What are PPMDs?

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What are PPMDs?

Joy. Hope. Elation. Love. Women are supposed to experience positive emotions after having a baby, right?

What if you’re sad, exhausted, irritable, agitated, weepy? Perhaps even heavier feelings have descended upon you: hopelessness, thoughts of suicide, or obsessive dread. Plus, there’s guilt for being unhappy or profoundly scared at a time when you’re expected to be happy. These emotions may be signs of postpartum depression, one of several postpartum mood disorders (PPMD). If you or someone you know thinks they may be experiencing postpartum mood disorders, the first step is to see a healthcare provider.

"Baby blues" or something more?

Some tears, feelings of being overwhelmed, and moodiness are normal after childbirth. After all, lack of sleep, the stress of bringing home a new baby, and hormonal changes are enough to send anyone on an emotional roller coaster.

These normal ups and downs are the so-called “baby blues.” They may arise two to five days after delivery and are likely linked to natural hormonal fluctuations: estrogen, progesterone, and cortisol drop precipitously within two days after giving birth. In most cases, mom’s blues subside within one to two weeks. When these feelings become moderate or intense and continue longer than a couple of weeks, they can be signs of postpartum depression.

Postpartum depression and other postpartum mood disorders can afflict any new mother regardless of age, race, income, national origin, or education level. Moms of multiples may experience postpartum mood disorders. Moms who experience a miscarriage or stillbirth may experience postpartum depression beyond bereavement. Fathers, too, can experience moderate to severe postpartum depression. Their depression may show itself as frustration and anger.

Risk factors

More than half of new mothers may get the baby blues. While any new mom (and some dads) can experience postpartum depression, there are several risk factors that increase the likelihood of postpartum depression or other mood disorders, including:

  • History of previous depression, including bipolar disorder
  • Thyroid dysfunction
  • Anxiety during pregnancy
  • A family history of depression or any of the postpartum mood disorders
  • History of one or more traumatic experiences, such as a difficult childbirth, miscarriage, or one’s own history of physical or sexual abuse
  • Recent stressful life events, including job loss, financial difficulty, separation or divorce, and other significant events
  • Difficult relationships with close family members and friends
  • General lack of social support
  • Marital/relationship difficulty

Common misconceptions

I must be a horrible person for feeling anything other than joy and excitement for the birth of my baby.
When parents are expecting the birth of their baby, attention is focused on the arrival and its celebration. These cultural ceremonies often do not allow for the time to express common feelings of apprehension, anxiety, and depression. Sleepless nights and uncertainty about parental ability are a natural part of the process for many parents. It is important to recognize and share these feelings. Parents find that often it is helpful to be involved with a community of other families or parents going through the same transition to parenthood.

Only mothers experience postpartum mood disorders.

While mothers play an immensely important role in providing the physical and emotional care for their babies, dads also play a vital part in their children’s socioemotional development. Research tells us that fathers also experience postpartum distress, irritability, and mood disorders. This is why it’s important for both parents to be aware of each other’s experiences during this critical transition to parenthood, so each can provide support for each other.

I feel this way because I haven’t had a lot of sleep – I’m fine.

Feeling fatigued because of lack of sleep is a natural experience for many parents. But it is important to recognize that when feelings of fatigue, sadness, low interest, anxiety, irritability or worry continue longer than a couple of weeks postpartum, it’s probably time to ask for help. Family and friends can supply much needed emotional support and practical assistance. Medical or mental health professionals can offer careful evaluations, trained guidance, and other therapies.

I don’t need to get any help, as long as my baby is okay.

Having a postpartum mood disorder may significantly impair how parents interact with their baby. Often, parents do not realize how mood disorders can affect how they play with their baby. These changes in their style of play—being more withdrawn, intrusive, or showing less positive response—have been shown to have significant effects on a child’s socioemotional development. This often results in signs of attention difficulties, aggressive behavior, anxiety, and delays in language development, as well as other developmental difficulties and delays.

If a mom doesn’t get postpartum depression right after giving birth, she won’t get it at all.

Postpartum depression can develop any time in the first year after giving birth.

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