Baby blues, postpartum depression & postpartum psychosis: What everyone should know

By Cheryl Dizon-Reynante

In light of the recent news events in Winnipeg regarding the deaths of two young children and the search for their mother (at the time of article submission, the mother was still missing and considered a “person of interest,” not a suspect), it is important to increase public awareness about the baby blues, postpartum depression and postpartum psychosis.

The most common among the three is known as the baby blues, experienced by up to 80% of mothers. It is an emotional reaction to childbirth that begins a few days after delivery and can last up to two weeks. During this time, mothers may be weepy, anxious, and unable to sleep. It is common to feel joyful one minute, then sad the next.

But for some women who have recently given birth (studies cite between 8-15%), symptoms of postpartum depression can develop, which are more intense and last longer. An episode of depression can appear four weeks to one year after childbirth and lasts for at least two weeks. Common symptoms include depressed mood throughout the day, decreased interest in activities that used to be pleasurable, significant weight loss or gain, a major increase or decrease in sleep levels, fatigue, feeling worthless or guilty, difficulty concentrating or thinking, and even feeling suicidal.

Stories most often sensationalized in the news are about mothers who are likely dealing with postpartum psychosis. Approximately 4% of mothers have a chance of harming themselves and about 5% have a chance of harming their baby. And of course, a small number act on their thoughts. So what you hear in the news is actually a rare occurrence.

Because the baby blues, postpartum depression and postpartum psychosis are not openly talked about by mothers and their partners, it can be hard to understand what it is like. To get a sense of how it feels, here is an excerpt from the book Down Came the Rain: My Journey Through Postpartum Depression by Brooke Shields (2006):

Brooke’s Story

“At first I thought what I was feeling was just exhaustion, but with it came an overriding sense of panic that I had never felt before. Rowan kept crying, and I began to dread the moment when Chris would bring her back to me. I started to experience a sick sensation in my stomach; it was as if a vise were tightening around my chest. Instead of the nervous anxiety that often accompanies panic, a feeling of devastation overcame me. I hardly moved. Sitting on my bed, I let out a deep, slow, guttural wail. I wasn’t simply emotional or weepy, like I had been told I might be. This was something quite different…

In general, I have always loved babies, and Rowan was not only amazing and alert but also quite beautiful. Her features were perfectly formed, and she looked like an angel. But I felt no appreciation for the little miracle. Although I didn’t dislike her, I wasn’t sure I wanted her living with us…

I wasn’t afraid she was too fragile; I just felt no desire to pick her up. Every time I have ever been near a baby, any baby, I have always wanted to hold the child. It shocked me that I didn’t want to hold my own daughter.

Chris and I were alone, and there was a great deal of silence in between my bouts of crying. Often he would break the silence by asking me to please tell him what was wrong. My response would be to shake my head and say I didn’t know.”

In most cultures, there is great emphasis on the joys of a new baby, so much so that mothers do not feel comfortable voicing their exhaustion, being overwhelmed, scared, and even feeling no emotion towards their baby. Within the Filipino culture, the emphasis on family and pride can further cause a mother to feel shame and be reluctant to ask for help.

What is most important for the public to know are the warning signs indicating that a mother needs support. Ask her the following questions: Are you able to laugh and find enjoyment in things? Do you blame yourself unnecessarily when things go wrong? Do you feel anxious or worried for no good reason? Do you feel scared or panicky for no good reason? Do you feel that things are too much for you? Do you have difficulty sleeping because of unhappiness? Do you feel sad or miserable and have been crying a lot? Do thoughts of harming yourself occur? Are you afraid to be alone with your baby? Do you find it hard to make decisions? Does your partner know how you are feeling? (Source: Edinburgh Postnatal Depression Scale and The Post-Partum Stress Center)

Mothers are not to blame for the development of postpartum depression. Several factors such as hormonal changes, the stress of childbirth, maternal age, amount of support available, and whether the woman has experienced depression earlier in life, are likely contributors.

There are also significant effects on fathers/partners as well. They are likely to feel confused about the disorder, frustrated about their inability to help, and very worried about their partners. Fathers are also likely to become depressed and not surprisingly, the relationship is negatively affected.

Unfortunately, there can be negative consequences on a baby’s development. Studies have linked mothers having postpartum depression to their babies having cognitive deficits, insecure mother-child attachment and future violent, oppositional behaviours.

There are things that mothers can do to alleviate symptoms of the baby blues or postpartum depression. Make sure you eat well, get as much sleep as baby will allow, and grant yourself little treats such as a favourite magazine or a bubble bath. Venture outdoors with baby in a stroller and go for a stroll or meet a friend. Talk to your doctor about your symptoms – medication has been found to be effective for some women. But most important, share your feelings with your partner, family or good friend. Women have also found it helpful to access counselling, whether in an individual or group setting.

In Winnipeg, there are many mommy-baby activity groups such as stroller classes, salsa dancing, baby sign language, and breast-feeding support groups. Not only do they promote wellness, but mothers also have the support of others who are going through the same things that they are. One such place that is an excellent resource for mothers with young children is the Nest Family Centre on Stafford St. (204-453-8160). There is a variety of pre- and post-natal classes, including pre-natal fitness classes, a breast feeding support group, and weekly playgroups. In addition, there is a support group for mothers called Beyond the Baby Blues that offers group therapy for mothers experiencing postpartum blues and depression. Learning about coping strategies while getting support from mothers going through the same experiences is incredibly therapeutic.

Mothers… stand up and recognize how much you do for others. You are amazing! But don’t be scared or ashamed to ask for help when you need it. Know that taking care of yourself also means taking care of your family!

(Editor’s note: On July 27, 2013, the lifeless body of the 32-year-old mother was found south of the Alexander Docks in Winnipeg.)

Cheryl Dizon-Reynante is the founder of Nexus Counselling and a licensed counsellor with the Canadian Counselling and Psychotherapy Association. She provides counselling services at the Nest Family Centre on Stafford St. and is a proud member of the Manitoba Filipino Business Council. Cheryl has experience helping clients with issues such as grief, depression, relationship difficulties, parenting, aging and illness. She can be reached at (204) 297-6744 or info@nexuscounselling.com.