Prenatal & Postpartum Depression

May 04, 2017

Prenatal & Postpartum Depression

The month of May is just beginning, and from now until the end of June we're going to take an in-depth look at various issues pertaining to parental care, and the parenting experience. This is the first in a series of posts dedicated to an open discussion of depression during pregnancy or after childbirth. We will focus this month on maternal prenatal and postpartum depression, then address the topic from the paternal perspective throughout the month of June.

Until recently, depression experienced around the time of motherhood was a taboo subject. Expectant mothers often undergo a lot of stress, often torturing themselves with notions of being a perfect mother. The reality is that there is no such thing, and most of us simply do the best we can.

After the baby is born, the pressure is on to feel like your world is complete, and your life completely fulfilled. New mothers can become exceedingly stressed and anxious, particularly when they don't feel as happy as they thought they would with the arrival of their new baby.

Statistics show that both forms of depression are relatively common in Canadian women. The Public Health Agency of Canada  released a 2014 report that published the results of their Canadian Maternity Experience survey. The results tell us that:

7.5% of women surveyed experienced symptoms of postpartum depression.

15.5% were diagnosed with depression before becoming pregnant.

12.5% reported that most days in the year before childbirth were very stressful.

13%  had little to no support during their pregnancy.

The statistics above highlight the fact that non-ideal pregnancy experiences are a lot more common than we might assume. They also show that a surprising number of women experienced a highly stressful pregnancy, which differs greatly from the image we often consume of radiant expectant mothers who are excited about their future. As such, it seems that pregnancy-related depression and/or stress is not as rare a phenomenon as we previously thought.

In order to discuss these issues in more depth, let's examine the definitions and symptoms of these two forms of pregnancy-related depressions:


What is Prenatal Depression?

Prenatal depression is a form of clinical depression that can affect a woman during pregnancy. If left undiagnosed or untreated, it is often seen as the precursor for postpartum depression.

Symptoms of Prenatal Depression

The symptoms below are signs of prenatal depression if they occur consistently for a period of two weeks or more. Most women will experience these symptoms from time to time, but it's not clinical prenatal depression if it only occurs occasionally:

  • Feelings of extreme sadness, or feeling depressed: while this sounds general, it may be better understood if described more specifically: you quite literally feel that there is an abundance of sorrow in the world, you may feel like your heart is breaking and you don't know why.
  • Crying for an unknown reason: particularly if the crying is hysterical. Often, those with depression describe a feeling of 'tears behind the eyes' constantly. This means that even when you are not crying, you feel like you are constantly holding back tears, even when there is nothing in particular causing distress in your life.
  • Feeling guilty, useless, worthless, or hopeless: often for no apparent reason or over-thinking minor flaws in your character.
  • Restlessness, unmotivated, lethargic: walking through daily life like a zombie, losing interest in things you usually find fun, a feeling of general apathy: 'what's the point in doing a, b or c?'
  • Sleeping difficulties: not enough sleep, too much sleep, difficulty getting out of bed in the morning due to a general feeling of purposelessness.
  • Withdrawing from things that you usually thoroughly enjoy: time spent with family, going out with friends, your relationship with your partner.
  • In some cases, suicidal or disturbing thoughts, often dark or morbid in nature.

Prenatal depression is more likely to occur during the first or third trimester of the pregnancy, as these are the times when the expectant mother's body undergoes the most drastic changes.

What is Postpartum Depression?

Postpartum depression is a form of clinical depression that occurs in new mothers after giving birth to their newborn, as opposed to before giving birth.

Symptoms of Postpartum Depression

The symptoms of postpartum depression are almost identical to those of prenatal depression. Additionally, there are two main symptoms which can occur in postpartum depression which differ from prenatal depression:

  • Strange behavior towards the newborn baby: this behavior can range from indifference to the baby, or being overly anxious about the baby. New mothers are often over-protective of their newborns. This is normal. It is only when paired with a number of the symptoms outlined above that postpartum depression may be the cause of the unusual behavior towards the baby.
  • Though extremely rare, sometimes postpartum depression can evolve into postpartum psychosis. This means that the new mother actually experiences a psychotic episode that can include symptoms as severe as hallucinating. Thankfully, postpartum psychosis is extremely rare: it only affects 1-2 of every 100,000 women who have given birth.

How to Help a Loved One

Watching a loved one deal with depression can be very upsetting. We all experience times when our loved one is having a bad day, but depression is another level entirely. It can truly be heart-breaking for the observer of the person who is clinically depressed.

In order to deal with the situation, it's important to remember a number of things that will hopefully help you stay focused and optimistic about the future of your loved one's emotional and mental health:

  • You will get frustrated from time to time: this only makes you human.
  • You cannot read their mind or travel inside a person's head: often people with depression have very unhealthy or disturbing thinking patterns.
  • Logic doesn't work. Don't try to enter into a rational debate with a clinically depressed person. Their illness means that their mind is in a highly disordered state, so don't expect them to react 'normally' to statements or observations.
  • Give them space, and you'll definitely need it yourself too.
  • Monitor their medication. It is not uncommon for mentally ill people to forget to take their medication, or decide to stop taking it because they believe they're 'better' (when they're actually not).
  • Understand that it is up to them to get better: you can only do so much.
  • Encourage a routine: this can be incredibly difficult, but try your hardest to introduce some form of consistent routine into the daily life of your loved one. Clinical depression makes it hard for the sufferer to do even the most basic tasks, but even if they manage one small task a day this will help them on the road to recovery.
  • Overall, the best way to deal with a clinically depressed person is to love and support them unconditionally; even when their behavior is upsetting, disturbing, and doesn't make sense to you.

Conclusion

While most parents will have occasional days where they experience what's known as the 'baby blues', this isn't the same as clinical depression. Clinical depression, no matter what type it is, is defined in terms of duration and intensity. Everyone has good and bad days, but it is only clinical depression if you experience such negative feelings intensely, for a long period of time.

However, all parents can benefit from support strategies. Parenting can be stressful and difficult, particularly when you experience days that make you feel like parenting doesn't make you as happy as the outside world seems to think it should. Take comfort in the fact that every parent experiences these feelings from time to time: this doesn't make you a bad parent, it simply makes you human.

If you are worried you may be suffering from prenatal or postpartum depression, or if you think you know someone who is, don't despair. There are many resources dedicated to helping you, including the Toronto Distress Centre. Contact their 24/7 helpline at: 416.408.HELP (4357)

We will be continuing our discussion throughout this month with programs and methods that may offer support to sufferers of prenatal or postpartum depression. Subscribe to our blog to stay up to date with invaluable information about depression during and after pregnancy.

 

*Disclaimer: The information provided here is for educational/advocacy purposes only. 
It is not intended to diagnose or treat any medical or psychological 
condition. Please consult your own healthcare provider for individual 
advice regarding your specific situation and needs.

 



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