November 18-24 is Postnatal Depression (PND) Awareness Week – It’s Not All Black and White in Australia. This is an initiative organized by PANDA, the Post and Antenatal Depression Association, located in Victoria, Australia. As you can see, I don’t just blog about postpartum depression (PPD) news/events in the U.S., because PPD is an illness that is suffered by women all over the world. My post for last year’s Blogging for World Mental Health Day sums up why public awareness about PPD is so critical. PPD isn’t black and white. There are varying “shades” of PPD and there is actually a spectrum of perinatal (before/during/after) mood disorders. Each mom’s experience will be unique in terms of duration, treatment, and symptoms.
Here is an excerpt from my book on the spectrum of perinatal mood disorders, or the different “shades” of PPD, that make it so darn challenging to understand by the public and even healthcare professionals:
PPD can occur anytime within the first year after you give birth. It can start as early as a few days postpartum, but appears to occur most frequently around six to eight weeks postpartum. It has even been known to occur in mothers weaning their babies at two years postpartum. PPD often serves among writers on the topic as a catch-all phrase for the spectrum of perinatal mood disorders, or those mood disorders occurring before pregnancy (antepartum, antenatal, or prenatal), during pregnancy, and after childbirth (postpartum or postnatal). The spectrum of postpartum mood disorders includes postpartum anxiety, postpartum panic disorder, postpartum OCD, and postpartum psychosis.
Not everyone who suffers from PPD suffers the same symptoms. The extent to which women suffer from PPD varies and depends on the woman’s biological makeup and past experiences with stressors. PPD experiences range from bouts of crying, heightened anxiety, and fatigue to feeling completely unable to function and to the extreme cases of postpartum psychosis where the mother may hurt or even kill herself and/or her baby. My symptoms were, for the most part, physical rather than psychological. For example, I had no self-esteem issues, and baggage from the past did not resurface (e.g., unresolved issues with a parent’s death or departure during childhood, I have to be a better mother than mine was, etc.). I felt so anxious and unable to function that I could barely get myself to leave the house for my doctor’s appointments. My only symptoms were insomnia, high levels of anxiety, and panic attacks. I was always prone to worry more than the average person, but I had never had any panic attacks before. Hard to believe that my fear of never being able to fall asleep and stay asleep on my own, without medication, could drive my body to have panic attacks. I wanted to fall asleep, but didn’t want to take the Ambien so that I could prove to myself that the insomnia was temporary. When I couldn’t fall asleep, that led to my panic attacks, where my heart raced uncontrollably, my extremities would turn cold, and, when I woke up each morning, I’d be in a cold sweat. All this was so overwhelming.
- Women throughout the world suffer from PPD, but just as one woman’s genetics, physiology, life experiences, and coping strategies are unique to her, one woman’s PPD experience will vary from the next woman in terms of the triggers, symptoms, severity, reaction to medication and/or therapy, and duration. The way everyone reacts to things like fatigue, stress, and lack of support is unique.
- A woman may experience PPD for one but not all of her pregnancies.
- PPD symptoms may differ from one episode to the next.
- A woman who has suffered from nonpregnancy depression in the past can experience very different symptoms with PPD.
- There is a wide range of possible symptoms.
- The timing of the onset of symptoms varies, ranging from a couple of weeks to several months to as late as two years postpartum. Most cases begin six to eight weeks postpartum, though it can begin up to a year postpartum, and even as late as two years after childbirth due to weaning.
- Recognizing the onset of PPD can be difficult due to the fact that such symptoms as mood swings, tearfulness, irritability, and anxiety are also symptoms of the baby blues.
- Some amount of stress, anxiety, irritability, hypersensitivity, difficulty sleeping, and exhaustion (mental and physical) are considered normal consequences of having a brand-new baby to take care of. If you tell your doctor or another parent that you’re anxious and having trouble sleeping, he or she will look at you and say, “What new parent can sleep? It’s perfectly normal to feel some amount of anxiety.” Not being able to sleep at all even when the baby sleeps and you are utterly exhausted is insomnia, and you need to drive that point home.
- Even women who had smooth pregnancies and deliveries, with no history of emotional problems or depression, can also develop PPD.
- Fathers can also develop PPD.
- Adoptive parents can also develop PPD.
Now, do you get why the tagline is so perfect for this awareness campaign?!
It gives me hope whenever I see a U.S. state–or in this case, a different country–acknowledge that PPD is a real illness and the stigma surrounding it must be combated through public awareness campaigns to educate the public about an illness that strikes in as many as 20% of new mothers. Last year, Postpartum Support International declared May National Maternal Mental Health Awareness Month with a “Speak Up When You’re Down” Campaign, an awareness campaign dedicated to increasing support for pregnant and postpartum women and their families here in the U.S. Certain states like California (CA Perinatal Mental Health Awareness Month), Oregon (Maternal Mental Health Awareness Month), and Illinois (Perinatal Mood Disorders Awareness Month) have passed legislation declaring May a month dedicated to educating the public of the resources/treatment programs available to women and their families should they experience a perinatal mood disorder, as well as reducing stigma associated with maternal mental health. Other states like New Jersey and Massachusetts have passed legislation relating to public awareness, screening, research, and support services.
Now, getting back to the Land Down Under, there are some wonderful PPD bloggers and their blog posts in support of Postnatal Depression Awareness Week. I’d like to highlight fellow alumna Debra Dane and her blog post, who does a great job explaining why this awareness week has the tagline of “It’s not all black and white,” and my friend Yuz Rozenblum’s Not Just About Wee blog post.
If you look at the end of each of these two blog posts, you will see all the posts written by other PPD mamas. Please check them out! For moms currently suffering from PPD, you are NOT alone.