May 14-20 is Mental Health Awareness week
PPD can be a sneaky one. You’ve gone from pregnant to not pregnant in the same moment you become the center of the universe for a “hot off the press” human. Recovering from childbirth is at best messy; it takes days, weeks, years to get things back to normalish again. Sleep is tortured. Rhythms and routines obliterated, so why would you expect to feel like yourself? Our common sense helps us excuse a certain amount of crying, anxiety and irritation. But then for some of us – a whopping 20 percent – the emotional fog settles in and remains.
Mood disorders such as depression and anxiety that occur during pregnancy or within a year of delivery are now referred to as Perinatal Mood Disorders (PPMDs).
The Stats:
About 20 percent of women report feelings of anxiety, sadness, depression, panic, frustration and hopelessness.
- Thirty percent of these women had a history of depression prior to pregnancy.
- Forty percent had a depressive episode during pregnancy.
- Nearly 70 percent of the women also had signs of an anxiety disorder, the symptoms of which are not often associated with depression.
- Twenty percent of the women studied were diagnosed with bipolar disorder.
- One in five of the women with PPMD had thoughts of harming themselves.
- Suicide is the second leading cause of death in postpartum women.
Screening for and identifying postpartum depression will save lives.
Personal PPMD Assessment:
- The Edinburgh Scale, a widely used post-partum depression assessment: http://www.maternalmentalhealthnow.org/images/advocates/EPDS.pdf.
- This is the Beck Depression Inventory, it can be used to assess depression at any stage, including during pregnancy: https://www.bmc.org/sites/default/files/For_Medical_Professionals/Pediatric_Resources/Pediatrics__MA_Center_for_Sudden_Infant_Death_Syndrome__SIDS_/Beck-Depression-Inventory-BDI.pdf
Remedies:
- Be self-aware. Know your symptoms of struggle. Do not lack awareness of tell-tale signs that you’re going to pieces. Notice how often you’re crying, yelling, being super negative, comfort eating and experiencing insomnia (when you DO have the opportunity to sleep.) Notice how well you’re able to connect with others, and if you just don’t feel like yourself. Depression and anxiety can make you feel distracted, socially awkward or struggling to find your words. Keep your doctor posted if you notice these drains on your emotional state.
- Think about a time when you were doing well in life. What did it feel like to be inside your body back then? Was your head peaceful and optimistic? Did you laugh more? Do you connect easily with your people?
- Be willing to hear others’ concerns about you. Listen to what your spouse, family and friends say about how you’re doing. Don’t blow them off, keep an open heart. Pridefulness around your mental health struggles needs to die. So, what if you’re a wreck? It isn’t forever, but hiding it or avoiding the truth will certainly drag it out much longer than necessary. Depression and anxiety are NOT identities, nor are the opposites of them such as “totally fine” and “always put together.” You are you; you are precious and special and needed. If you’re feeling crappy, admit it.
- When you have gotten feedback that your nearest and dearest are worried about you, do whatever it takes to get out of your deep funk. Therapy, meds, a tiny bit more babysitting so you can get some self-care and time with your much-needed community.
- Be in community. A social support network is worth its weight in gold. Early motherhood is a time of idealized dreams being replaced with shocking realities. There are very few resources in this world that can meet you where you’re at the way a MOPS group can. It’s a little like signing up for instant buddies who are also sleep deprived, but still striving to enjoy this stage of life and thrive in spite of the struggles with grace and humor. I have spoken at so many MOPS groups through the years and the themes I’ve consistently encountered are kind welcomes, excellent child care, decent to good coffee, good food, breathtaking speakers (I may be a little bias on this one), laughter and usually at least one exposed boob. How much more chill can a group get?
The more loving eyes you have on you, the more loving hearts you connect with, the healthier you will be as a mama. We can all agree that this mothering gig is not for the faint of heart, and it’s always a good reminder that you’re not in this alone.
For additional information and references, check this out.
Fierce Love Collective: What to do With the Big Emotions of Motherhood is for any woman who has experienced emotions, thoughts or moods that feel too big for her heart to handle. If you’ve experienced anything from baby blues to postpartum depression, anxiety, scary thoughts, bipolar or panic disorder, and everything in between, this small-but-mighty workbook is for you. 
Kelley Gray M.A., L.P.C. has been in private practice in Denver, Colorado for 16 years. She is wildly passionate about growth, healing, her two daughters and two weenie dogs. She has been married to Brian Gray for 14 years. You can find a little of her on the web at kelleygray.com.