Depression, Anxiety, and OCD - Real Expectations of Postpartum Depression

PPD with baby
Postpartum depression isn’t something new moms plan on. It’s great to understand and know, but hey, it’s not going to happen to me, right?

Luckily we have a fair amount of understanding about postpartum depression and there are amazing postpartum depression support groups, in hospital and out, aimed at helping moms understand their body. This post will focus on the signs and advice from a recent Nurse Dani interviewed with Eric Dykes, founder of The Emily Effect, and they discuss several postpartum topics including:

What is Good Advice for Those Struggling With Postpartum Depression?

We’ve seen Letters of Light, right? Moms being able to share their stories online and feel liberated in sharing.

"I've held hard feelings and I thought I was crazy, but in reality I'm not. And I'm going to put it out there and I'm going to help others.”

When moms make themselves vulnerable, it not only helps them, but also strengths those who they share their story with. Nationwide statistics say 15 to 20 percent of women develop postpartum mood disorders. If you line up all of your friends who have ever had babies, you don't realize how many friends, and family members, neighbors have suffered with postpartum mood disorder, because people don't walk around with a stamp on their foreheads saying, "I have postpartum depression.” It makes it really easy to have feelings of guilt and inadequacy because you think you're the only one who's having a hard time after having a baby.

“I know the anecdotal evidence is pretty high, even if it's two in 10 – which I think is low. I just know I have lots of moms coming to me, some in a very confidential nature and some just very openly describing the challenges that they've experienced over time and they didn't exactly know what was going on. Whether it's higher than the national statistics or not, what I've experienced over the past year is, in Utah we probably haven't channeled our resourced as well as we should have to focus on the moms and the struggles that they have postpartum,” said Nurse Dani.

Foundationally there are two primary areas - focus on better screening and focus on better treatment resources locally.

Have Real Expectations of Postpartum Depression

On your  first baby life can hit you like a ton of bricks. I had my first baby almost 10 years ago and I struggled with postpartum depression. I didn't dare tell anyone because for one, I was a nurse and I was supposed to be the one who helped people; not the one who went through postpartum depression.

It's important to have realistic expectations on what life will be like when you bring your first baby home - or even your fourth. That's one of my big missions, is to help families understand what's realistic after you've had a baby. It's not all bliss and butterflies all the time. You're not going to love it all the time, and if you have these feelings it is normal. Postpartum blues are experienced in 80 - 90 percent of women. Personally, I would says it's 100 percent of women.

Your hormones dramatically change after you have a baby. The placenta is delivered, estrogen and progesterone levels fall, thyroid levels change, stress hormones kick in, and all these things can affect your mood. Most women stay in the hospital for a couple days and then come home with new elevated emotions. It's a proven fact that a few days after delivery to two weeks hormones cause you to cry for no reason, feel despair, and anxiety. 

I remember on my second, I felt this desperate need for a hug from my husband and my oldest daughter asked, "What's wrong mom?" And I said, "I don't know. Just go get dad." Those types of moments are normal and everyone needs to understand that. When it comes to postpartum depression there are a few truths: 

  • Sometimes you just need a hug and to feel loved
  • Sleep is important - when baby is sleeping you should be sleeping
  • It's ok, and necessary, to get out of the house
  • Accept help, don't be too proud

How do you Feel When Experiencing Postpartum Depression Anxiety Mood Disorder? 

Baby blues is very common and other compulsive tendencies might manifest themselves in very different ways. Eric Dykes shares, I've had moms literally check on the baby every 10 minutes in the middle of the night. They're afraid they'll stop breathing and become obsessed with the idea of the baby has stopped breathing. And so, mom is obsessed, starts focusing and fixating on the baby's breathing, and because of fixated she's not sleeping and then the cycle starts, this pattern grows and things get a lot worse.

Feelings of the world is caving in and your world is ending - that's how it feels and grows. And that's why when somebody has panic, they try to get to a safe spot, but because they don't understand, their spacial awareness and understanding of what reality is. Often, as was the case with Emily you know, she got herself in a bad spot and couldn't get out.

There are so many ways postpartum depression can manifest itself: it can be anxiety, panic, OCD, depression, not wanting to get out of bed, genetics, or their current environment. The point is it's unique to you and you can seek treatment, but it all starts with communication. You have to talk, you have to tell your partner.

You need to tell people that you trust, if you need to get scheduled with a doctor before six weeks, get in with a doctor before six weeks. Call, ask, research online, the point is to take action.

In some cases moms will have intrusive thoughts, these are scary thoughts that moms have. It can be something like impending doom for your child, an unsafe situation, or impending doom for you. Or, in some of the extreme cases, a mother thinking that she might do something to hurt a child, which are quite rare, but those types of feelings come as well. And the self-shame that comes from a mom feeling those feelings is horrible, but there is help.

Does OCD Get Worse After the Birth of a First Child? 

Postpartum depression is often hardest with your first baby.

Although postpartum depressions is often most difficult with your first baby, it doesn't mean you're not going to struggle in future pregnancies. Postpartum experiences can be different each time. I’m around pregnant women all the time - I teach prenatal classes, I worked in labor and delivery, and I work in maternal fetal medicine I like to hear everyone's story and they're all different.

However, a common theme I hear are new moms currently or finishing school and being their new family. This stage is full of life changes, financial difficulties, and the many other challenges student families are prone to; can make it even more difficult to function normally after you've had a baby. These life changes can result in elevated risk. Specifically, I would say OCD does get worse after the birth of the first child. If you had it on your first, you need to be aware you could have it again in the future. You're at higher risk and should look for warning signs in yourself. If you didn't experience symptoms with your first that doesn't mean you won't in the future. Emily suffered with this on the fifth child at 38 years old. 

Being Anxious About Being Anxious

I shared a little bit about how on my first, I struggled with postpartum depression and either didn't want to or just didn't recognize it in myself. But it all came down to breast feeding for me, because I had to be induced at 37 weeks and at 37 weeks often have a sucking reflex, so they don't latch well. She did not latch for six weeks, so the lactation specialist told me try to nurse her for 30 to 45 minutes and if that doesn't work try pumping and offer her a bottle. It was a struggle for me time, patients, and all the emotions around breastfeeding had me frustrated. 

My husband said, "Just give the baby a bottle of formula, she's going to be fine". I believed I have to breast feed; how could this be an option? There was this intense drive to do it and I felt like a failure if I didn't. And finally after about two months ... all along I was making sure the baby was gaining weight and getting what she needed, but then at some point I'm like, "Okay, now I need to start taking care of myself". And I just quit and went to formula, and life was so great.

My second child experience was much different. I took a softer approach toward baby and myself, because the last experience about ruined me. Fortunately, he came out ready an willing to breast feed and life was good with him. I appreciated having both experiences because I definitely think that the breast feeding experience you have, because feeding your baby is so important, can lead to more anxiety, more depression, more obsessive compulsive tendencies for sure. The hormones behind breast feeding aren't necessarily going to increase your chances of postpartum depression. Actually, they say one of the benefits to nursing is that it reduces your chances of postpartum depression, but I think stressing about it if it's not going well definitely increases your chances.

A good friend of mine who's one of the best therapists in the state of Utah, her name is Amy Rose White. She's been phenomenal in kind of guiding us and our foundation. And I went to a training she did a while back and she said, "Let me give you a little bit of advice. Instead of asking a mom are you breast feeding or are you not breast feeding, which is inherently full of guilt if somebody says, 'No I'm not breast feeding, I'm not that mom. I'm not good enough.' Instead you ask, how are you choosing to feed your baby?"

Take Action

Be at peace with knowing it's ok to ask for help if you notice change within yourself. It may be enough to say it out loud to your partner and then eventually talking with a doctor. This is step one to getting help. Four words I leave for moms: anticipate, communicate, educate, and regulate throughout your life.

Anticipate, communicate, educate, and regulate. That's the process that I wish Emily would have gone through, through this experience, but there is hope. Utah's a fantastic place to give birth and raise children. Resources are coming together and we'll continue to improve the resources the best we can. The work The Emily Effect is doing is amazing, thank your for sharing your experience for other moms to learn from. If you have more questions, go to Facebook.com/intermountainmoms and of course you can look up the Emily Effect.