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Are you at risk for developing postpartum depression?

POSTPARTUM,DEPRESSION
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You might be able to act now to head PPD off before your little one arrives.

Society’s made great strides in understanding postpartum depression in recent years. It’s taken seriously now, and the American College of Obstetricians and Gynecologists recommends that doctors screen for it regularly, before the baby is born as well as after. The problem is, once you have a diagnosis of postpartum depression, what do you do? You may be referred to therapy, or given antidepressants, or encouraged to make lifestyle changes. All of that can help. Still, none of those solutions work quickly. In the meantime, the whole family struggles.

We’re not talking about a rare condition here. According to the United States Preventive Services Task Force, postpartum depression “is one of the most common complications of pregnancy and the postpartum period,” and “affects as many as 1 in 7 women.”For certain groups of the population, says Rhitu Chatterjee, writing for NPR, the number can be as high as 1 in 3, if the mother is a veteran, a teenager, or very poor. 

It’s so common, in fact, that the Task Force is considering recommending that doctors offer women at high risk for developing perinatal or postpartum depression the option for preventive therapy, so they can learn the tools to cope with PPD before it even hits them.  

The idea is still in its early stages; doctors aren’t currently being asked to refer at-risk women to therapy, but the research is encouraging. The Task Force found both Cognitive Behavioral Therapy and Interpersonal Therapy to be effective. Learning the tools to handle the tumultuous postpartum period before you’re neck deep in it means that you don’t have to learn those same things when you’re also sleep-deprived, stressed, and adjusting to life with a new child.

Everyone knows that postpartum depression can have a biological component — a mother’s hormones are re-regulating after birth, and sometimes that process is rocky. What these new recommendations acknowledge that’s so essential is that the condition is also strongly influenced by factors that have nothing to do with a woman’s body, and everything to do with the people around her.

The National Institute of Mental Health lists as risk factors having: “A family member who has been diagnosed with depression or other mental illness, a stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness, medical complications during childbirth, [or] a lack of strong emotional support from her spouse, partner, family, or friends.” A 15-year study on the risk factors of postpartum depression even reports having poor self-esteem as a factor that puts you at risk for PPD. We are clearly not dealing with a purely physiological condition here.

If PPD were only a matter of biological factors, adoptive parents wouldn’t suffer from it as well, but they often do. A study comparing the experience of 147 post adoptive mothers to an equal number of postpartum women found that “the severity of depressive symptoms does not differ between postpartum and adoptive mothers,” and that similar factors were likely to play a role in whether they would develop the condition: “Stressors [like] sleep deprivation, history of infertility, past psychological disorder, and less marital satisfaction were all significantly associated with depressive symptoms among adoptive women.”

If you see your own life reflected in any of those risk factors, you don’t have to spend your pregnancy just crossing your fingers that the transition will be smooth, and that you’ll feel okay. Maybe you will. But you should know that there is something you can do now, to lower your risk of getting postpartum depression, especially if it’s high. You can start therapy. It doesn’t mean you’re weak, and it doesn’t mean you’re crazy. It’s just a tool, and it might make a big difference. Given what we now understand about postpartum depression, it certainly looks like it could.

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