Postpartum II – Misery and Moms

One night when I was teaching Lamaze, a grandma-to-be asked, “Are you going to talk about – postpartum?” I must’ve looked confused. From the look on her face and the tone of her voice, it seemed to me she was talking about something besides “the time after childbirth”.

That’s because that grandma-to-be had been separated from her own mother as a baby, because of postpartum mental health challenges. Was it a deep depression, or even a psychosis? I don’t know, but I do know that it’s a topic we don’t discuss much. Are we afraid we will make it happen if we acknowledge it?? (It’s not exactly rare. Most sources say 10 – 20% of new moms experience postpartum depression.)

The Common Thread

Research about postpartum depression has come a long way. For many years, we pretty much blamed the mom. Also, moms who are already having a hard time in their lives also tend to get whammied postpartum. It just doesn’t seem fair that a young woman who has been sexually abused, has a history of trauma, is getting knocked around or verbally abused by a partner, would also be at greater risk of depression. But it does make sense.

But Brooke Shields had a hard time – we don’t think of her as being abused. Maybe she was under a lot of stress. Moms who are suffering from PPD often describe their babies as “difficult to care for” – and those babies are definitely out there. Once of my personal pet peeves is people who blame moms for unsettled babies. “If you weren’t such a wreck that baby would be fine” – Well, if that baby wasn’t such a wreck I would be fine!

Another thing that puts us at risk is “sleep disturbance” – that’s a lot of us with a new baby. And women who suffer from pain are also at higher risk – that doesn’t seem fair. That can mean sore nipples! Or pain from a cesarean. Or pain that you have in your everyday life.

After all those years of thinking it was “hormones” that caused postpartum depression – it seems that the common thread with pain, stress, sleep deprivation, abuse – is inflammation. The inflammation is caused by cytokines. When our cytokine levels are normal, they are a happy part of our immune system, helping us to fight infections. When the cytokines go up, things can go awry. Here’s what Kathy Kendall-Tackett notes in her article, A new paradigm for depression in new mothers: the central role of inflammation and how breastfeeding and anti-inflammatory treatments protect maternal mental health.

Proinflammatory cytokines cause a constellation of sickness behaviors in humans, which includes alterations in sleep, appetite, activity, mood, energy, sexual activity and socialization – all behaviors associated with depression. The relationship between inflammation and depression appears to be bidirectional: inflammation increases the risk of depression and depression increases inflammation.

Should you be worried – about yourself, or someone you love? The Edinburgh Postpartum Depression Scale is considered one of the best tests to use. Take the test here.

So you are worried – about yourself, or someone else. Here are some things that we know will help.

  • Help! If you are the mom having a hard time, tell your partner: “I don’t feel like myself. I need some help.” When the help comes – YOU hold the baby. The help holds you! That may mean tossing a load of laundry in the washer, or bringing you Thai takeout. If you can’t imagine what to ask for, click here. There’s lots of other good advice  – but just look at the list and ask for someone to do one of those Home Blessing tasks for 15 minutes.
  • Exercise. Don’t try to start a spinning class. Just put your baby in a carrier or stroller and go outside and walk around for five minutes. Hopefully that won’t feel long enough and you’ll do a bit more – but just get started.
  • Fatty Acids. Fatty acids are a great help with inflammation. Read Can Fats Make You Happy?
  • Talk. It’s amazing but true – “talking therapy” really helps. Ask your doctor or midwife for a referral. If you’ve got a counselor you’ve talked to before, go back (if you like them!).
  • Don’t stop breastfeeding. Breastfeeding is an anti-inflammatory, and recent research shows that breastfeeding moms get more sleep – and describe themselves as happier – than moms who feed formula. If the breastfeeding isn’t going well, get help!

Next week we’ll look at some local resources for new moms.

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