Postpartum Depression is significantly under-screened for, under-diagnosed, and under-treated. 1 in 7 women experience post-partum depression.

When does postpartum depression begin?

Onset can be anytime in the first year after delivery. Yet, it’s important to remember that postpartum is the rest of your life!  Matrescence is the process of becoming a mother, marked by significant hormonal, emotional, physical, psychological, and spiritual changes (similar to adolescence and menopause).

Risk factors for postpartum depression

Some risk factors include a history of pre-menstrual syndrome (PMS) or pre-menstrual dysphoric disorder (PMDD), and previous miscarriage or abortion.  These conditions have overlapping hormone imbalance root causes.

How is postpartum depression diagnosed?

A woman’s OB/GYN or midwife typically will use a postpartum screening tool, such as the Edinburg Scale. If over 5 symptoms are present for at least 2 weeks, this will usually indicate postpartum depression.

Symptoms of postpartum depression

Common symptoms include crying daily, not being able to sleep even when given the opportunity, and not wanting to eat. There are many other symptoms, which can include: anxiety, anger, phobias, lack of grooming, over-worry for baby, suicidal ideation, repetitive fears or thoughts, guilt, emotional numbness, heart palpitations, chest pain, numbness/ tingling, headaches, feeling hopeless.

 Baby blues vs postpartum depression

70-80% of women experience baby blues in the first 1-2 weeks post-delivery. Symptoms may include loss of appetite, insomnia, fatigue after sleep, overwhelm, excessive worry, overly excitable,  irritability, restlessness, anxiety, sadness, weepiness, and poor concentration. Baby blues symptoms can overlap with postpartum depression, but baby blues alone will usually improve in a couple of weeks.

How long after delivery can it be considered postpartum depression?

Postpartum depression can begin directly after delivery or anytime up to a year postpartum. There is a great hormonal shift in the first year postpartum.

When women breastfeed over a year, it may even take up to 2-3 years before the menstrual cycle “normalizes” and a more regular hormonal balance re-establishes itself. This will be thrown off even more when women are using artificial hormones.

Why is postpartum depression undertreated?

• Lack of screening for postpartum depression:

  Since the postpartum depression screening is typically given at 6 weeks post-partum, many women “fall through the cracks” of the healthcare system. Much energy and attention is focused on the newborn baby, with monthly pediatric appointments, so it’s easy for the mother to be overlooked. Some practitioners may use a universal screening tool or may not use it past the 6-week postpartum visit.

• Uncertainty about treatment:

  Providers may be unsure how to treat women, especially if they are breastfeeding.

• Stigma:

  Women may feel embarrassed, ashamed, or guilty about feeling depressed

• Atypical presentation:

  Women may not associate the feelings they are having with depression. Also, they may think it’s normal to feel this way. They may be less aware of their own needs due to so much attention being given to their newborn.

Treatment for postpartum depression

Conventional treatment for postpartum depression may include an anti-depressant medication (known as SSRIs, like sertraline/ Zoloft).  Interestingly, estrogen and progesterone modulate neurotransmitters, like serotonin and dopamine.  So a hormone imbalance can lead to neurotransmitter imbalances.

Doctors often recommend counseling, support groups, and self-care such as relaxation techniques.

See my blog article on Treating Postpartum Depression Naturally.

Support groups for postpartum depression:

https://www.postpartum.net/get-help/locations/

https://www.postpartumstress.com/

https://www.sbpep.org/

Summary:

If you or someone you know is experiencing challenges, know that support is available, and recovery is possible.  Postpartum depression is not just an emotional or psychological diagnosis but has underlying physical causes as well. Seeking help is a sign of strength and the first step towards feeling better.

About Dr. Whelan

Dr. Whelan is a highly regarded licensed naturopathic doctor (N.D.) and Creighton Model FertilityCare™ Medical Consultant, based in Vermont. She is renowned for her expertise in treating women’s reproductive hormone disorders. Her practice specializes in lifestyle medicine, nutritional counseling, botanical medicine, and bioidentical hormone replacement therapy.

Dr. Whelan’s main focus addresses hormone imbalances related to conditions such as PCOS, Hashimoto’s, heavy menstrual bleeding, PMS, perimenopause symptoms – (including insomnia, brain fog, fatigue, anxiety, depression, digestive issues), insulin resistance, adrenal dysfunction, fertility issues, irregular menstrual cycles, endometriosis.

She earned her Doctor of Naturopathic Medicine (ND) degree from the National University of Natural Medicine. She completed additional training as a Creighton Model FertilityCare™ Practitioner and NaPro Medical Consultant from the St Paul VI Institute in Omaha, NE.

Visit Dr. Whelan’s website and learn more here.