Postpartum Depression and Anxiety are usually the last things you are thinking about
when you both muddle and dance through the 9 or so months of your pregnancy. You’ve
heard about PPD before in the news or perhaps your midwife or OB has mentioned it to
you, but my guess is that, for the most part, the idea of these very unfortunate happenings
kind of go in one ear and out the other. There are myths about PPD that we all know and
quiver at anyway: If you have PPD it means that you want to hurt yourself or your baby;
If you say you have PPD someone will take your baby away; If you are not happy in
early motherhood you must be a terrible mother; If you are depressed or anxious during
pregnancy or early motherhood you should just plow through and get over it. And with
these myths (and yes, they are all myths but more on that later) who, on earth, would
want to consider being affiliated with anything like postpartum depression?

But here is the thing, Perinatal Mood Disorders (occurring during pregnancy and/
or postpartum and including PPD) are pretty darn common- In fact, about 1 in 5 new
mothers will struggle with some form of depression and/or anxiety sometime during
pregnancy or the first 12 months after having a baby. And, guess what, these moms are
really no different than you and me. . These women are professors. They are artists.
They are lawyers. They are athletes. They are students. They are cooks. They are
writers. They are labor and delivery nurses. They are pediatricians, obstetricians, and
midwives. They are accountants. They are mothers. They are wives. They are partners.
They are friends. They are human. They are creative. They are witty. They are wise.
These women are thinkers. They are dreamers. They love to laugh. They often cry.
These women are bold. They are brave. And they are beautiful.

As my colleague William Meyers at Duke University so eloquently notes:
These are mothers in strained relationships with the baby’s fathers, or those dealing with
the added stress of an unconventional life style. These are the mothers with careers who
always wanted to be mothers but now, at home, miss the challenges and adult stimulation
of their former employments. They are the working mothers who out of necessity had
to return too soon to work and had to leave their babies in less-than-optimal child-care.
They are the relocated mothers who just moved to the area due to their partners’ job
transfers and find themselves alone in an unfamiliar city. They are the anxious mothers
of hard-to-soothe babies. They are the perfectionist mothers who have always held
themselves to impossibly high standards and now as new mothers feel they are failures.
They are the mothers who were used to having a fair amount of control over their lives
until they had early deliveries, unexpected c-sections, or babies with special needs.
They are the giving mothers whose babies have colic, won’t sleep, won’t take the breast
and won’t be consoled. They are hard on themselves, sleep-deprived, and even food-
deprived.

These are women who are highly competent and well loved. They just also happen to be
struggling at a time when they least expected or wanted to.

We now know that PPD is the most common complication of childbirth and it’s the one

that most of us don’t expect. Perinatal Mood Disorders are primarily a physiological
issue- meaning that they are caused by biochemical changes that occur in a woman
after she gives birth. Because of the major hormone shifts that take place immediately
following delivery, sleep deprivation that manages to come right along with having
a newborn, and common nutrient depletion that results from pregnancy, childbirth,
and breast feeding, many women (again, about 20%) are more vulnerable to other
psychological and social stressors that might occur with the addition of a new baby. And
so, Moms at risk may become depressed and/or anxious because they are simply less
resilient to stress than they might otherwise be. Psychological and social stressors that
might team up with the physical stressors mentioned above include but are not limited
to: a personal or family history of mental illness including depression/anxiety, negative
thinking patterns including perfectionist thinking and high expectations of self, a history
of abuse, trauma, or family conflict, major life changes during pregnancy or postpartum,
lacking social support, a sick or colicky newborn, and a traumatic birth experience. The
biggest take away from this? PPD is not a woman’s fault and has absolutely nothing to
do with the kind of mother that she is or wants to be.

But it is important that these Moms get the support that they need and deserve. Because
while PPD does not mean that you are a terrible mother, it does make it difficult to enjoy
the early weeks and months of parenting and may interfere with your ability to bond and
attach with your baby.

So, lets get back to those myths:

1. If you have PPD it means that you want to hurt yourself or your baby.
Most women who are struggling with depression and/or anxiety are not at risk for hurting
themselves or their children.

1.Feeling badly is a normal part of being a new mother.
Although becoming a parent is overwhelming and exhausting for most, it is not normal to
feel down for a long time or continuously after a baby is born.

2. If I tell anyone how I am feeling, they will take my baby away.
Having PPD is not a reason for anyone to take your baby away. In fact, women who seek
help are doing so not just for themselves but also for their families.

3.I should just pull myself together.
Depression and anxiety are real illnesses and you are really suffering. It does not mean
that you are weak and lazy and usually this is not something that mom can conquer on
her own.

4. If I feel this badly, I am not meant to be a mother and I am a bad mother.
PPD is not a reflection of a mom’s love for her baby or desire to take care of her baby,
but it does interfere with her ability to enjoy pregnancy or the first weeks and months
after childbirth.

5. There are no safe treatments, so why bother getting help?
There are many excellent, safe, and effective treatments for PPD. Each and every
Perinatal Mood Disorder is treatable, and women who seek out and follow through with
appropriate support and treatment DO GET BETTER.

The raw truth about it is that having a new baby is not easy for anyone, no matter what
kind of “perfect” they appear to be from the outside. We all struggle, each and every one
of us. But those of us who’s struggle out weighs the happiness and hopefulness need not
feel this way. There is help. Asking for it is usually that hardest part.

Kate Kripke, LCSW