

  • Postpartum Support Virginia

  • postpartumva.org

  • Moms on call, support groups and mental health professionals