Postpartum Anxiety & Depression
Did you know that approximately 1 in 7 new mothers suffer postpartum anxiety and depression?
And as they observe at the American Pregnancy Association, postpartum anxiety and depression can happen to ‘the strongest, most intelligent and loving moms’.
We’ll start with depression first and then address anxiety.
PPD (Postpartum Depression Disorder) is the most common of the six perinatal mood and anxiety disorders. However, it is not to be confused with the Baby Blues.
Postpartum Baby Blues Overview
The Baby Blues usually only last for the first couple of weeks, unlike postpartum anxiety & depression.
Nevertheless, they can still come as an unexpected shock to a new mum.
For a complete overview of Postpartum Baby Blues and a comprehensive Survival Plan see my post Postpartum Baby Blues Survival Plan – click here
Typically, postpartum depression develops within 4 to 6 weeks of giving birth. However, it can sometimes take several months to appear – any time in the first year after birth.
The highest rates can be found 3 to 6 months after childbirth. And even fathers can experience postpartum depression.
And no, age alone is not a factor for increased risk of PPD!
The Good News!
Don’t panic because postpartum depression is completely treatable!
That said, a new mum first has to recognise that she has PPD and so many new mothers simply do not recognise the signs. They think that there is something wrong with them and that they are failing as a mum.
Nor do they understand how certain factors contribute towards the painful emotional experience they are going through.
So let’s start by clarifying contributing factors.
Factors Contributing Towards Postpartum Depression
Why do you feel so miserable and depressed?
The answer is, there is no one single cause to how you are feeling.
Rather, there is a cluster of interrelated causes and risk factors.
- Following birth, your estrogen and progesterone hormone levels plummet. Thyroid levels may also drop, leading to fatigue and depression.
- When you add changes in blood pressure, immune system functioning and metabolism and maybe high levels of homocysteine (possibly caused by low intake of folic acid or poor conversion of folic acid to its usable form), the combined experience may trigger postpartum depression.
Labour & Birth
- Giving birth brings numerous physical changes and you may have had prolonged or difficult and painful labour.
- Possibly you suffered the trauma of an unexpected C-section or premature delivery.
- Regardless, giving birth will leave your body feeling depleted and exhausted.
- The reality is that you are going to suffer sleep deprivation with a newborn. If you are breastfeeding, you will most likely experience the most sleep loss.
- Why? Because some newborns nurse as often as every hour or two, sometimes for 30-45 minutes each time!
- This is a problem because not only is your body tired, but fragmented sleep also affects how you think and cope, leaving you feeling scattered and foggy.
‘I never had any symptoms until my daughter was five months old. I went to numerous doctors because I knew something was “off” but no one mentioned postpartum depression ever and that is the hardest thing for me to still accept. I finally started doing my own research and found a website about PPD; I had every symptom listed.
My husband and I went to my doctor and I was finally diagnosed with postpartum depression and anxiety with OCD tendencies in 2008.’
Your body needs greater quantities of specific nutrients during pregnancy and postpartum.
Deficiencies in these nutrients through pregnancy, childbirth, postpartum healing and lactation, inadequate nutrient intake or a poor quality diet, may increase the risk of postpartum depression.
Because nutrition plays an important role in hormonal regulation, gut health, immunity, and neuroendocrine functioning.
The depletion of nutrients such as trace minerals, Vitamin D, B-Vitamins, and essential fatty acids, including EPA/DHA can be the trigger for poor functioning of many systems in the body and increase the risk of mood disorders like postpartum depression.
You may also be depressed that you are not losing your baby weight as fast as you had hoped.
Stress & Postpartum Anxiety & Depression
Caring for a newborn is extremely stressful, even more so if you are a first-time mum. Here we have the depression and anxiety double-whammy as the experience is both overwhelming and anxiety-provoking.
Just the thought of being responsible for her daughter’s life sent one mother into a tailspin whilst still in the hospital.
In less than 10 minutes she says she went from ‘serene new mom into a full-scale panic’. She didn’t want to leave the hospital because of her sudden fear of going home and ‘doing this mom thing.’
Lack of Support
Lack of social support is regarded as a big risk factor for postpartum anxiety and depression.
Here it is the quality of your relationship with your baby’s father that counts. A supportive partner is a protective factor against postpartum depression.
If you lack family support or support from extended family members, this may also put you at risk of feeling depressed.
Being new to a neighbourhood or State or from another country can also exacerbate your sense of isolation and lack of support.
After giving birth you might feel like you never want to have sex again! It’s hard to be interested in sex if you’re exhausted, stressed or not feeling well.
On the other hand, both you and your partner may go cool on sex, so it’s not such a problem. However, if you and your partner have different levels of desire, this can add some stress to your relationship.
You may also have unvoiced concerns about your sexual attractiveness.
‘Recovery’ Health Issues
After childbirth, you may have abdominal cramps, constipation, urinary problems, haemorrhoids, night sweats, chills, back pain, injured pelvic floor muscles, headaches, engorged breasts. It’s so not fun!
If you had a C-section, you may have incision pain. Then there’s pain in the perineum, pain and difficulty walking after a tear, and did I mention exhaustion!
‘High Need’ Baby
Here I’m not referring to the needs of a baby who has a serious medical issue.
I’m referring to the situation where your baby is ‘needy’ and you believe that it’s your fault. You believe that if you were a better mother this would not be happening.
Maybe your baby refuses to nap unless held or screams when put down, or needs constant interaction and you end up at your wit’s end.
As one mother said, ‘As the months progressed, I started to feel less like “me” and more like a shell of my old self that would never be the same again. I started to become numb to emotion.’ (Holly, www.thefussybabysite.com)
It was only then that Holly finally realised there was something seriously wrong with how she was feeling and she went and spoke to her doctor and got help for her postpartum depression.
For a list of 12 Characteristics of High Needs Babies click here
Whilst not fitting the definition of a High Needs baby, a colicky baby is equally stress-provoking. Mothers become utterly exhausted and often don’t know where to turn for help. This, in turn, leads to self-blame because they don’t know how to help their baby and this can then lead to depression.
You may have other responsibilities putting you under pressure. For example, you have elderly parents with health issues or, as one mum said, pushing yourself to ‘cook or clean or care for other kids or even work!’
Other Risk Factors for Postpartum Anxiety & Depression
- A history of non-pregnancy related depression can be a risk factor.
- A previous history of postpartum depression may be a risk factor, though this is not inevitable.
- Financial pressure can also add to your levels of anxiety and stress.
Signs Of Postpartum Anxiety (PPA)
All of the above factors can be anxiety provoking.
However, the following are clear indicators that you are suffering from postpartum anxiety.
- You constantly fear something bad is going to happen
- Worrying thoughts are continually racing around in your head
- You struggle to stay focused
- Changes in eating (you have lost your appetite or overeat and/or don’t have the energy to prepare nourishing meals for yourself)
- Changes in sleeping – Duh!
- You feel nauseous and dizzy
Signs of Postpartum Depression (PPD)
- Feeling completely overwhelmed
- Mood swings
- Sadness and guilt are your constant companions
- It’s hard for you to make decisions
- You have trouble sleeping (not just because you have a newborn)
- Changes in eating and hence nutritional intake
- And this is where it gets very serious … withdrawing yourself from family and friends
- No interest in your baby
- You think about hurting yourself or your baby.
Treatment For Postpartum Anxiety & Depression
You have three options when it comes to treating postpartum anxiety and depression.
- The Medical Model – with medication
- The Natural Approach – without medication
- A Combination of Both
Within the medical model, your doctor will quite likely prescribe an anti-depressant. In some cases, a mother may even be admitted to a hospital.
Please Note … If you have thoughts about harming yourself or your baby call 911 (000 in Australia) or go to the Emergency Department at the nearest hospital. The most important thing you can do for your baby and yourself right now is to get immediate help.
With the natural approach, the focus is on a healthy diet and nutrition and supplements.
But again, you must speak to someone you trust and tell them what’s going on for you.
Parenting organisations can be an excellent resource and they often have a Help Line. In Australia we have Tresillian.org.au – The Parent Help Line is 1300 272 736.
Anxiety & Depression Support & Recovery Plan
You need support and help to put together a plan for your recovery.
The person you talk to could be your partner, relative or close friend. Ask them to help you decide what you want to do based on their knowledge of you and your preferences for medication or a natural approach.
Your next step (or possibly your first) is to speak to an expert whom you trust, who can give you advice about your options. This might be your doctor or dietician, or naturopath, or even a parenting helpline as suggested above.
Once you have taken action and spoken to someone whose advice you value and realise that no one is going to judge you, you will feel a thousand times better.
The very worst thing you can do is keep how you are feeling and struggling to yourself and pretend that everything is ok for fear that you will be judged as a bad mother who can’t cope.
If one in seven women giving birth gets PPD and anxiety, that means there are thousands and thousands of women worldwide feeling and suffering like you. You are not alone in this.
And once you have people on board who can give you the advice you need about your options and choices and can help you put a recovery plan in place, you will start to feel in control again. You will start to see the light at the end of the tunnel.
No more judging yourself as ‘wanting’ as a mother. You have only ever wanted the best for your baby and once you are back on track everything will gradually settle down.
You and your baby are going to be absolutely fine!
Here are some strategies and tips to help you on your way.
Steps To Address The Contributing Factors
Addressing Hormonal Changes & Nutrition
The good news is that the massive drop in your estrogen and progesterone levels, and possibly thyroid levels, after birth is quite normal.
The bad news is that it happens so darn fast!
This postpartum drop is considered the single largest sudden hormone change in the shortest amount of time for any human being, at any point in their lifecycle!
These hormones are essentially back to baseline by about day three. So it’s no wonder that you experience an emotional rollercoaster whilst your hormones are doing a ping-pong!!
Whilst your body is busy repairing and rebalancing postpartum, it is essential that you eat healthy, nourishing fresh food. This includes fresh fruit and vegetables, foods low in GI, good protein and healthy fats.
It’s important that you don’t skip meals or let your blood sugar drop.
Keeping your blood sugar steady helps to keep your mood steady.
Nutritional supplements can play an important role in your postpartum self-care.
You need supplements designed to reset, repair and re-balance your body.
Our Unique Programs
Carmel has designed four unique programs for Midlife Mummies, based on nutritious food and the perfect combination of organic, holistic supplements. As part of each program, you get free, downloadable food and shopping lists, meal plan and delicious recipes.
Once you join, the first month’s supply of products are already loaded in your shopping cart (no sign-up fee or auto-ship). So all you have to do is complete the order and wait for the delivery to your door and then get started on bringing your body back to optimal health and wellbeing.
Just what you are needing right now – all done for you and ready to go!
Resolving Labour, Birth & ‘Recovery’ Health Issues
Healthy, nutritional food and the right holistic supplements will also aid your recovery from labour and birth and other issues encountered since returning home.
More specifically though, click here for a great post on recovery tips for healing after a vaginal delivery.
If you are suffering from postpartum perineal pain, click here for steps to relieve it.
Click here for tips on how to take care of vaginal tears, to include home treatment methods.
Urinary incontinence? Check here for what it is and what you can do about it.
On a more general note, it is fortunate that today we have a far better understanding of the complexity of postpartum anxiety and depression. We know that it involves the interplay between hormones, the immune system, diet, environmental exposure and modification and so on.
If you feel that you are not healing as fast as you expect, Kelly Brogan MD suggests that you get your doctor to check out the following:
- Rbc folate
- B12, methylmalonic acid
You can check out Dr Brogan’s post about the causes of postpartum depression here, if you would like a more in-depth understanding of a personalised and biochemically updated perspective on this syndrome.
Combatting Sleep Deprivation
There is no way to avoid it with a newborn, you are going to be very tired… strike that … try ‘exhausted’!
However, I do have a tip for you which I think will help.
Every time your baby sleeps you need to sleep. Try and get 40 – or at least 20 – minutes each time.
You have to be strong and resist the urge to fly around the house tidying and cleaning and don’t pick up your phone!
This is where you either have to bring in paid help or get your partner, family or friends to help with washing, ironing, cleaning, preparing a meal, shopping. Get your supermarket to deliver your weekly big shop.
Keep this up for at least the first two to three weeks.
There is a scientific basis for this suggestion, believe it or not!
You see when you keep having these mini-naps, you are doing what is called ‘Sleep Banking’.
I know, sounds weird, right?
However, what you are doing is storing energy for future use by preempting some of the impact of lost sleep down the track.
This will make a huge difference in your healing and life, so please give it a go.
Addressing Lack of Support
Many midlife mamas feel isolated because their friends have children at older ages.
One avenue you could try to see if there are other midlife mothers in your area is to ring the national peak body supporting breastfeeding mothers in your country.
They should be able to put you in contact with the groups in your area. Then you can check out if there are other midlife mums in the group.
Bonus if you are wanting breastfeeding support!
These are the contacts for Australia, the UK, and the USA
- The Australian Breastfeeding Association 1800 686 268 – website
- In the UK – The National Breastfeeding Helpline 0300 100 0212 – website
- In the USA – website
Private Facebook Group
When you join any one of our 4 programs, we have a private Facebook Group. You will also get on-going support from myself and Carmel.
This support is free and included with the program. And, of course, there is the wonderful support that our mamas give to each other.
Check out your Team here.
Caring for a newborn is stressful – full stop!
Here are some ‘feel good’ suggestions to help you cope with postpartum anxiety & depression.
Start by picking just one…
- Get outside, breath the fresh air and get some sunshine. Your body produces Vitamin D naturally when it’s exposed to sunlight. And Vitamin D plays an important role in regulating mood and warding off depression.
- Aromatherapy and essential oils are wonderful for relieving stress and aiding sleep. Try Lavender, Lemon or Yuzu, Bergamot, Ylang Ylang, Clary sage or Jasmine
- Nothing can lift the spirits like a beautiful bunch of flowers in the middle of the table. Treat yourself or drop a big hint to your partner! Alternatively, buy yourself a plant to brighten up the kitchen!
- Ask someone to take your baby walkabout whilst you get your nails or toenails painted or get your hair done. Get a massage or just take time out to go and have a coffee by yourself and read a trashy magazine!
From Intimacy To Sex
In the early stages following the birth of your baby, start reconnecting with your partner by rebuilding intimacy.
Open up the lines of communication by talking and listening to each other express how you are each feeling now that your baby is here and turning your life upside down!
Make time to have a meal together or go for a walk and talk, taking your baby along for the ride in the pram.
Hold hands, give each other a hug, share cuddles. Build on these displays of physical affection and moments of intimacy, eventually leading to sex when you feel ready.
When it comes to your body … think ‘positive’!
This is the body that has housed your baby for nine months and is feeding your child if you are breastfeeding. So much for which to be grateful.
That said, it is also perfectly normal and understandable that you want to take care of yourself and look your best. You want to ditch the ‘preggers’ gear and start to feel and look like ‘you’ again.
The safest and most effective way to do this is through eating the correct healthy, nutritious food and taking the right supplements specifically chosen to support your weight loss naturally.
We have four unique programs, two of which focus specifically on postpartum weight loss.
Our 4 Bespoke Diets
The Yummy Mummy diet has been specifically designed to help you lose your postpartum belly pouch.
We show you how to lose weight after having a c-section birth with a balanced diet plan and nutritional support customised to your individual requirements.
This diet also applies to mothers who have given birth the natural way and want to have the best nutrition and lose their belly fat.
The meals have been expertly crafted by Carmel to give the body the vital nutrients and minerals it needs the most during this postpartum time, including foods high in protein, calcium, and iron.
The Breastfeeding Diet is specifically designed to nourish you mama, whilst you are supplying a food source to your baby.
The breastfeeding supplements provide nutritional support to maximise the health of your body and that of your baby.
The Lifestyle Diet is designed to help you get back to feeling energised and like YOU again! If you have a little baby weight to lose, that will slowly disappear too – bonus
Check out the above 3 diets here.
The Quick Weight Loss Diet has just been added for our ‘mummies in a hurry’ to lose their weight! It’s for you if you have a deadline or a big event coming up.
This diet will reboot your body and transform you from the inside out. Your incredible results will be gained by detoxifying and reshaping your body.
Check this diet out here.
Dealing With Other Stressors & Risk Factors
The absolute key here is to recognise how the stressor or risk factor is impacting on your health and wellbeing, and ask for help.
If you have elderly parents whom you help regularly, let others take on the responsibility, at least for the short term.
Get help with household duties and the care of other children. Do not try to do it all yourself plus care for a newborn.
You need a period of recovery and time to adjust to your new baby and the impact this little human being is having on your life and that of your family.
And if you do have a history of depression, or had previous experience of postpartum depression, it is essential that you get support.
What form that takes is your decision, but please don’t delay reaching out.
My hope is that this post has helped you to recognise just how challenging and overwhelming the above-contributing factors can be and that you are not alone in experiencing them and needing support.
Please share this post as we need to get this information out to other women.
And I would love to get your feedback if you have found any of the above suggestions, strategies, tips or resources useful in helping you navigate your way through what is undoubtedly an extremely challenging period of motherhood!
And finally, be kind to yourself and …
Take care of you.