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Ten key facts about postpartum depression

Allegheny Health Network cares for women as they make their journey through pregnancy, delivery, and adjusting to having a new little one in their lives. They believe so strongly in the emotional health of moms that they built a facility dedicated solely to it – the Alexis Joy D’Achille Center for Perinatal Mental Health.

This center features a unique intensive outpatient program that treats women struggling with postpartum depression and anxiety with a focus on strengthening the bond between mom and baby. AHN’s program provides support for moms and their families – the first of its kind in western Pennsylvania and one of only a handful in the country.

Dr. Sarah Homitsky, Medical Director of Women’s Behavioral Health at AHN, answered a few questions to provide greater insight into postpartum depression.

How many women get postpartum depression?

Dr. Homitsky: Postpartum mood and anxiety disorders are the number one complication of pregnancy, affecting an estimated 1 in 7 women. More than half the time, a woman starts experiencing symptoms of depression during her pregnancy, which is why universal screening for depression is so important during pregnancy. Screening during pregnancy improves the identification of women with depressive disorders and allows for earlier treatment.

How does postpartum depression affect mothers of different ages or ethnicities?

Dr. Homitsky: Postpartum mood and anxiety disorders can affect any woman, regardless of age, education level, ethnicity, or socioeconomic status. With that said, trauma, financial problems, lack of social support, and having a baby with medical problems can increase a mother’s risk for postpartum depression.

During pregnancy, what chemical or hormonal changes occur in women that cause postpartum depression? And what chemical changes happen after delivery?

Dr. Homitsky: Both estrogen and progesterone levels increase during pregnancy. We suspect that the rapid decline in these two hormones that coincides with delivery can trigger postpartum depression in susceptible women. A metabolite of progesterone called allopregnanolone may also play a key role. Allopregnanolone helps to keep our mood positive and keep us calm, so some women may feel restless and sad postpartum because of the abrupt decline in allopregnanolone.

What are the common signs of postpartum depression?

Dr. Homitsky: Some of the signs to look out for are a loss of pleasure or interest in activities, a feeling of sadness most of the time, a change in appetite, feeling guilty about not being a good enough mother, feeling irritable or having a low frustration tolerance, struggling to interact or connect with your baby, isolating yourself from family and friends, or a change in your sleep. Postpartum depression typically lasts longer than two weeks and does not go away without treatment.

Why do you think women are hesitant to address their feelings after having a baby?

Dr. Homitsky: There is a preconceived idea that the postpartum period should be the happiest time in a woman’s life. Therefore, it is easy to understand why women often feel embarrassed or guilty about their sadness, often saying things like, “There must be something wrong with me." It is our job as medical providers to educate women and families on the fact that it is common for women to feel sad postpartum and good treatment exists.

Can a woman not have postpartum depression with one pregnancy but experience it with another?

Dr. Homitsky: Postpartum depression occurs in both first-time mothers and mothers of more than one child. A prior episode of postpartum depression can increase a woman’s risk for another episode — however, it is not a necessity. No pregnancy and delivery is exactly the same. Therefore, if a woman with no prior history of postpartum depression delivers her second child amid family and/or financial stress following a traumatic delivery, she is at increased risk for postpartum depression, given her current circumstances.

What are some common misconceptions around postpartum depression?

Dr. Homitsky: Postpartum depression is not a choice, it is not uncommon, and it is treatable. If you are struggling with depression, this does not mean you are a bad mother! Specialized perinatal mental health treatment is available, so ask your OB-GYN or primary care provider for a referral.

What language should we use to empathize with someone going through postpartum depression?

Dr. Homitsky: It can be helpful to say simple things like, “I love you and I am here to help you. What can I do to help you today?” Make sure she understands that it is not her fault that she is suffering from postpartum depression.

How can I approach a loved one who I think might be suffering from postpartum depression?

Dr. Homitsky: Being a new mother is exhausting! Saying things like, “Just snap out of it” or “It’s all in your head” doesn’t help her feel better and can cause increased guilt. Also, try not to compare her to other mothers. Tell her she is not alone and ask what you can do to help. Offer to watch the baby for a few hours so she can do something she enjoys, like taking a walk or a warm bath. It is also important that you help her get the mental health treatment she needs to start feeling better.

What resources are available for women, family members, and friends to learn more about postpartum depression?

Dr. Homitsky: In addition to contacting the Alexis Joy D’Achille Center for Perinatal Mental Health at (412) 578-4030, women have more information available than ever. MotherToBaby is a great resource for women who are prescribed psychotropic medication during pregnancy and/or postpartum. Postpartum Support International (PSI) has a lot of quality information about the symptoms of perinatal mood and anxiety disorders, as well as helpful resources for new mothers and families.

For more information on managing postpartum depression or helping a loved one with postpartum depression, visit AHN.org/hope.

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