Postpartum depression ("PPD") strikes one in eight of all new mothers. What is going on? May is PPD Awareness Month, so we asked Dr. Harvey Karp for his insights into the causes, cures, and, most importantly, prevention.
Why do so many new moms get postpartum depression?
Despite what we all see in the media, the nuclear family is not normal. Up until 100 years ago, babies were never raised by just moms and dads; they always had several "nannies," including (but not limited to) their moms, sisters, cousins, and friends. But today, parents are doing the time-intensive work of baby rearing without a village. And it’s even harder than that because many have hardly ever held a baby before having one of their own. This 21st-century "experiment" has put incredible stress on new parents, nudging more into postpartum depression and anxiety than ever before.
On top of these cultural factors, there are three big triggers that can provoke postpartum depression: exhaustion, persistent baby crying, and feeling unsupported and unprepared. Studies show feeling "very tired" is associated with a seven to 27 times increase in postpartum depression! And, having a baby who cries lots can up your risk four times. But while the triggers are known, the medical community is currently doing little to address them.
How do I know if it's postpartum depression or just "normal" anxiety?
Postpartum depression might start right after birth or take months to appear. Most people think of it as sadness, but it’s more commonly felt as anxiety, like when you toss and turn in bed, and your mind just won’t "turn off." Or, it’s being obsessive about little things. (A mom recently shared her compulsion to reach into the bassinet and touch her baby’s head four times every minute before she could fall asleep. She feared that if she did it fewer times, something terrible might happen.)
The health of moms, babies, and dads can all be affected by PPD. A little-known fact: Up to 25 percent of men whose partners have postpartum depression get it, too. And the depression can lead to infant neglect, breastfeeding failure, unsafe bed-sharing, and accidents. Plus, PPD actually rewires a mom’s brain—making her more prone to get depressed again in her lifetime.
What can I do to help prevent postpartum in myself, friends, and family?
Those are the facts, and while they are alarming to some, I believe we can reduce the numbers significantly by taking a new approach.
Doctors recommend doing a full examination (for example, postpartum hypothyroidism can push some woman into depression). However, no proven way to prevent postpartum depression has been discovered. So, when a mom hits rock bottom, she goes to the doctor, gets screened, and gets treated with psychotherapy and drugs. And, while those tools are godsends to afflicted moms, it’s terrible to wait until one in seven new moms (over 500,000 in all) start to suffer before helping them.
How can we prevent PPD? To start, we need to spread awareness of the three triggers—and help expecting parents take steps to combat them. I suggest creating a prevention plan before the baby arrives:
1. Arrange how you'll get support in advance.
Create your modern mini-village, with the key aim of getting more sleep:
- Ask family to come for an extended visit. Invite relatives who will really help. And don’t have them all descend in the first week. Support is extra golden during the challenging next month, too.
- Lean on technology. Babies sleep better with the soothing cues they love in the womb: motion, sound, and snug holding. Happiest Baby’s SNOO Smart Sleeper is the world’s most effective baby bed. It responds to a baby’s upsets with the perfect combination of all the soothing cues, which means more sleep for you, too.
- Peace of mind. Do everything you can to keep the baby safe. Stay away from bulky bedding, no bed sharing, and breastfeed if you can.
- Hire help. A night nurse, babysitter, dog walker, or housecleaner, and don’t feel guilty about it.
- Invite friends to stop by for chats and chores. So simple, but it’ll prevent isolation. And ask them to wash hands when they arrive; just say it’s doctor’s orders!
2. Learn the 5 S's.
3. Appoint dad as chief baby calmer.
The awesome thing? Dads are usually best at executing the 5 S’s—they bring the needed vigor to get the jiggle just right to stop a baby’s cries: a great way for partners to be supportive from the get-go!
Here's how you can help others with postpartum depression.
You can take your first step right now by sharing this article during Postpartum Depression Awareness Month. And, if you see signs of postpartum depression in a new mom, offer to help and encourage her to sleep while you do. Let her vent about how she feels—and suggest she talk to a doctor. The more each of us does this, the more we’ll get moms talking openly and erode the stigma some feel around treatment. Finally, PSI—Postpartum Support International—is an excellent resource.