Postpartum Depression: What to Look For

Nancy Pristas seems an unlikely candidate for depression: She had wonderful pregnancies, natural childbirth and a supportive husband. It is difficult for someone who has never gone through a depression to understand how it feels.

Like almost all women who experience PPD, Pristas eventually recovered fully and is leading a busy and happy life. She also shared what she has learned by coordinating the Post Partum Support Group in London, Ont.

PPD has many faces: Some women have mild depression, while others are completely overwhelmed. The symptoms may begin within weeks of the baby’s birth, or they may not appear until a year later.

What is PPD like?

PPD is different from “the baby blues,” which many women experience soon after giving birth. These tend to pass within a day or two. But if unprovoked crying, emotional outbursts and irritability last beyond two weeks, says public health nurse Madeline Ryan, it could be the beginning of PPD, and a woman should seek help.

For Molly, “everything went flat.” She was unable to motivate herself to do anything. Everyone told Molly this was supposed to be a happy time, but her life seemed layer upon layer of sadness and isolation.

Pristas says women with PPD are often upset by feelings that they don’t want or love their baby. Pristas reassures women that love will grow with time. Public health nurse Madeline Ryan emphasizes that despite their feelings of inadequacy, “depressed moms give good care to their babies.”

Symptoms of PPD

• Major, prolonged unhappiness
• The feeling of complete exhaustion
• Anxiety — a pounding heart, tight chest or difficulty breathing
• Lack of interest in the baby
• Sleeping or eating disturbances
• Inability to concentrate
• Feelings of helplessness, inadequacy, loneliness or guilt
• Thoughts of suicide

The road to recovery

Each woman’s recovery is different. But the Pacific Post Partum Support Society (PPPSS) handbook advises, “The most important thing a woman with postpartum depression needs is to talk, in confidence, with other mothers who have had the same experience.” The local public health unit is usually a good source of information about support groups and other resources. Some support groups match pairs of women and set up a telephone link — a line of communication at a time when a woman is unable to venture to a group meeting.

For Molly, the turning point came when she met a woman who’d had a similar experience and who recognized the signs of depression. Finding someone with whom she could share her feelings broke the isolation, and this small victory gave her the confidence to find a support group.

Pristas knew she needed to talk to someone, or she would “explode.” At the first meeting of a support group she attended, she found out “it wasn’t just me,” and the healing process began.

Sometimes, a support group is not enough. Medication will not cure depression, but in some cases, it may help a woman over the hump. There are antidepressants that can be taken while breastfeeding, and they are not addictive. Home support may also be needed for the mom who cannot manage.

The road to feeling better after PPD is not a smooth progression. One day, a woman may think, I don’t feel too bad today, and the next day, she may be down again. The good days will eventually come more often. Bit by bit, she will get better.

Pristas says that although PPD was “the most devastating experience of my life,” she has emerged from it stronger and more compassionate. When she meets a woman in one of her groups, she asks, “How are you doing? How are you really doing?” Sincere concern, expressed by someone who’s been there, gives that mother permission to express her uncertainty and her fears. And Nancy Pristas has offered a nurturing hand to one more woman.

Resources

Your public health unit, family physician or staff at a parent resource centre may know of a support group. In a moment of immediate need, call 911, a crisis or distress line or go to the emergency room.