What You Need to Know About Postpartum Depression

I have never really been afraid of depression. Upon learning what was happening inside my body — my physiological limitations — I actually felt empowered. Through intervention, I could feel the mental peace others are capable of feeling. It was freeing!

It is for that reason I have never quite understood the fear some people have over admitting symptoms of depression and a need for help. While many people experience this, there is one group in particular that resonates with me: new mothers.

Hormones and Lack of Sleep

lack of sleep
Lack of sleep is an unfortunate reality for new moms.

A toxic combination for new moms is the plummeting of hormones — estrogen and progesterone — and the inevitable lack of sleep. The rapid decline in hormones happens after a steep build-up to accommodate the baby during pregnancy. Within 24 hours, that high level of estrogen and progesterone is back to what it was before pregnancy.

Women to Women explains that the endocrine system is linked to emotions and mood, which is why hormone fluctuations have such an impact.

“It is like an orchestra that needs to have everything in balance or the overall effect is off,” writes Marcelle Pick, OB/GYN, NP. “This explains why women are more prone to problems with mood during their hormonal fluctuations. These periods of vulnerability include puberty (menarche), pre-menstruation, pregnancy, childbirth, and menopause.”

Combine that with lack of sleep and new moms are fighting an uphill battle. Scientists look at lack of sleep as associated with depression in a chicken-or-the-egg way. Insomnia is a symptom of depression, but lack of sleep is known to lead to depression.

R. Robert Auger, MD, a sleep specialist at the Mayo Center for Sleep Medicine in Rochester, Minnesota, acknowledges that fact, but also the undeniable truth that to have a healthy mind one must be rested.

“There is a well-established connection between lack of sleep and mental and physical health,” Auger says. “Sleep is as important an aspect of health as exercise and nutrition. Sleep is non-negotiable.”

Unfortunately for new moms, the baby doesn’t negotiate either! Lack of sleep is a fact of life that can, unfortunately, contribute to postpartum depression. It has nothing to do with a woman’s resilience, ability to cope with change or level of happiness in her life. It is a physiological combination that can result in a burnt-out mind.

Inexplicable Distortion

Distorted thoughts are a common symptom of postpartum depression.

Those who have not experienced depression firsthand would have a difficult time understanding the distortion that comes from it. Depression isn’t a sadness someone can will themselves out of. It’s almost like low fuel in a car or a motor that has been burnt out. You can’t think your way out of the problem, you need to repair it!

A woman suffering from postpartum depression may feel a conflict between her logical mind — how she believes she should be feeling — and her actual mood.

One analogy is to envision yourself looking at a blue car. You know the car is blue. It’s a fact. But you can’t stop yourself from believing it’s red. Whether you think the definition of blue and red have changed and no one told you, that there is a filter you can’t see, or that you have suddenly grown color blind, you cannot convince yourself to change your mind.

Sounds ridiculous, right? Exactly. Depression is the same way. It tricks you into the most ridiculous (or sometimes scary) thoughts that you know are wrong, but you can’t change the way they are processing in your mind. You aren’t stupid, broken, or pathetic. You have just been through a lot and need help to get back to where you once were!

Treatment Options

Treatment options include psychotherapy or antidepressants, sometimes both. It can be extremely helpful to talk to a professional who understands what your brain is experiencing.

Trying to talk through the blue and red car example above to someone who has no idea what a depressed mind is like would come across relatively ridiculous. But to a trained professional, it makes perfect sense. You’d be surprised how far validation can go toward getting better.

Antidepressants are another way to treat postpartum depression. Many associate the word “antidepressant” with benzodiazepines, such as Xanax, but that association is false. Antidepressants don’t act as a drug stimulant, they help the brain retain natural-occurring substances called neurotransmitters, which affect mood. These neurotransmitters include serotonin, dopamine, norepinephrine, and epinephrine.

The neurotransmitter that is depleted will dictate the drug that works best, but doctors can’t know which is depleted without a trial-and-error process.

Get Help

If you believe you are struggling with postpartum depression, reach out to your doctor. You could be experiencing symptoms months after you have your baby, so don’t be afraid to call!

For a more specific list of symptoms, visit mayoclinic.org.

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