Postpartum depression is a problem in Utah; experts say we need to talk about it

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Following a three year struggle with infertility and receiving IVF treatment, Mandy Nielsen, Social Media and Communications Manager for the Healing Group, says she delivered a miracle baby girl.

“I felt like I should be happy,” Nielsen says. “And if I wasn’t happy, I was doing a disservice to all of the women that I knew in the infertility community, to all the people who supported me to get my daughter here. To my older son, I felt like I wasn’t being a good enough mother… I didn’t understand that there’s no shame in needing help.”

After the birth of her daughter, the mother of two experienced symptoms which friends helped her to identify as Postpartum Depression, a mood disorder characterized by sadness, anxiety, and exhaustion which makes it difficult to go about one’s daily activities.

National data shows that postpartum depression is common in Utah. 15.3 percent of Utah women reported experiencing frequent postpartum symptoms in 2009 through 2011, in comparison with 10.1 percent nationwide.

Furthermore, TermLife2Go, a life insurance company, recently found each state’s most googled mental health concern. Utah’s was postpartum depression. The study stated that due to Utah’s high birth rate, this is not surprising.

According to Ashley Henderson, Owner/Clinician LCSW at Reach Counseling, a more inclusive term for postpartum depression is perinatal mood disorder. These disorders can appear throughout pregnancy as well as after and can encompass anxiety, depression, bipolar disorder, psychosis, and trauma. She said that as many as 1 in 5 Utah women and 1 in 10 men will experience a perinatal mood disorder.

Nielsen said it was difficult for her to recognize that she had postpartum depression since she did not feel sad all the time. In fact, postpartum depression can look different for everyone.

Symptoms

For Nielsen, postpartum depression manifested itself through a lack of feeling strong emotions, irritability, and postpartum anxiety.

“For me, postpartum depression was really sneaky,” she said. “I feel like I didn’t understand at first that having postpartum depression didn’t mean feeling sad all the time. I felt very blah, like everything was gray. I should feel excited and thrilled and happy or have any strong emotion… I was just kind of neutral.”

She said she had an overwhelming feeling that she wasn’t doing enough or would feel guilt for being sad or overwhelmed or for snapping at someone.

“Everything felt like it was in a cloud,” she said. “Except for being angry- that I could feel.”

Nielsen said it wasn’t until her daughter was six months old and her symptoms were continuing to worsen, that she reached out to friends. They helped her recognize that, though her symptoms were common, they were not normal.

“It’s easy to write off a lot of the feelings you have as a new mother as exhaustion because you’re just so physically and emotionally exhausted all the time,” she said.

However, she learned that there is a big difference between being tired and being depressed, and that people need to be aware of symptoms that don’t improve with time.

“I wish I would’ve recognized or understood that depression doesn’t just mean sitting and crying in your room all the time,” Nielsen said. “Depression manifests itself in a lot of different ways. It can be feeling kind of blasé about life, feeling angry, feeling upset, having suicidal or intrusive thoughts- all of these things are not from sleep deprivation or the baby blues.”

Henderson said that women experiencing perinatal mood disorders can sometimes experience intrusive thoughts about harming their baby, even though they have no intention of acting on these thoughts.

She says this is a common symptom which many women are hesitant to discuss while seeking help.

Heather Kunz is a Licensed Clinical Social Worker with the Salt Lake County Heath Department. She supervises a program called Parents as Teachers, a home visitation program for children aged 0 to 5 and their families.

Postpartum depression is not the same thing as the “baby blues,” she says.

According to Kunz, up to 80 percent of women will experience the baby blues, which is characterized by irritability and feeling overwhelmed and exhausted. However, this should dramatically improve within a few weeks after the birth.

If these symptoms persist past the first three weeks, she said, it is likely that the mother is suffering from postpartum depression.

“Is someone having a lot of anger, sadness, irritability, guilt? Is this something that is going on, and is she ruminating about something awful happening to the baby or in a state of constant worry or having trouble concentrating?

According to Kunz, these are all red flags to bring up with a doctor. Sometimes, symptoms can go unrealized for years.

“It’s always devastating if it does go unrecognized because it can bring in so many other factors that just don’t enhance and promote wellness in a family,” she said. “Really, I think the most important thing is that getting help early on is important…”

However, Kunz said people can and should seek help a any point that they realize the symptoms of postpartum depression.

“I want to reassure people that really, at any point in recovery from something like this, we get treatment, it’s going to be effective and provide hope,” Kunz said.

She said experts consider birth through first two years to be the postpartum period.

Postpartum Depression Experience

Lina Buchanan, a mother of two, said she had a tendency to stuff down or ignore emotional symptoms in order to get things done. Because of this, she says she didn’t recognize the emotional and psychological symptoms of perinatal mood disorder until they manifested through physical symptoms.

Buchanan said she felt that her primary care doctor didn’t take her symptoms seriously.

“I felt very dismissed and very much like I was making it up,” she said. “I kind of ended up just spiraling into this downward pit of, “I know that I’m having these symptoms, nobody believes me. Something horrible must be going on.””

Soon after, Buchanan says she remembers having one of the worst panic attacks she has ever experienced.

“I was screaming and yelling at my husband at four in the morning… it was very unlike me to react that way to a situation, and it felt like I was losing my mind,” she said.

Following a trip to the emergency room, Buchanan realized that she needed to seek help and contacted Reach Counseling, where she received intensive outpatient therapy.

“Being able to come and meet with therapists… and other people who have gone through the same thing was super helpful,” she said. “It made me feel less alone. Even though my experience was my own, I felt more sense of a community around me.”

Buchanan said that experiencing postpartum depression can be extremely lonely and isolating.

“I think people should know that it’s more common,” she said. “They shouldn’t wait until it becomes an emergency room situation. Becoming a parent is hard; it’s so tough. So, admitting that you need help or that you might need some expertise- I don’t think that that’s unwise to do.”

Buchanan said that the stigma surrounding perinatal mood disorders is something she definitely experienced.

The Stigma

Buchanan said she didn’t want to be perceived as weak by asking for help.

“People still feel like they are perceived as weak if they have something going on,” Buchanan said. “For me, I wanted to stuff it down, not deal with it, and think, “I’m going to be fine. This is just a short period of time. Just muscle through it and it will be okay” because I didn’t want to be perceived as weak or as a mother who couldn’t deal with it…”

Nielsen said she would like others to know that though postpartum depression is common, it should not be taken casually. It is very important to seek treatment and provide support for both mothers and fathers who experience it.

“It doesn’t mean that they’re crazy. It doesn’t mean that they’ll never be the person you knew before again… There’s a lot of adjustments physically and emotionally and mentally, and the more safe and loved you can help a person feel, the better off they will be in their healing process,” she said.

She also said it’s important to remember that postpartum depression is a medical condition that requires treatment from a medical professional. The stigma surrounding postpartum depression sometimes discourages people from reaching out for help.

“Postpartum depression, postpartum anxiety, postpartum psychosis- these are medical diagnoses. These are not things that can be taken away with more exercise or more faith or more prayer… a mother can’t will her way out of postpartum depression… While faith and effort and trying all have important roles to play in the healing process, they do not automatically heal a medical condition,” Nielsen said.

Suffering from postpartum depression doesn’t mean that parents aren’t also overjoyed to welcome their new baby said Nielsen.

“Women and men that have these new babies are happy and are excited and are joyful- all of that can live inside them at the same time as postpartum depression and anxiety. They’re not mutually exclusive. It doesn’t mean they’re not happy and grateful and loving their baby and being good parents. It just means they’re having a hard time, and they need help,” she said.

Kunz says the shame people sometimes feel is a factor that can intensify the difficulty of postpartum depression.

“I think every parent wants to be a good parent,” she said. “They want to be the best parent that they can, and if they’re having these kinds of thoughts and fears, it can be even harder to reach out for help because of that stigma.”

According to Henderson, there is no reason for the stigma in the first place because perinatal mood disorders are not caused by anything anyone necessarily has control over.

“It might be a hormonal shift, it might be something with sleep deprivation, it might be something connected to the way your body is responding to pregnancy… there’s not anything that someone else could have done to control or change that,” she said.

Who is at risk?

According to the Utah Department of Health’s website, teenage moms are at higher risk of experiencing postpartum depression than older moms.

However, Kunz says that all demographics of women, and even new fathers, can experience perinatal mood disorders.

Furthermore, Henderson said that those who have struggled with mental health in the past are often more likely to experience it.

Nielsen said it’s important to be aware of things that can be triggers for perinatal mood disorders. For example, she said she experienced infertility, a traumatic birth experience with her daughter, and had a colicky newborn- all factors which raise the possibility of experiencing perinatal mood disorders.

Though no one can prevent these mood disorders from occurring, those close to new parents can recognize and help ease the symptoms.

How can friends and relatives help?

According to Kunz, being gentle with those who may be experiencing a perinatal mood disorder can be helpful.

“… it’s hard enough to have just had a baby,” she said. “Bringing a little one into this world is a big deal and can be overwhelming anyways.”

People don’t decide to have a mood disorder, Kunz says, so it’s important to support moms.

“It really helps our whole society if we do more to support moms and families so that this upcoming generation has the support that will promote wellness, so I think we all benefit when babies benefit,” said Kunz.

Prescribed medication, exercise, time, and the support that Nielsen received from her family and friends is what she said got her through postpartum depression. She said new moms need support.

“We have to bundle them up with our love and say, “you are safe here, and you are loved and valued just as you are right now, and we know you will get through this. That feeling of safety and community really pulled me through the postpartum depression and brought me to a place where I really was passionate about helping other women,” she said.

Nielsen said if someone who has experienced perinatal mood disorders recognizes that a friend is having similar symptoms, they can share their own experience.

“Say, I see in you that you’re acting this way or acting different… I miss the way you used to smile. Are you feeling okay? Don’t feel afraid to dig a little deeper depending on your level of comfort,” she said.

She also said that getting help can look different for everyone.

“Maybe that’s going to therapy, maybe that’s a support group, maybe that’s medication, maybe it’s all three of those things,” she said.

Henderson said that friends and family can be aware and watch for certain symptoms which can signal perinatal mood disorders.

“One thing that they might notice is the mom or dad struggling to attach to the infant, struggling with bonding, withdrawing from family and friends, not being able to sleep when the baby’s sleeping, not eating well…”

Once they notice something, step in and help out, says Henderson.

“So many of these women and men need help. They need someone to come over and bring them meals,” she said. “They need someone to come over and sit and hold their baby so that they can get some sleep and they can be reassured that someone is caring for their child…. They need someone to talk to and feel that they can be honest with.”

Furthermore, new parents need to be checked in on even after their baby is born.

Screening

According to Henderson, perinatal mood disorders are the number one complication related to childbearing, but they are not receiving the amount of attention they need.

“…. It’s something that is definitely being under-diagnosed, not acknowledged, not screened for properly or as well as we need to be yet…” she said.

She says the more screening, the better.

“What would be best is if we screened at the 2-week, the 1-month, the 2-month, the 4-month, the 6-month. You know, really being able to screen at all stages of postpartum, but also during pregnancy,” Henderson said.

According to Henderson, dads often are not screened for mental health problems at all, though research indicates that 1 in 10 dads deal with a perinatal mood disorder.

Resources

According to Henderson, there are numerous types of resources available to parents experiencing perinatal mood disorders. Some of those resources include free support groups, general outpatient counseling, and intensive outpatient programs where parents can come in for 9 hours a week with their child.

Please see the following sites for lists of resources in Utah:

Postpartum Support International Utah

The Emily Effect

The Healing Group

Reach Counseling

Henderson’s advice to parents experiencing perinatal mood disorders is simply Postpartum Support International’s motto, which states “You’re not alone, you’re not to blame, and with help, you will be well.

“I think that those are really crucial things to understand,” she said. “That you’re not alone- 20 percent of women experience these, so it’s not uncommon.”

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