The Most Asked Question About Postpartum Depression

Speaker 1: 0:10

Hey guys, welcome back to Preview Alliance podcast. This is Sarah and. Whitney, we are back and Whitney, you're used to, hey, whitney questions.

Speaker 3: 0:19

Oh yeah.

Speaker 1: 0:20

So and our listeners love that. But what we're doing today is similar, but it's most asked questions about post-burning depression. Okay, I like it. This is for our listeners. If you're new here, please refer back to last May series we did, which was what is so. We did a whole series of perinatal mood anxiety disorders, ranging from post-burning depression anxiety. We talked about pregnancy and psychoses and kind of did a high level conversational approach about that and gave more specific examples.

Speaker 1: 0:53

So please refer back to that if we're new to you, so you can kind of get some background knowledge here. These questions come, of course, from our Preview Alliance moms, and there is also a search engine marketing tool that literally tells what women are googling. I like it. So here we go. The most common ones and this is not one, is more than not kind of just the high hitters. What causes post-partum depression? Whitney.

Speaker 3: 1:21

We have a lot of different things that go into it. Let me just say that. So number one if you've ever had a history of depression, anxiety, ocd, ptsd, adhd, bipolar disorder, if you've got any history of a mental illness before, you're at higher risk for post-partum depression, post-partum anxiety. The reason is your genetics are already at greater risk for it. So let's say you've never been diagnosed with anything but your mom and dad have, or you've got a grandparent that has, or a sibling that has. Well, chances are, your DNA is just higher risk for mental illness. And especially when we look at post-partum, we look at that hormone crash that we go through, where a progesterone just bottoms out on us. That is really going to be a huge culprit. So, first thing, genetics, dna. That's a big thing. If you've got family history of it, you yourself have a history of something You're going to be higher risk.

Speaker 3: 2:23

The other part of it is that hormone crash that we mentioned, progesterone. So every mom goes through it with delivery. We cannot avoid it. To my knowledge, there's not a type of a progesterone supplement we can take post-partum to head that off. Not to my knowledge, but I've been out of the hospital for two and a half years, so who knows? So when that happens, we have to acknowledge okay, we're going through a significant hormonal crash. At that point where we're recovering, we're sleep deprived, basically we already have a campfire.

Speaker 3: 2:59

Everything's throwing gasoline on it, everything is making it worse. You hear people talking about the baby blues Again. That's where we cry very easily over things. I mean, it can be the cat food commercial and we're boo-hooing over it and we're like why am I crying about this? This is not that big of a deal.

Speaker 2: 3:17

This is not that serious.

Speaker 3: 3:19

It's not but your hormones. They're really going to amplify anything and everything that you're feeling. Yeah.

Speaker 2: 3:27

So we have to take that consideration.

Speaker 3: 3:29

Yeah, so hormones play a big role in it. Birth trauma is a huge indicator for any type of post-partum mental illness. It can be an unplanned C-section, even if the C-section goes well and uncomplicated. An unplanned C-section, an emergent C-section? So we're talking about oh, baby's heart rate dropped, we got to go. Now, like we can't play around, that is a huge thing.

Speaker 3: 3:56

Even if the C-section itself goes uncomplicated, that unplanned that emergent, that plays a role in it. If you have a traumatic vaginal delivery forceps vacuum I've had TMI people but I've had a first degree and a second degree. I did not personally feel like those were traumatic. I would think a third or fourth degree would be incredibly traumatic. That's Whitney's two cents on that. If you have instruments or interventions that take place that you feel like you have no control over, that's a traumatic delivery. If you have a C-section that has complications, that's trauma. Stillbirth let's look at that trauma that that is, especially if you went into the hospital and everything was okay when you got to the hospital and something happens during labor and delivery. That shouldn't happen. Nicu stays, birth defects or genetic defects All kinds of things like that that take place in L&D that we can see coming. Those are huge risk factors for postpartum anxiety, depression, ocd, psychosis, all of the above.

Speaker 1: 5:07

Yeah, and, like you said, a lot of two, and we see this with our premium moms and we screen heavily about risk factors that Whitney was saying. But the lack of family support, the financial stresses, the big life events we're talking about like a move, a health event. We're talking about husband deploying. We're talking about history of physical sexual abuse when we could again go into trauma and multiples. That's a risk as well. Risk losses, miscarriages, infertility. The more you really know about the risk factors of postpartum depression, it really makes sense how postpartum depression is like now. Post COVID one and three. One of the most common complications is there's so much, like Whitney said, that comes into play. You touched on this, but let's dive a little different. Someone's like Whitney give me the low down, the difference between the baby blues which she mentioned and postpartum depression.

Speaker 1: 6:00

All right you know, I'm getting serious because I'm pulling my hair back now, I love it when she gets her hair pulled, but I'm like, let's go. This is. You know, I'm digging into it.

Speaker 3: 6:08

Or if I'm in session with someone and I'm not wearing a dresser skirt and I sit up with my legs crisscross, they're like, oh, you're buckling up. I'm like, oh, I am, so we're buckling up here because I can really dig into this. Stuff said baby blues, and I know this dad say it's like 80 or 85 percent of moms. Truly, I would be shocked if it's not a hundred percent of moms.

Speaker 1: 6:31

I mean you can't tell me it's not a hundred percent, I believe it is.

Speaker 3: 6:34

Like how, even if, because like for me not to brag, but like both my labors and deliveries were uncomplicated, non-traumatic, all the things, I still experienced it Okay.

Speaker 1: 6:47

And it's because my progesterone crashed, because I delivered my babies, because it is the greatest hormonal drop that any human will experience, and that is what mom's experience great like and you don't see it coming, and the biggest thing that happens. And it helps that people are googling this. I hope they're getting the right information. They confuse the two Mm-hmm box are we in? If we're postpartum depression, what box we are in? Baby blues?

Speaker 3: 7:16

So baby blues, you can anticipate that to really set in about 48 to 72 hours postpartum. So you're either just about to leave the hospital or you've just gotten home from the hospital. You're gonna cry over Seemingly little things. So, for example, when I was postpartum with my first, I accidentally knocked over the cat food bowl, burst into tears. And when I tell you, number one, I'm not much of a crier. Number two, especially over cat food, that's really not that big of a deal. We can just sweep it up, throw it away and we're good to go. But I stood there and saw the knowledge of my husband said I have no idea why I'm crying. So you can acknowledge this isn't me. Yeah, I don't get upset over this kind of stuff like this is really out of character. So you know it's out of character. You can acknowledge me. Knocking over the cat food bowl should not equate to solving.

Speaker 2: 8:09

Mm-hmm.

Speaker 3: 8:10

I should not. So we're gonna be crying over things that normally would not make us cry. So you've got your onset 48 to 72 hours. We're crying or getting emotional over things that normally don't make us do that. The other kicker is baby blues will wear off between two to three weeks, so they go away on their own they do.

Speaker 3: 8:32

They go away on their own and you know it's one of those. You don't necessarily have a specific reason for the crying were, for feeling emotional. It's just there, it just exists, and you're like I don't know why I feel this way, but I just do. We don't have an intrusive thought with it, we don't have a root of anxiety with it, we're not stressing over one particular thing. We just know that that exists. We just know that I'm more hyper vigilant, maybe, than I thought I would be, and and yeah but it goes away on its own about two to three weeks postpartum.

Speaker 3: 9:05

That's when our progesterone starts to level out, our estrogen starts to level out. If you're breastfeeding, more often than not your supply is starting to come in a little bit better at that point. If your formula feeding, then you're probably drying up. If you had a supply to begin with, that's nice. So you know our lactating hormones. They're starting to get a little bit more even keel. That's one of those reasons we say two to three weeks, because that's when our hormones are trying to get back to normal. And Again we have the absence of intrusive thoughts. Now, postpartum depression, postpartum anxiety we're gonna put those together. Right now we do have those intrusive thoughts we have. The thoughts of my baby deserves better than me. I'm not cut out for this. What if my baby dies in their sleep? When I'm sleeping, that was me that was my percent me.

Speaker 3: 9:59

That's why we had to have a since monitor, because I could not sleep without it, because I was terrified of SIDS. We won't allow ourselves to sleep for that fear of our baby dying of SIDS. We have very self-deprecating talk. It's very negative, consistently, in constant. Yeah, you and we have thought sometimes. Sometimes we can have thoughts of self harm, we can have thoughts of suicide because we think everybody's better off without me. We feel like a burden to other people. We're not, but we feel it and we believe it.

Speaker 1: 10:38

The thing about postpartum depression that I had to learn is mine hit four months postpartum. That was my worst, that was my lowest and we know it can happen in the symptoms the first year of childbirth, postpartum. That is high alert time. So if you are four months, six months, nine months, 12 months and you are resonating with this, that is not the baby blues, that is postpartum depression. Even it says that the negative outcomes of that can last up to four years post childbirth. So it's not going away without intervention. Thank you for touching on that Cause I think that is something that society lack of information, whatever you want to call it.

Speaker 3: 11:14

Intervention is solely medication. Medicine is an intervention, but we can also do therapies.

Speaker 1: 11:22

Therapy has saved my life. I've been very open about that. It changed me completely and that is why Preview Alliance had the score is we are early intervention and connection to therapy and ensuring that the OB providers have the proper resources and education, access to train psychiatrists, reproductive psychiatrists, to give them medication. So that is something I'm glad we hit on. Okay, this one made me sad a little bit. Can I still be a good mom and have postpartum depression 1000%? And that made me sad because I also remember when I had postpartum depression severely, I was like I'm not a good mom and the fact that this is being Googled so much Postpartum depression, postpartum anxiety.

Speaker 3: 12:04

It won't allow you to see the good, or the hope, or the possibility that you're a good mom. It is that inner critic in your head that constantly says well, you're not good enough because you forgot diapers that one time, or you're not good enough because your baby isn't sleeping through the night yet, or because you were unable to breastfeed, or you delivered prematurely. Or, fill in the blank, your postpartum depression is going to tell you you're not enough.

Speaker 1: 12:31

And so it's probably-.

Speaker 1: 12:32

Or it'd be better without you, right? Like they can go on without you, baby. I remember being just convinced if I was out of the picture then everybody would just be better off, and so if you're questioning that and it really resonates, I really strongly encourage you to speak to someone your OB provider, to reach out for therapy, to talk to your primary care physician, to talk to a trusted friend or your spouse and it's sad but it lies to you and you can't see the light of that. And you know, one of the other frequent Google questions. Now, granted, this could be anybody besides moms Googling this is postpartum depression real? And I thought, are these people really asking that? Of course it's real. It's a clinical disorder. It's in the DSM, it is a clinical. I mean, if you like someone saying, well, is bipolar real? Yes, it's interesting because I have had people say, well, that wasn't a thing back in my day and I've heard other people say that and I'm just like, oh, yes, it was.

Speaker 3: 13:25

It was, it just wasn't discussed. It was discussed. It was discussed. They were acknowledged.

Speaker 1: 13:30

No, and you will hear stories of, well, aunt so-and-so went away for a while after she gave birth, or aunt so-and-so you know I had to raise her child because she-.

Speaker 3: 13:40

How do we not?

Speaker 1: 13:41

realize. I can't believe. We're in the year 2024 and people are still questioning. The number one complication of pregnancy is real, so that makes me sad. That it's like. This is again why our platform is education and awareness. So when you know this, please spread this knowledge so we can stop that being one of the most Google questions. And now there's one. Whitney, if I had postpartum depression before, will I have it again? And I'm sure you have clients that come to you now. They're pregnant and they've suffered. I was scared to death if I would have it again. Yes, and what do you say to them?

Speaker 3: 14:14

It's not an absolute, it's not a guarantee. You know that's like somebody saying oh, just because I was in a car accident the last time I drive a car, I'm gonna be in a car accident again. There's a risk. We can't say that there's not and that you're completely immune from it. But is there an absolute guarantee that you're gonna be in another car accident just because you're driving? No, there is not an absolute for it. I will tell you, because I have postpartum anxiety with my first, I did not with my second and it is because I knew what to better expect postpartum with the hormone crash. Still had some of the baby beliefs because I was very emotional, but I could tell myself it's okay, it truly is the hormones. Not to use that as the cop out for everything, because I don't love when people are like oh, it's your hormones, I'm not here for that.

Speaker 3: 15:05

But I could logically say okay, it is because your progesterone crash like, let the tears come, it's fine, it's gonna fix itself. I had that logic and I knew that because of what I had been through before, I knew better what you expected of myself. Postpartum, I knew what was actually appropriate for me to think I could get done in a day with a new baby, versus when I was postpartum the first time, I thought I had to do all the things all the time.

Speaker 1: 15:34

Yeah there is a season of knowledge that you bring into it right, like you do, you are at risk right, there is a risk. Like you said, the car is laying. I had a different postpartum experience with will. Then I did with James. I postpartum rage, which is a subset of depression with James. But if I look at my factors too, I had a lot of those heavy risk factors again. Yeah, traumatic delivery. If I would have had again a traumatic delivery, you know we had just moved lack of family village you know, high risk pregnancy again, like who's to say that was not a part of it, maybe?

Speaker 1: 16:10

not postpartum would not have been that, so I think it too. It comes into play. Well, are you dealt the same cards that you were with that pregnancy before?

Speaker 3: 16:19

That is such a huge component is we're not always dealt the same scenario. We can have similar scenarios. Right, you know, I think about it. I weigh it out. I should have been more higher likelihood of postpartum anxiety depression with my youngest because she was a COVID baby. Yes, because I thought she was ectopic in the beginning. You know, I really was much higher risk my second go around in my first go around, but I had knowledge, I knew how to be equipped with it.

Speaker 3: 16:50

I will say I was more higher anxiety during the pregnancy. Yeah, that is where my struggle was and I can tell you with I mean full honestly. It was because of COVID and working in the hospital during that time. That's why I was so paranoid that I was going to lose my baby. Yeah yeah, you know, very, very yeah for me having her. I was like, oh, we made it, and see, like this, this was the finish line, like we did it.

Speaker 1: 17:19

Yeah, and I hear that a lot and you know perfectly. To. The next question was can you have postpartum depression or pregnancy? We won't call it postpartum depression, but we'll call it perinatal depression. Yes, 100%, you can. It's very common about 50% of postpartum depression. Moms will say that it started during pregnancy. It was not recognized, it was not intervened, it was not treated. So then we call on postpartum. It makes sense why they would suffer that way.

Speaker 3: 17:49

You're absolutely well and I will say you know OBS, their specialty is not psychiatric care. Okay, their specialty is not mental illness. So, admittedly, I'm going to say 90% of the time, and OB is going to default to Zoloft, prozac, lexapro, busebar, because those medications have been researched in pregnancy and breastfeeding. They've been proven to be safe. So the OB is going to default to that because, like, hey, we've got research to back that up, we know it's safe. They're going to go with their knowledge base, whereas a psychiatrist can be like, okay, well, if you had a bad experience with Prozac before, we don't need to do Prozac. Maybe we need to do well, butchering, but in pregnancy maybe we need to approach it differently with your dosage and when do we start your medications and things of that nature. So do you think it's challenging to find a doctor that's willing to prescribe during pregnancy that is also willing to say you know what, like, if you had bad experience with whatever medicine before, we're going to have to choose something different.

Speaker 1: 18:55

That's very taboo still when we're talking about antidepressant medications or anxiety medications when coming to pregnancy. But, like you said, there is such a greater research and knowledge base and reproductive psychiatrist Blair is the one for us, the Preview Alliance, but there is more of them out in the country. They're hard to find, I will say they're calm unicorns out in the wild. But there is starting to be greater access programs for OB providers to have access to them, to have this information, to have social training, so ask. So if you are feeling depressed during pregnancy, which is blurry we've talked about this again refer back to our previous episode of depression during pregnancy because loss of appetite. Well, I'm throwing up, is it?

Speaker 1: 19:37

because of that, or is it because I'm depressed, I'm feeling physically fatigued. Well, is it because you're growing a human, or is it depression?

Speaker 3: 19:43

No, like a motivation. Am I physically too exhausted to go do something, or do I not want to do it at all? Like to those, it's hard right, and so when?

Speaker 1: 19:52

you're asked basic questions, right, it's hard for someone to pinpoint it. So, absolutely, depression can occur during pregnancy. It's more common than not and if you an easy way, you can kind of pinpoint what. You taught me this when he was okay. What's one thing I love to do constantly? And if I had that opportunity and I'm physically like I'm not throwing up capable. Am I going to choose to do that? Am I going?

Speaker 1: 20:17

to do it Right, and that was something that helped me kind of differentiate in my turn. Is this depressive or is this therapy in pregnant? So hopefully that's a little helpful there. And another calming. Well, this is this will roll perfectly too. What does it feel like? Postpartum depression? So we kind of talked about pregnancy. What does it feel in postpartum Like? How do you what's more common when your clients are sitting in front of you saying I feel X, y and Z, what do you? What do you hear in their words?

Speaker 3: 20:44

So I will say postpartum depression, anxiety can be similar, but they do have some very distinct things, that kind of differentiate from each other and they can coexist. Not to scare anybody, but just to educate hey, you can actually have both occurring at the same time. So if we look at our depression camp over here, it is going to be that lack of motivation. Nothing really seems to excite you. I mean, someone can hand you a check for a million dollars and you're like, okay, fine, but at the same time nothing really just devastates you. You're just going oh well, that sounds sad. You're very flat line, a very flat A-effect, where it's just no real reaction, no real emotion.

Speaker 3: 21:28

This part is hard to pinpoint. Postpartum fatigue, because we're sleep deprived, so that fatigue naturally comes in. I will say sleep differences that are not based on the baby. Okay, Maybe you get that unicorn baby that sleeps and gives you three-hour stretches from the get-go, but you can only sleep for 30 minutes. Or you have a very hard time getting out of bed because you're like what's the reason? What is my way to get out of bed?

Speaker 1: 21:57

Feels very hopeless.

Speaker 3: 21:59

Right, very much a lack of hope, no optimism at all, Appetite changes which, again postpartum, we have to think about. Are we breastfeeding, Are we in pain, Things of that nature. But if you notice that you're eating for comfort, not out of physical appetite or need, that would make me think okay. Well, we're trying to eat for emotions, we're trying to comfort the emotions with macaroni and cheese, which then there, I've done it. But when we see a pattern with it, that's when it's a little bit of a red flag, or if you're not eating at all and I know we're moms like sometimes we go through the day and we're like, did I drink wine.

Speaker 3: 22:39

Did I go pee today? Sometimes we do get so busy and tied up in life that we lose track of things, but we don't want that to be the pattern. That doesn't need to be our day-to-day pattern by any means Very difficult bonding.

Speaker 1: 22:53

It felt like I remember I felt disconnected. It felt hard at times and it did. It felt like again back to those previous statements be better without me or somebody else could do this better. I'm a failure, but yeah, just really going through it and not being affected by things was really scary for me.

Speaker 1: 23:12

So that flight line is very much a depressive thing yeah and it's hard right and you may have not felt that before in your life, or you felt that a lot before in your life, right, so it can be challenging. How common is it? We've mentioned on this pre-COVID Whitney. They said one in five, one in three. You see it a lot.

Speaker 3: 23:32

Now, okay, that being said, working in the hospitals, working in private practice now, where my specialty is maternal mental health.

Speaker 1: 23:40

So women are seeking you out specifically. So yes, there's a bias here with our numbers.

Speaker 3: 23:45

Yep could be the minority per statistic is gonna be my majority Right, but I do believe post-COVID an increase in postpartum depression but really anxiety and OCD really took off post-COVID. That was a big thing that we were seeing. So personally and I don't have a statistic in front of me, but kind of guesstimating it I would say 80 to 90% of moms experience some form of a postpartum mental illness.

Speaker 1: 24:17

And that research backs that up. Honestly and I guess that's another one is why did it happen to me? People screw going this and we go back to the risk factors and we go again and we talked about everything that's up against us and it's not a character flaw to this mom, right, I wanted to know why. I told them my other day. I said I don't know how I couldn't have had something happening to me and I think it. Moms really tell their story to someone or share it with a therapist. You're gonna hear it and it's been very helpful to me. You hear what you've experienced, what you're coming into pregnancy with, what your life was like, what your delivery was like, and to hear it. You know that was wild. That was wild and gosh. Yeah, that childhood trauma really brought back.

Speaker 3: 25:02

Well, and when we say things out loud which I mean, everybody knows I'm a big advocate of voice telling. But when we say things out loud it gives validity to the experience, because and tell me if I'm wrong, cause I didn't go through what you went through when you're experiencing the trauma, our brains dissociate and it can feel very surreal In the moment it can feel almost like a lot of body experience so it doesn't feel like a real trauma.

Speaker 3: 25:31

You can have the doctor sit down with you two hours post-op and say, hey, x, y and Z complications occurred. And you're over there like, yeah, yeah, I got it. And then it could be six months down there and you're like what happened to me. Wait a minute. Like that actually happened.

Speaker 1: 25:52

Yeah, and, as I said, you described it perfectly. I mean, and it's been very helpful to me to have a safe space to talk about it and live it again and process it. So I would challenge because this is kind of the question can anything I do to prevent it? That was another one, and how do you treat it so we can kind of group those together? But the prevention is what kind of you're listening right now? That's the form of prevention is education and awareness and recognizing what we're carrying in.

Speaker 1: 26:22

We say everybody kind of comes to pregnancy with suitcases, right, and maybe what's in my suitcase is different than what's Whitney's, but it can still hit different kind of categories of maybe trauma or loss or infertility, socioeconomic issues, lack of support.

Speaker 1: 26:39

You know what you're going through in that life. I mean it just you need to unpack that and know that when you put in hormones, you put in I mean we are not guaranteed how our delivery is going to go. We're not guaranteed how our postpartum is going to go, and I think that has a lot to do with it too. Like that's a I mean you've seen a lot, I've heard a lot from the stories and it truly just having an open dialogue about this and being aware and saying it is real. This is what it is. This is kind of to the expected versus not having loved ones, knowing that, having an OB provider, like Whitney said, who's up to date on medications, who's more progressive when it comes to finding what's best for you and your mental health because we always say your mental health is just important as your physical health Absolutely Well they go together.

Speaker 1: 27:26

I mean it's a risk versus risk, right? Everybody's like oh, it's risk benefit. When you talk about your mental health and physical health, you know like there are risks and there are physical risks if a mom's mental health is not treated.

Speaker 2: 27:37

Absolutely.

Speaker 1: 27:38

Free term labor high blood pressure. Bad outcomes for her and baby. So people don't want to see that side of it. But if she is not, okay. Essentially, like you said in the previous episode, if the mothership is, taken down If the mothership goes down, everybody goes with her.

Speaker 1: 27:54

So that I think was kind of a round Robin, just quick hit. But, Whitney, it was great and I appreciate your knowledge here and I know our listeners do, and we're going to hit post-partum anxiety next. So I'm excited about that. All right guys, stay tuned. We're going to hit post-partum anxiety. But please, if this is resonating with you, go back to our last May, may 23 episode series. What is? And Whitney and I break down what is every perineal mood anxiety disorder and just learn about it and share with a friend. Right, all right guys, till next time. We appreciate you.

Speaker 2: 28:30

Nice to see you guys Returnal. Mental health is as important as physical health. The Previous Lions podcast was created for and by moms dealing with post-partum depression and all its variables, like anxiety, anger and even apathy. Hosted by CEO founder Sarah Parkers and licensed clinical social worker Whitney Gay, each episode focuses on specific issues relevant to pregnancy and postpartum. Join us and hear how other moms have overcome mental health challenges, as well as access tips and suggestions on dealing with your own challenges as moms. You can also browse our podcast library and listen to previous episodes at any time. Please know you're not alone on this journey. We're here to help.