Breaking the Silence

Breaking the Silence

Understanding Postpartum Depression

What is postpartum depression?

Postpartum depression is an "umbrella term" used to cover a variety of emotional problems that can affect all childbearing women. There is no single or accepted definition of "postpartum depression," or PPD for short. Instead, it is described as a group of symptoms that can negatively affect a pregnant or new mother. These symptoms change her behavior, her personality and outlook.

PPD can begin during pregnancy, right after birth or anytime within the entire first year. The symptoms range from mild blues to total despair. Serious depression--a constant, intense, sad and empty feeling that lasts 2 weeks or more -- is a problems that requires medical help. All forms of PPD are real illnesses that can be treated.

What causes PPD?

There is no single specific cause of postpartum depression. Instead, a cluster of symptoms creates PPD, in much the same way that a certain set of symptoms creates a common cold. None of the symptoms of PPD are the mother's fault.

Who gets it?

Depression and anxiety around childbirth can affect any childbearing woman, regardless of race, income, culture, age or education. It doesn't matter whether your baby is born healthy, or whether you've had prenatal medical help or taken childbirth classes. Breastfeeding does not cause PPD. Even if your marriage is happy or you've had pervious babies, PPD can occur with a new baby.

Postpartum depression strikes without warning. It brings guilt, misery and helplessness at a time that you thought would be one of the happiest of your life. You expected to feel confident and wonderful. Instead, you feel cheated, confused, and depressed, or even on the brink of despair. It's not uncommon to also feel guilty and ashamed of yourself.

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What factors contribute to PPD?

There is no single or simple reason. The following factors may cause PPD:

	a plunge in the level of your hormones
	going home from the hospital
	a birthing experience that did not go as planned
	chronic sleep deprivation
	your family's previous medical history
	a colicky or hard to care for baby
	medical problems for you or your baby
	changes in your lifestyle
	your need to feel in control at all times
	what you expect of yourself or what your partner expects of you
	build up a day-to-day hassles or "overload factors"
	lack of support from family or friends
	previous PPD or other type of depression
	loss of freedom, loss of identity and self-esteem
	or, simply being alone

Checklist of PPD symptoms

There can be a wide range of PPD symptoms.

They basically fall into the following 4 categories.

They are not absolute and can overlap a lot.

Use these check lists if you think you might have PPD.

(All fairly normal feelings to have:)

	sad
	weepy
	guilty
	isolated
	angry
	resentful
	exhausted
	anxious
	tense

The symptoms in the following categories are more serious:

2.	3.	4.
ashamed	hopelessness	loss of control
"not yourself"	worthlessness	loss of confidence
overwhelmed	low self-esteem	thoughts of hurting
drained	oversensitive	thoughts of hurting your baby
excessive crying	distracted	scary fantasies
lonely	confused	hallucinations
helpless	extremely agitated
mood swings	panic attacks
full of doubts	inability to laugh
appetite change
physical symptoms

If you checked any of the symptoms in categories 2, 3 or 4, you need to get help right away.

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How can you make it go away?

The first big step is to ADMIT you feel bad. Sometimes, it is possible to get rid of some symptoms of mild PPD by yourself. Here are some guidelines to follow:

	Get as much sleep as you can.
	Accept your need for help. Turn to friends neighbors, family or pay for a sitter or household help. Just because women in the past were able to do it all doesn't mean that you can.
	Accept being less than perfect.
	Accept your feelings as normal.
	Do not let motherhood take over your entire life. Try to keep some aspects of your old life. Being a little selfish can be a good thing.
	Find time for yourself without quilt and learn to relax into motherhood. For example, take a bath and lock the door.
	Avoid overloading factors.
	Read all you can on the subject.
	Express your feelings. Write them down. Get them out.
	Find a caring listener, especially someone in the same situation. Sometimes just talking about it helps.
	Join a group of new mothers or parents. Talk about and share your difficulties with those who will judge you.
	Avoid being all alone.
	Eat a good, healthy diet. Eat small, frequent meals.
	Exercise. It will give you more energy. Fresh air and exercise are good for both you and your baby.
	Make a real effort to talk openly with your partner. Hold on to the affection and sharing you have had together.
	Solve the problems you can and accept the rest.

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Breaking the Silence

Today, there is no reason for childbearing women to suffer silently at home. The silence is being replaced be people who are talking, learning, caring and healing. There are writers, professionals and volunteers who offer education, crisis and ongoing support, as well as plans for prevention.

Asking for help

There is the potential for help all around you. Find a sympathetic listener. This could be your

	partner or his family
	your family
	a friend
	your health provider
	a nurse practitioner
	a therapist
	counselor
	social worker
	minister
	a new-mother's group at your church or temple, and perhaps ever a
	a national organization or local self-help PPD group

Do not feel bad about asking. Do it for your own health! It is ok to ask for the receive help from others. YOU would help THEM, if they asked YOU. You will be helping each other if you join a support group.

Many women with PPD are far more comfortable at giving support than asking for it. They are used to being strong for themselves and everyone else. Let your family and friends read this information so they better understand what PPD is all about and that you need help.

Seeking professional help

If your case of PPD is more sever, and you are really suffering, you must consider seeking help. Most people who suffer from depression can be helped with treatment for depression are psychotherapy (sy'-ko-ther-ap-y) and medication. Psychotherapy involves talking to a healthcare specialist who understands your condition. Taking prescribed medication from a doctor is another way to treat symptoms. Often, people with depression need both types of treatment.

Psychotherapy

Psychotherapy is another word for "counseling" or "talk therapy." It is a helpful treatment for depression. You meet regularly with a trained healthcare specialist and talk about the causes of depression. The therapist teaches you how to figure out the causes and how to cope with depression.

Medication Treatment

Medication prescribed to treat depression is called an anti-depressant. Do not feel ashamed to take it if your doctor recommends it to you. It might be all you need and might greatly reduce your suffering. Take the pills with careful monitoring from your health provider.

PPD is not something you have to live with. It is a very real illness. You would take medication for other forms of illness.

Remember, postpartum depression (PPD) is very common- and very treatable.

Support Groups and the Internet

There are growing numbers of PPD support groups in the U.S. and Canada. They provide you with direct line into sharing and support with other mothers. They are also good places to start because they can pass you on toward local professionals and volunteers who will be able to listen with knowledge, compassion, and expertise.

These days, you can find support groups and a wealth of other PPD information on the Internet. Try typing in "postpartum and blues" or "postpartum and depression" into a search engine. You will see that PPD is very common subject! Allow yourself some time to look up and read a variety of sites. Print out the pages that interest you.

One of the most helpful PPD websites is:

Here are some places for you to contact immediately:

United States Postpartum Support International (PSI), California (805) 967-7636 (7am-10pm, Pacific Time) thonikman@compuserve.com	Depression After Delivery (D.A.D.), New Jersey: 1-800-944-4PPD
CANADA "Pass-Can" (Postpartum Adjustment Support Service) Ontario (905) 844-9009	Pacific Postpartum Support Society, British Columbia (604) 255-7999

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This is written to inform you about postpartum depression. It is not meant to take the place of professional help. For more information please contact your local health department or physician.