Postpartum Depression Doesn’t Just End After One Year
Postpartum depression and other mood disorders are confusing.
To start, there’s a lot of misconception about when the postpartum period ends. And that misconception leads to confusion and arbitrary rules about when and how moms can get help. It can also dictate the type of health care provider that moms have access to. Too many moms spend a lot of time struggling after the birth of their baby, running from one doctor to another in an effort to get the right diagnosis. In the meantime, they’re not getting better and continue to try and wade through their depression and anxiety on their own.
Some moms are referred to a perinatal mood disorder program or put on a waitlist to see a perinatal psychiatrist. By the time they finally make to their first appointment they’ve reached the “magical” one year postpartum mark. This usually means they can’t be accommodated or seen by the experts that are best positioned to help them.
Postpartum Depression Doesn’t Just End After One Year
It seems arbitrary that our health systems are set up to only offer specialized help to new moms whose babies are less than a year old. While it’s a consequence of there being not enough mental health resources, it leaves moms holding the bag. And coming up with the short straw.
Any of you that have struggled with postpartum depression or anxiety know that once your baby turns a year old, your intrusive thoughts don’t suddenly stop. The feelings of dread or inadequacy suddenly don’t turn into thoughts of love and total confidence. This is why we have to recognize and advocate strongly that postpartum depression doesn’t just end after one year.
We also can’t forget that there are moms who don’t start to experience symptoms until maybe they’re nine months postpartum and by the time they’re able to figure out what’s going on with their mental health, they’re months past their baby’s first birthday. They can’t access providers that understand perinatal mood and anxiety disorders simply because of bad timing. There are other moms still who don’t have symptoms until they wean from breastfeeding and that may be years after the birth of their last baby.
Major Depressive Disorder & Generalized Anxiety
Providers will tell you that after the first year postpartum, a mom struggling with her mood is likely to be diagnosed with major depressive disorder or generalized anxiety. While this is true it doesn’t change the need to work through the specific and unique challenges that new moms face. A mom can’t be put into a general depression treatment program and get better as quickly as if she’s receiving specialized treatment.
Research shows that peer support and having other moms around that can offer a comforting “me too” is crucial for recovery. It’s hard to relate to others that are struggling with depression, but don’t also have and infant, toddler or other kids to take care of. The timing of your diagnosis shouldn’t mean that you can’t access a new mom support group. Or connect with health care providers that can effectively treat your unique mental health needs.
Depression & Anxiety Can Come Back
What also doesn’t help is that moms aren’t told that their depression and anxiety can come back months or years later. Depression and anxiety can be chronic illnesses. Once you’ve had one episode, the chances of you having another one increase by 50%. And when it does occur, it’s not postpartum depression coming back. It’s a new depressive cycle triggered by other stressors or events.
There are too many moms that think they’re failures because they’re still struggling when their youngest is in preschool. This couldn’t be further from the truth. Experiencing another depressive cycle or having your anxiety triggered again is a regular part of having a mental illness. This is hard to accept and it’s one the reasons we fail to tell moms that depression and anxiety can come back.
By not having this important information, moms don’t have the tools to manage their health. If we know that depression and anxiety can become chronic, lifelong conditions, we’re likely to act differently. We might be more watchful of our stress levels or know what our triggers are. We may be more willing to reach out for help earlier to prevent our symptoms from getting worse. We’re also more likely to be more compassionate and understanding with ourselves if we know this is part of our illness.
What You Can Do to Make Things Better
There aren’t enough mental health care providers that work with postpartum women. We know this is true across the US and Canada. We can’t suddenly train more doctors, nurse practitioners and therapists to be perinatal mental health experts overnight. What we can do though is start to share accurate information with our providers. Moms are the front line and gatekeepers to a wealth of information about their lived experience. Tell your doctor about your experience. Share what you’re feeling and how you’ve been struggling. If you haven’t been screened for postpartum depression or anxiety already, ask that you be assessed. You can also share resources like the New Mom Checklist with your provider to use with other moms.
If you’re struggling with depression and anxiety and you’re more than a year postpartum, there is still help available. There are many online support groups on Facebook, SmartPatients and Inspire that can be useful. Organizations like Postpartum Support International and Pacific Postpartum Support Society have warm line telephone services you can call to speak with another mom for support. Most importantly, know that you’re not alone and just because your baby is over a year old and you’re still struggling that you’ll never get better. Recovery takes time and there will be ups and downs. With the right treatment and support you can and will get better.
Shannon Hennig is the Program Director of the Maternal Mental Health Research Collaborative.