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Preventing postpartum depression (PPD) is possible. Because PPD is a bio-psychosocial phenomenon, the causes of PPD involve more than just hormones.
Stress and coping issues, as well as the social organization of the postpartum period, are also major factors in the development of PPD and postpartum adjustment problems.(1-2)
In 2005, I conducted a major study on mothers’ postpartum experiences. (3-4). I discovered that there are six main resources for preventing postpartum depression. These six resources are the main reasons that the mothers in my study gave for “why they felt the way they did,” emotionally, in the weeks and months after their baby was born. In other words:
- The moms who adjusted well and stayed emotionally healthy said it was thanks to these six resources they did so well.
- By contrast, the mothers who had PPD and who struggled emotionally in the postpartum felt that a big reason for why they had such a tough time was because they lacked many, most, or all, of these resources.
The six key resources for preventing postpartum depression are:
1. Prioritizing your own self care.
As tough as it is sometimes, it is essential to place your own needs for sleep, for “getting a break,” and for adequate nutrition and activity on the same priority level as your baby’s. Prioritizing self care is also important while you are still pregnant. Many women who struggle with postpartum depression feel that getting physically worn down while pregnant set them up for emotional problems.
2. Having enough help in meeting your day-to-day demands and responsibilities.
Having material support (i.e., “help”) is crucially important for preventing postpartum depression by helping to keep those stress levels in check, and to help you prioritize your own self care.
Do you feel guilty about asking for help? Believe me, there is no need. Mothering is not, nor should it be, a one-persona job. The adage that ‘it takes a village to raise a child’ is as true to today as it has ever been.
3. Having manageable levels of situational stress.
Sometimes you can’t help the stressors you face. The key, though, is to find ways to keep that stress manageable. Sometimes it means doing less. Sometimes it means changing expectations. Sometimes it means getting more help. Sometimes it means getting emotional support by talking to others about what you are going through. Sometimes it means developing new coping skills. Figure out what it is for you and do it.
4. Feeling understood by, and connected to, others.
This resource for preventing postpartum depression is about reaching out emotionally. Having a confidant helps you share your feelings and experiences, and helps you make better sense of things. Reaching out also provides you with information and knowledge, helpful for figuring out what to do.
So TALK to the important others in your life. If you can’t do that, find an online or in-person support group where you can connect with other mothers, and talk honestly and openly. Believe me, you are not alone.
5. Having realistic beliefs and expectations about mothering and motherhood.
Experiencing some gap between expectations and reality is normal. Indeed, finding ways to reconcile those gaps between expectations and reality is one of the main tasks of the adjustment process.
However, if your “core” beliefs or expectations (those beliefs that are SO central to your very idea of being a “good” mom) become threatened, this can lead to emotional difficulties.
Among moms I’ve interviewed, some of these “problem” core beliefs are: the belief that mother/baby bonding should be instinctual and immediate (it’s not); the belief that breastfeeding is necessary for good mothering (it’s not); and the belief that mothers must always be there completely with/for their babies (also not true).
These are all examples of mythical “perfect mother” constructs. The key is to not get sucked in by them! As one of my interviewees so eloquently said:
“…definitely, there’s an ideal out there about what the perfect mother is. It’s not me. And that’s fine. I know you can be different than this perceived ideal and still be a great mother.”
5. Feeling ready, both physically and emotionally, for the baby and all that that entails.
This is a resource for pregnancy. One part of this resource for preventing postpartum depression has to do with knowing what to expect. Knowledge and information provide coping skills — if you know what to expect (both good and bad), you’re better prepared to handle what comes along.
Another part of this resource is emotional readiness — getting emotionally prepared for taking on the new responsibilities of parenthood. That means being honest about your feelings about this new baby. You will need to deal with ambivalent feelings sooner or later — better to acknowledge and start confronting them now.
The third part of this resource for preventing postpartum depression is to take care of yourself physically, as best you can, during pregnancy.
Use the EPDS to Screen Yourself for PPD.
References Preventing Postpartum Depression
1. Corwin, Elizabeth and Kathleen Pajer. 2008. The psycho-neuroimmunology of postpartum depression,†Journal of Women’s Health 17(9): 1529-1534.
2. Dennis, Cindy-Lee. 2004. “Preventing postpartum depression part II: A critical review of nonbiological interventions,†Can J Psychiatry 49(8): 526-538.
3. Knaak, S. 2009. “Having a tough time: Towards an under-standing of the psycho-social causes of postpartum emotional distress,” JARM 11(1): 80-94.
4. Knaak, S. 2008. The Process of Postpartum Adjustment. Unpublished dissertation. University of Alberta.
Image may be NSFW.
Clik here to view.
Image may be NSFW.
Clik here to view.
Image may be NSFW.
Clik here to view.
Image may be NSFW.
Clik here to view.
Image may be NSFW.
Clik here to view.
Image may be NSFW.
Clik here to view.