Postpartum Depression: How to spot it and when to get help

On the day you give birth to your baby, you go through the greatest physical, mental, emotional, and spiritual change you will most likely ever experience.

Your hormones are raging. Milk production is starting. Stitches are healing. You haven’t slept properly for days. You are dealing with a new, helpless being who might be crying all the time. You start wondering whether you are even capable of keeping your sweet newborn alive until the next day, much less be a fit mother for years to come.

No wonder almost 75 percent of us experience some depressed feelings. These feelings are commonly known as baby blues. We’ve all been there: you cry for no apparent reason, get easily irritated, worry about how you are going to do this thing called motherhood.

Usually, these feelings disappear after a week or two. If they do not, however, you might be experiencing some degree of postpartum depression (PPD). PPD affects about 10 to 15 percent of women, making it the most common complication associated with childbirth. It should be noted that women who have had a miscarriage or an abortion also suffer from PPD.  This condition can seriously impair a woman from taking adequate care of her baby – and even herself.

What causes PPD?

There are several factors that contribute to the development of PPD. Physical factors that can result in depression include a steep drop in hormones as well as changes in blood pressure and metabolism. Also, postpartum thyroid disease affects 10% of women and can be an underlying cause of depression. Having your thyroid levels checked is therefore crucial if you have PPD symptoms.

Other factors that can cause PPD include everything from more general health and life issues to stressful baby-specific problems: a traumatic birthing experience, a colicky infant, difficulty breastfeeding, anxiety about the overwhelming responsibility of caring for your newborn, having trouble identifying with your new role as a parent, body image issues, relationship problems, financial problems, feelings of solitude caused by a lack of social support, single parenthood, unwanted or unplanned pregnancy and cigarette smoking.

Who is at risk for PPD?

In principle, any woman could be afflicted. However, certain risk factors, or predictors, have been identified that are found to be common with women suffering from PPD. These include:

  • psychological disturbance (such as depression or anxiety) during pregnancy
  • stressful life events (such as death, divorce, traumatic birth)
  • previous history of depression
  • low levels of social support

This last risk factor is especially relevant for the expat mom, who is away from her normal support network. Add to that the fact that most new mothers spend a lot of time indoors alone with their babies, and you are left with serious social isolation.

What are the symptoms of PPD?

According to the DSM-IV, the main diagnostic manual used by mental health professionals worldwide, women suffering from PPD experience at least two weeks of depressed mood and/or loss of interest or pleasure. Additionally, at least four of the following symptoms are experienced:

  • rapid weight loss or gain
  • excessive or lack of sleeping
  • restlessness
  • loss of energy
  • hopelessness
  • excessive guilt
  • diminished ability to think or concentrate
  • recurrent thoughts of death

Some of these symptoms, such as lack of sleep, are of course normal when you have a newborn. Sometimes, however, these symptoms are outside the norm. For example, you can’t sleep even though your baby is sleeping or being taken care of by others, or you lose weight quickly because you are not eating enough.

If you are experiencing these symptoms and they are interfering with your daily activities and your ability to take care of yourself or your newborn, it is time to get help.

Getting help

The first and often most difficult step is to acknowledge that there is a problem. To help you do so, take this self-test. PPD might be common, but you do not need to go through it alone. Don’t try. It’s not worth it. You and your baby deserve and need better. Coming to terms with the fact that there is a problem is the biggest hurdle. When you are depressed, it is possible that you can’t imagine feeling better is an option, don’t have the energy to find help, and think you must be the only mother out there who could feel so bad and have such horrible thoughts.

The reality is this: You are not alone. Talk to someone you feel close to. They will not think you are crazy or a bad person. Call your family doctor (huisarts) or one of the organizations or therapists listed below for support. If that is difficult for you, ask your partner, a close friend, your midwife, or someone else that you feel comfortable with, to call for you. Having someone by your side will make the process easier.

Why do you need help?

If you don’t acknowledge the problem and you allow yourself to go untreated for PPD, you will be undertaking a long, lonely, difficult journey. The long-term emotional effects are adverse and wide-ranging. Everyone close to you can be affected adversely: yourself, your baby, your family.

But with the help of counseling and support groups, many women recover very well – and so can you!


List of organizations and practices that deal with PPD

Large organizations that have access to a variety of expertise and facilities. These possibly have waiting times and you might see several therapists:

Pop Expertise Centrum (also known as PopPoli) at Sint Lucas Andreas Hospital: You cannot make an appointment here yourself, but need to be referred by a family practitioner (huisarts) or a therapist.

PuntP: Go to the website for different locations and phone numbers. You do not need a referral here.

Mamakits (affiliated to the VU Hospital): No referral needed. Phone numbers are 020-7884570 (Amsterdam/Amstelveen) or 023-5187604 (Hoofddorp/Haarlem).

Infant Mental Health CentrumNo referral needed and they strive for first appointments to take place within 14 days. Can be reached through 020-5904949.

Independent practices without waiting times and with one-on-one therapists. Possibility of being referred to one of the organizations listed above when medication or hospitalization seems necesseary.

Perspectief Praktijk: Private group practice, no referral needed, phone number is 020-6128290.

Access Counseling Service Network: Contact the counselor on call and you will be referred to a counselor who can support you through PPD. See who is on call here.

Of course you can also see me and reach me through 06-45180342 or I see individuals and couples with a range of concerns, including postpartum adjustment and (new) parenthood issues.

This article was also published on the website of Amsterdam Mamas.

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