How long does postpartum depression last?
Seven years. That’s how long I have personally battled postpartum depression. I’ve tried all kinds of different treatment options over the years and it regularly fluctuates between better and worse. There was a time in my life when I thought I was cured. But now I know better. I know that it will never go away. I have accepted that managing my mental health is going to be a lifelong journey.
Yes, postpartum depression can last longer than a year or more. Here’s what you need to know.
Postpartum depression is a form of a major depressive disorder that happens to women after they give birth. Something along the journey into motherhood triggers the brain to revert into a depressive state. Sometimes the cause is obvious, such as a difficult labor or a history of trauma, abuse or mental illness. In other cases, the cause lies much deeper and is harder to pinpoint. Regardless of the cause, a mental illness has now been triggered and that means it’s here to stay. While similar in symptoms, there are a few differences between depression and postpartum depression.
Hormones have a lot to do with it.
Creating a life is unlike any other event in the world. Women’s bodies go through immense changes that we can’t even begin to understand. We’re all too familiar with the hormonal changes that happen during pregnancy, causing an expectant mother to feel everything from uncontrollable weepiness to pure rage. After giving birth, those hormones now have to work overtime to regulate themselves and it’s not an easy process.
The majority of women will experience some form of the baby blues, which is not a mental health disorder, but rather a normal response to the hormonal and environmental changes. It’s easy to blame all these new and scary feelings on the baby blues, but those only last for a couple weeks. Postpartum depression can begin anytime in the year after giving birth, and long after hormone levels have regulated.
Depression can be triggered by trauma.
In addition to those 9 months of changes, there is the trauma of childbirth. No matter what your labor and delivery story was like, it was traumatic on your body. Like a soldier going to war, you will come out of it a changed person. For some, their body adjusts to the trauma and they are able to move on, at least to some degree. For others, however, the trauma leaves it’s mark.
Bear in mind that what is considered traumatic to you, may not be considered traumatic to others. Just because you had a smooth delivery without any major problems doesn’t mean you’ve escaped unscathed. Birth has a way of uncovering deep feelings and vulnerabilities that we didn’t even know we had. Speaking to a therapist or using cognitive behavior therapy can help to discover the root cause of your postpartum depression.
Maternal postpartum care sucks.
There is no elegant way to put this, it just plain sucks. A lot of emphasis is put on prenatal care, but not nearly enough on postpartum care. Once a mother becomes pregnant, she is seen by a doctor monthly, then bi-weekly, weekly and sometimes even daily until she gives birth. Then there is a whole lot of commotion surrounding the birth and the 3 or so days afterwards.
And then she is sent home with a follow up appointment for 6 weeks later. She’ll have to haul that baby in to get checked out on the regular, but now that the baby is on the outside, her body doesn’t seem to matter anymore. Unless there is a physical postpartum complication, then she will get the care and attention she needs. But mental postpartum complications are never treated with the same sense of urgency.
What [actually] happens in the 4th Trimester?
Here is a woman who’s physical, mental and emotional state has just gone through the roller coaster ride of it’s life. She is in pain everywhere as she’s literally just been ripped open and had a part of her removed. A brand new person is now completely dependent on her for their survival but there is a major communication barrier.
Despite feeling the highest levels of exhaustion, she’ll be unable to sleep for longer than a 3 hour stretch… for months. The pressure to breastfeed weighs heavily on her. She will feel vulnerable, exposed and judged every time her baby is hungry, and that will be a lot. She will lose all confidence in herself as a woman if she is unable to produce enough milk.
The first three months postpartum (or 4th trimester) should be the time when a mother rests and gets to know her newborn. She should have support and help. She shouldn’t need to worry about anything other than herself and baby. But this rarely happens. A lot of people will “visit” but only the odd few will actually be of any real help. Many mothers even have to return to work before they have time to properly heal.
Years Later and Still Depressed.
When we take into account the terrible state of maternal mental health care, it’s no wonder that more and more women are battling depression long after giving birth. Postpartum depression and other perinatal mood and anxiety disorders should be treated with much more respect. Mothers need time to heal, they need help and proper support. The level of care for a new mother should be just as important as it is for a newborn baby.
But the blame is not solely on the health care system. Take my story, for example. I am fortunate that I live in Canada and was able to take an entire year of paid maternity leave. I also delivered by midwives and the postpartum care that I received from them was far superior to anything I got in the hospital. They came TO. MY. HOUSE. for days and weeks afterwards just to check up on me and baby. They stayed for hours and drank tea and helped me breastfeed and changed diapers. But I still got postpartum depression, despite all of that.
What it comes down to is that mothers need to take better care of themselves. They need to understand the importance of rest and accepting help from others. And most importantly, they need to speak up if they feel like something isn’t right.
There is no cure for postpartum depression. Treatment will make the symptoms manageable but it will never go away.
This will be my seventh year fighting against postpartum depression, so I can confirm that this is a long term battle. But I say this not to make you feel even more depressed, but to encourage and inspire you. Talk to you doctor, fight for your rights, demand better treatment and speak up about postpartum depression to everyone who will listen.
Most importantly, seek treatment. With the right treatment, you can live symptom free for the rest of your life. All it takes is that first step.
With more and more information about postpartum depression readily available to new moms, will they take the time to read it?
When I was an expectant first time mom, I knew very little about postpartum depression. It was surprising because, as a researcher by nature, I wanted to know about every possible complication I could get. But I scoffed at the thought of getting postpartum depression. In my mind, mental illness was for the weak. And even if I did get it, I would never let it get the best of me – I was a strong, positive, confident person.
But I horrifically underestimated the power of postpartum depression.
Ultimately, it did get the best of me and it’s a battle that I still fight to this very day. I sadly regret not taking the time to learn more about maternal mental health and postpartum depression 10 years ago when I had the chance. So now I urge all new mothers, expectant mothers, first, second, third time mothers, to read as much information about postpartum depression as they can find, even if you doubt that you’ll get it.
Here are some specific things about postpartum depression that I wish I had known.
1. You don’t need to have a history of mental illness in order to get it.
One of the biggest misconceptions about postpartum depression is that it can only occur if you have a history of mental illness. But because there is no clear reason why women get postpartum depression, this is not a fact we can rely heavily on. This means that you could get postpartum depression even if you’ve never dealt with mental illness before and have no family history of it.
Another thing to take into consideration is the silent struggle of mental illness. It’s likely you DO have a family history of mental illness but it was never, ever spoken of. If we think the stigma of mental illness is an epidemic now, imagine what it was like 40 years ago, or more.
Ruling out postpartum depression based solely on the fact that you have no history of mental illness is not a guarantee that you will not get it.
2. You can get it even if you have zero risk factors.
Some of the risk factors for postpartum depression include:
- A personal history of mental illness (depression, anxiety, bi-polar, etc.)
- A family history of mental illness
- An unplanned pregnancy
- A difficult pregnancy
- A stressful experience surrounding pregnancy or childbirth (infertility, miscarriage, premature labor, complications, special needs baby, etc.)
- A traumatic labor and delivery
- Childhood trauma
- A history of domestic violence or sexual abuse
- Stress (including financial or marital stress)
- Lack of a proper support system
- Difficulties caring for baby (postpartum complications, breastfeeding problems, colic, etc.)
The list is long but basically it says that if you experience anything other than a “perfect” journey into motherhood, you’re at risk of getting postpartum depression. So let’s take a long shot and say that everything, from the moment you conceived until your child’s first birthday, went exactly as you imagined and nothing terrible happened along the way…
You could still get it!
Again, no one knows exactly why women get postpartum depression. Some theories say it has to do with a shift in the hormones – which would mean the risk factors actually have nothing to do with it at all.
3. It is not always triggered by trauma.
Trauma is a recurring theme on the list of risk factors because it plays a huge role in mental illness. In fact, our first response when faced with postpartum depression is to think back to what traumatic experience could have caused this.
It’s important to know that trauma is not the only trigger of postpartum depression. Mental illness tends to prey on the weak, and we are often at our weakest shortly after experiencing a life changing event such as becoming a mother. Sleep deprivation, physical pain from labor, fears and anxiety and even the simple act of change can all trigger feelings of depression.
Cognitive behavior therapy is a great method to help figure out what is triggering the postpartum depression so that you can learn how to manage it.
4. It doesn’t necessarily start right after birth.
Making it through the first six weeks unscathed does not mean that you’re in the clear. Symptoms of postpartum depression can show up anytime within the first year after giving birth. Some women experience the highest of highs after giving birth and can ride it out for months. This can make the drastic fall into postpartum depression that much more difficult.
Care for new mothers normally ends around six weeks postpartum. So it’s not uncommon for symptoms of postpartum depression to show up after this point, when all the help and attention suddenly comes to a grinding halt.
5. It’s likely you will experience some form of the baby blues.
It’s reported that 80% of new mothers suffer from the baby blues. The fact that it IS so common can actually make postpartum depression harder to diagnose because many women and medical professionals have trouble telling the two apart.
There are some warning signs that could signal more than the baby blues. Generally speaking, if it lasts longer than a few weeks, it could be postpartum depression. This usually results in mothers being brushed off if they express any kind of concern about their mental health in the first few weeks postpartum.
While there’s no need to worry excessively that the baby blues will turn into something more – there are a few differences that you should keep an eye out for.
6. The most common symptoms are not the only ones.
When we think of the word “depression” we often associate it with sadness. But postpartum depression doesn’t always manifest as sadness. It usually manifests as a feeling of “nothingness.”
Feeling nothing, empty, or numb, is one of the most significant symptoms of postpartum depression because it’s what drives all the other symptoms. Being numb makes us feel fatigued and unable to do the most basic of tasks. We don’t want to go out anywhere or do anything. We don’t feel the urge to eat or sleep or laugh. We may not feel happy, but neither do we feel sad.
Postpartum depression can also cause a variety of different physical symptoms. Normally we don’t associate physical symptoms with mental illness and so we turn into hypochondriacs trying to find the cause of our physical pain.
7. It can show up as anxiety, or a combination of depression and anxiety.
Now here’s the real tricky part that always seems to confuse new mothers. Anxiety. When looking at a list of postpartum depression symptoms, the symptoms of anxiety and those of depression tend to be lumped together, making it even harder to know what it is you’re dealing with.
A new mother can experience anxiety in combination with postpartum depression, which means that all of that emptiness is replaced with a constant state of fear and worry. It’s the kind of worry that keeps you up at night. Things that never seemed to bother you much before now feel like the biggest threats. You imagine horrible scenarios in your head and do things to prevent them from happening, as far-fetched as they might seem.
Some new mothers deal with anxiety without the depression, in which case, they are not numb to all the normal emotions of motherhood but worry just the same. Anxiety is a dangerous mental health disorder that can open the door to intrusive thoughts, rage and obsessive compulsive disorder.
8. Your spouse or partner may be the first to notice that something is wrong.
The people who know you best will notice a change in you before you realize it yourself. They may not tell you that they notice it, depending on your relationship, but they’ll know. It’s kind of hard to live that closely with someone and not be able to spot that something just isn’t right.
Part of the responsibility of your spouse, partner, baby’s father, etc., is to help you through this postpartum period and recognizing the signs of postpartum depression falls into that category. Even if they don’t know exactly what’s wrong, they should speak up if they think you’re acting differently.
Try not to be offended or act defensively when someone you love says you might have postpartum depression. Approaching the subject of mental health is a hard task and the fact that they’ve said anything at all means they’re truly trying to help.
Know someone suffering from addiction due to postpartum depression? Here’s a list of resources for friends and family who want to help.
9. There is no shame in admitting that you have it.
Mental illness is so stigmatized that women who are suffering from a valid, medical, postpartum complication are afraid to tell anyone. They believe that battling a mental illness makes them look weak, when in fact, the opposite is true.
Warriors are working hard to end the stigma around maternal mental health, but until then, all we can do is educate others. The more people know about postpartum depression, the less shame there will be for those who carry the burden.
10. While there is no cure, it is treatable.
Once it’s triggered, postpartum depression lingers around like the annoying friend who’s overstayed their welcome. With treatment, and a little extra work, it is entirely manageable.
First off, mothers with postpartum depression need to proactively take care of themselves. They need to maintain their health and keep their stress level down. Mental illness thrives in a toxic environment, so it’s important to stay positive, eat right, sleep well and be mindful.
Secondly, a form of professional treatment is a must. This could be anti-depressant medication, cognitive behavior therapy, acupuncture, massage therapy, or hypnosis, to name a few. There are treatment options that are all-natural and safe for breastfeeding, so that is not an excuse not to seek treatment.
11. The best place to get help is from someone who understands maternal mental health.
When we hear of stories like Jessica Porten and Andrea Yates, the thought of talking to someone about postpartum depression is terrifying. These women are being treated like criminals by supposed professionals. And the public reaction to their “crimes” is even more disturbing.
That’s why it’s important to seek help from someone that you trust, and someone who understands the reality of postpartum depression. A great place to start is Postpartum Support International. You can call a helpline to get all kinds of information and support.
If you’re looking for more hands on help, talk to a postpartum doula who are trained specifically to help new mothers and recognize the symptoms of postpartum depression in it’s earliest stages.
12. If left untreated, you will likely struggle with symptoms for the rest of your life.
Untreated depression is the number one cause of suicide in the world. Postpartum depression has claimed many lives and while it is a worst case scenario, it CAN happen to anyone.
Even if the symptoms go away for a while, there is always the risk of a relapse. The only way to stay on top of the symptoms and win the battle against postpartum depression is by sticking to a treatment plan.
13. It’s entirely possible that you may not get it all, but it’s better to be prepared.
I had three all-natural, drug free births, but that didn’t stop me from researching epidurals and c-sections. I was thankful that I didn’t have either of them but I wanted to be prepared in the event that I did. So why is postpartum depression any different? It’s the most common complication of childbirth and yet no one seems to know anything about it.
There is no harm in researching postpartum depression prior to becoming a mother. My hope is that you don’t get it, because I wouldn’t wish it upon my worst enemy. But if you do, at least you’ll be prepared.
We are all incredible people, no matter what our journey is with postpartum depression.
Some women who end up with postpartum depression have battled mental illness their whole lives. Some may have gone through a depressed period as a teenager or following some tragedy in their lives. Maybe they’ve witnessed a family member deal with it, or experienced some kind of childhood trauma. PTSD can contribute significantly to depression and other postpartum mental health disorders.
But others, like myself, have never faced a childhood trauma or battle with mental illness prior to becoming a mother.
To go from living the “perfect” life to experiencing the darkness that is depression in such a sudden way feels like being buried alive. While I no longer struggle with depression on a daily basis, it’s effects remain permanently. I will forever mourn the loss of the incredible person that I was before postpartum depression took it all away from me.
I used to be an incredible person.
I had a really great childhood, with parents who loved me and loved each other.
My sister was my best friend and confidant.
Even as an awkward, mixed-race, home-schooled teenager, I never felt depressed or self-conscious.
I embraced my differences, stood up for others and voiced my opinions.
I loved to take care of people and when I started working, I delivered the type of customer service that got rave reviews.
I worked jobs that I loved and was successful at them.
I almost married the wrong man, but then met and fell in love with the right one and had a fairy tale wedding, just like a cliche romantic movie.
We renovated a house in the perfect neighborhood and got a couple of dogs before a baby soon followed.
Life wasn’t always perfect but it was pretty darn close to what I imagined “happily ever after” would be.
Most of these things haven’t changed.
I still have an amazing husband and a family who love and support me.
I still have the perfect house with the two dogs and three kids.
I still have success doing work that I find rewarding.
Except that now, I have postpartum depression.
It’s been 7 years so I doubt it’s even considered “postpartum” anymore, but I will always refer to it as that. Because until I got pregnant with my second child, I was anything but depressed.
For the past 7 years, I’ve had to fight every single day to be the happy, incredible person I was my entire life.
Things that came so naturally to me, such as talking to people or taking care of myself – are now things that I avoid at all costs.
Shopping dates and salon appointments were something I looked forward to doing with my friends. I loved fashion and beauty to the point of vanity. But these days, I feel zero motivation to get dressed in the morning, so I wear the same sweat pants and stained T-shirt all week long.
And when I do dress up, I criticize everything about myself. I count out grey hairs and wrinkles. I pinch the rolls of skin on my stomach and make disgusted faces in the mirror.
Instead of styling my hair, I fantasize about shaving it all off.
I can’t look people in the eye anymore, or make small talk with cashiers and servers.
When I talk to someone on the phone I stutter and stumble and forget what I was supposed to say.
I silence my phone when it rings because I need to work up the courage to take the call first.
And if I see someone I know out in public, I duck and hide and hope they don’t notice me.
I’ve never felt as much hatred for myself as I do now and I’ve lost all my confidence to postpartum depression.
I feel sorry for the people who have come into my life only after the postpartum depression because they never got the chance to meet the real me.
The fun me, who was hilarious and clever and the life of the party.
The powerful me, who loved to debate about controversial topics.
The competitive me, who hosted game nights and Rock Band showdowns.
The inspiring me, who gave the best pep talks and listened to everyone’s problems with empathy.
Those people will say that I’m still like that, but oh, if they only knew.
Those who did know me before, walk on eggshells around me now, afraid of what might offend me or set me off.
I make people uncomfortable with my presence, because no one is ever sure what to say to someone with a mental illness.
I’ve forgotten how to break that awkward silence with pleasant conversation.
Friends that used to come to me for advice just feel sorry for me now.
They look at me and think I’ve let myself go… that I’ve given up.
But what they don’t see is that I’m fighting a mental battle every single day just to survive.
I loved who I was before postpartum depression.
I was happy and fulfilled and determined before postpartum depression.
I was a people-person, a social butterfly, an extrovert before postpartum depression.
And now, I am merely a shell.
I look the same on the outside, but inside I am hollow and empty. The amazing person that used to live in here is all shriveled up now, unable to move or grow.
Life pushes me along like waves on the ocean, slowly rolling through the days and the months and the years.
I try to stop it, try not to move forward, but there is nothing to hold onto. I am simply grasping at water.
I want to stay still, I want to press pause.
I wish I could live in a glass box so I can watch life happen around me, without having to actually be part of it.
Participating in my own life is exhausting.
I don’t want it to end because there is a tiny glimmer of hope still inside of me.
I hope that someday I will feel the desire to live again and then I can come out of my glass box.
I hope that someday, I will be incredible again.
Postpartum depression isn’t a matter solely for mothers of newborn babies.
It’s a lifelong struggle. Even with treatment, a postpartum depression relapse can happen years after the sleep deprivation and breastfeeding days are over. The best way to describe it is to imagine that a depression gene is lurking somewhere within you. In some people, it is never triggered and lays dormant their entire life. In others, it’s triggered during childhood or puberty, from a traumatic event, or by pregnancy and childbirth.
The problem is, once it’s triggered, it’s more likely to keep happening.
Treatment can manage the symptoms and controlling specific triggers can help to avoid relapses. But it’s not something that is ever cured, and it will never go away because it was always there to begin with. It can only be controlled.
Here are some tips to help you avoid a postpartum depression relapse.
Identify your triggers
Find out what factors tend to make you feel more depressed. Keeping a journal can help with this. On days when you are feeling extra sad or anxious – write down things you’ve done recently, how you were feeling, conversations you had, medications you’ve been taking, what the weather was like, and so on. Postpartum depression triggers can be different for everyone.
Eliminate the problem
I know, it’s easier said than done. If we could all get rid of pain and stress, then the world would be a better place. Try keeping track of your sleep patterns and monthly mood fluctuations to help you notice patterns and triggers. But once you’ve identified your specific trigger(s), your next goal will be to work at ways to fix that issue in your life.
If you’re uncertain of where to begin to fix the problems affecting your mental health, then speaking to a therapist can help. Sometimes, it’s difficult to determine the root cause of our symptoms on our own. Cognitive behavior therapy is a great exercise to help with this. There are also licensed online psychiatrists available that you can have video chat sessions with.
Take care of yourself
Mothers are infamous for not taking proper care of themselves. Self care is not just a suggestion, it plays a huge role in avoiding a postpartum depression relapse. Taking time to relieve stress, sleep well, eat properly, exercise and meditate will ensure that you stay one step ahead. You can even create your own, dedicated self-care space to escape to when you start feeling low.
Stick to your treatment plan
Of course you’re going to be feeling great after starting a round of anti-depressants or therapy, but that doesn’t mean it’s done it’s job and now you can stop. Any changes to your treatment plan should always be discussed with your doctor, don’t assume that you no longer need treatment just because you’ve been free of postpartum depression symptoms for months.
Seeking treatment for postpartum depression is important. Don’t assume that it will go away on it’s own. Getting an official diagnosis of postpartum depression can be empowering. Knowing that you suffer from a mental health condition can validate everything that you are feeling and help you to accept that this is not your fault.
Find someone to confide in
If you didn’t tell anyone you had postpartum depression the first time it happened, then it’s likely you will also choose to suffer silently in the event of a relapse. Find someone that you can talk to about your feelings. It can be someone close to you, a complete stranger or a support group, as long as they will encourage you to speak up and seek help.
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As much as you might try to eliminate stress and other triggers, life still happens and much of it is out of our control. Try your best to plan ahead for situations that overwhelm you. If being locked inside the house during the winter months makes you feel dreary, plan a vacation. If you’re dreading the stress of juggling all the kids during summer vacation, hire someone to help you. If you’re planning a relocation, take steps to avoid feeling depressed during the move. Being prepared for a postpartum depression relapse may even be enough to make you feel like you can handle it, should it hit.
Don’t get discouraged
Sometimes, having a postpartum depression relapse is unavoidable. It doesn’t mean that you have failed or that you will never get better. While you may suffer more relapses in the future, each one will be easier to get through as long as you don’t let it get the best of you. While postpartum depression is a long term battle, it doesn’t mean that you will need to fight it forever. With the right treatment, you can live symptom free.
Take away it’s power
As long as your postpartum depression is a secret – it controls you. If you’re constantly afraid of a relapse happening, then it has power over you. The only way to take away it’s power is by accepting and acknowledging it. Tell everyone that you have postpartum depression and that there’s a chance you could suffer a relapse. Then you won’t have it hanging over your head, and you won’t have to suffer alone. Share your story, consider becoming an advocate for postpartum depression awareness, joining a maternal mental health movement or blogging about it.
Remember that it’s not about them
If you didn’t know that a postpartum depression relapse was even possible, then chances are, neither did they. “They” being your loved ones, your spouse, family or friends – even your own children. Once you start feeling better, others will assume that you’re cured. And if you suffer a relapse, you will be reluctant to tell them for fear of disappointing them. But it’s not about them, it’s about you and your health, and that’s far more important.
So before you even suffer from a relapse, tell your loved ones that it’s possible this could happen. Ask them to help you eliminate your triggers and watch for symptoms that your postpartum depression is returning. Don’t feel guilty or selfish because this is your life. It might be in a mother’s nature to put others before themselves, but when it comes to postpartum depression – you come first.
Contrary to popular belief, postpartum depression does not go away on it’s own. And a postpartum depression relapse does not only happen when you have another baby (although that can be a trigger). Many mothers find themselves battling the symptoms of depression years after giving birth. It’s discouraging and annoying and definitely unfair, but with the right self care routine and treatment plan, it doesn’t have to ruin your life.