A new mother is supposed to be happy. She has a healthy, beautiful baby, so what could possibly make her sad?
Stress, anxiety, surging hormones, and a lack of sleep can all play havoc with a new mom's emotions. But sometimes a mother is more than exhausted — she's suffering from postpartum depression, a very real and serious illness that affects 6.5 percent to 12.9 percent of new moms, according to Postpartum Support International.
Postpartum depression can occur anytime within the first year after childbirth. There is no single cause, but genetics play an important factor — such as a family history of depression. Major symptoms include sadness, fatigue, insomnia, trouble concentrating, anxiety, and feelings of guilt and worthlessness. While many new moms may experience "the baby blues" shortly after delivery, PPD differs in that it affects the mother's well-being, disrupts her ability to function, and requires medical attention.
Pat Guttilla knows firsthand how PPD can threaten a new mother. "With us it came on suddenly," says the 58-year-old grandmother of nine from Patchogue, NY. "My daughter was doing fine, then all of a sudden she didn’t want to be left alone. She told her husband and me that she wanted to go back to the hospital so that she could sleep."
Guttilla advises other grandparents to watch for panic attacks, severe melancholy, social withdrawal, excessive tearfulness, or other major changes in their daughter or daughter-in-law's personality. When her own daughter developed PPD, she says, "she would literally sit on my lap and cry."
Dr. Catherine Birndorf, director of the Payne Whitney Women's Program at New York Presbyterian Hospital, urges grandparents to trust their instincts if they suspect a new mom has PPD, because the risks are so high. "Believe what you see — you can't be in denial, and you mustn't keep quiet to be polite," she says. "If you notice the new mother doesn't want to be with the baby, can't stop crying, is hypersensitive, can't rest even when the baby sleeps, and wishes to escape, it's gone beyond the 'new mother' thing and you should definitely ask her how she is doing. She may not tell you, but a good litmus test is to look her in the eyes. You need real conversations."
If the mother isn’t willing or able to talk to a doctor, grandparents may have to contact someone for her. In some cases, mothers suffering from PPD neglect or even harm their babies. While you don’t want to be intrusive, you have to walk a fine line.
It's critical that family and friends offer as much in-person support as possible to a mother suffering from PPD, so she can get rest and, equally important, avoid being alone. Guttilla and her son-in-law, for example, took turns sitting with her daughter. "Encourage her to sleep," she says, "and try to get her outside in the sun and fresh air, even if she doesn't want to."
The bottom line, Guttilla says, is that "even if it means you have to drop everything else, drop everything and be there. She needs you more now than she ever has before."
Dr. Margaret Spinelli, director of the Women's Program in Psychiatry at the Columbia University College of Physicians and Surgeons in New York City, says that her profession has room for improvement in the diagnosis and treatment of women with PPD. "We are much, much better than we were, but although we have become better equipped to recognize and treat PPD," she says, many doctors still do not customarily ask new mothers if they are feeling depressed. And since personal and family history are good predictors of PPD, she adds, "that information should be collected and those women should be watched closely."
Today, Pat Guttilla and her daughter use their experience with PPD to help others — they are both volunteer counselors at the Postpartum Resource Center of New York. "I remind mothers that it will get better," Guttilla says. "Every day they'll get a little better."
POSTPARTUM RESOURCES
• Shoshana Bennett and Pec Indman’s Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression (Moodswings Press, 2003).
• Learn more about PPD from the U.S. Dept. of Health and Human Services.
• Mothers can get help from Postpartum Support International and the Online PPD Support Group or, if necessary, contact the National Suicide Prevention Lifeline, 24 hours a day, at 800-273-TALK.
• Fathers supporting their partners can get help from Postpartum Dads, and new fathers experiencing PPD themselves can get support from Postpartum Men.
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