This week we’re talking with Dr. Shoshana Bennett, Ph.D., or Dr. Shosh, clinical psychologist and survivor of two life-threatening postpartum depressions. She’s the author of Pregnant on Prozac, author of Postpartum Depression For Dummies, and past president of Postpartum Support International. Her first book, Beyond the Blues, won two iparenting awards. During the last 22 years Dr. Shosh helped over 18,000 moms recover from prenatal and postpartum depression.
Why do you believe that postpartum depression is more prevalent in parents of multiples?
Over 25 percent of mothers with multiples have postpartum depression and anxiety. One cause is believed by many to be greater hormonal levels and fluctuations during pregnancy and after delivery. In addition, these pregnancies often require bed rest, which is depressing by itself for many previously active and productive women. Social isolation is also common after delivery, since the logistics necessary to organize everyone and everything for an outing may be too overwhelming and felt to be not worth it.
Multiples are often born preterm, and it’s known that mothers of preterm infants experience a higher level of depression than those born full-term. Any health concern (or perceived concern) can raise the depression and anxiety risk in the mother, and preterm infants are known to have health problems.
Chronic sleep deprivation lowers serotonin, which can cause postpartum depression. It’s tough enough to get a few hours of uninterrupted night sleep with a singleton, let alone with more than one!
The exhaustion and burnout rate is especially high and fast with mothers of multiples unless they are careful to carve out time for themselves. When one is napping another one or two may be crying, so finding that downtime is particularly challenging.
There are different types of postpartum illness, can you discuss them?
Under the umbrella term of postpartum mood and anxiety disorders (PMAD), there are six identified disorders: postpartum depression, postpartum obsessive-compulsive disorder, postpartum panic disorder, postpartum post-traumatic stress disorder, postpartum bipolar disorder and postpartum psychosis. There can be overlap with the disorders, but it’s important to receive a proper diagnosis so treatment will be appropriate and effective. Following is a list of some of the most common symptoms in each of the six disorders.
Postpartum depression: anxiety, forgetfulness, sleeping problems, frequent crying, low self-esteem, lack of energy, hopelessness, overwhelm, appetite problems, irritability, anger
Postpartum obsessive-compulsive disorder: obsessive thoughts (including thoughts of harming the baby), anxiety, fear of being alone with the baby, repetitive behaviors like counting (bottles, diapers, and so on), checking (locks on doors, baby’s breathing, etc.), cleaning
Postpartum panic disorder: Heart palpitations, hot or cold flashes, fear of losing control or going crazy, numbness or tingling, dizziness, shaking
Postpartum post-traumatic stress disorder: extreme anxiety, flashbacks, recurrent nightmares
Postpartum bipolar disorder: severe mood swings (extremely high energy to very low mood)
Postpartum psychosis: hallucinations, losing touch with reality, incoherent statements
What is your personal experience with postpartum illness?
I’m a survivor of two life threatening postpartum illnesses experienced after the births of both my children. I had a combination of postpartum depression, panic, post- traumatic stress and obsessive-compulsive disorder. I was wracked with fear and hopelessness, unable to function. My family and I suffered for years, since I could find no help back in the ’80’s. When I began to recover, I knew I needed to make something positive out of the devastation. I vowed I would never allow another mom and her family to suffer like we had if I could help it. This began a new career.
What should families be watching for if they feel a mother or father has postpartum depression?
If depression is suspected in a parent, professional help should be sought from a healthcare practitioner who specializes in the field. This practitioner should be able to outline an individualized plan for recovery. Although mothers and fathers often show depression differently, there are general warning signs to watch for in every new parent. Some of these include:
difficulty sleeping at night when the baby is sleeping (insomnia can lead to serious mental health issues and needs addressing right away)
big appetite changes
low self esteem
lots of worrying
If a mother starts saying things that do not make sense or she begins hallucinating, she should be taken to a hospital immediately. She could have postpartum psychosis – a medical emergency that puts both her and the baby or her other children in great danger.
What are some of the treatment options?
There are natural treatments that should always be part of the plan, including sleep, great nutrition, emotional and physical support, exercise and therapy. There are other treatment options that can be tried depending upon the severity of the symptoms, type of symptoms, and her beliefs. Acupuncture, massage, certain minerals and herbs, energy psychology techniques and light therapy are among some alternative and complementary treatments used for recovery. Medication can also be useful for many parents. Often a combination of treatments is used and there is no one-size-fits all. That’s why a thorough assessment of each person needs to be completed so that a specific and individual plan for recovery can be made.
What are some resources on postpartum depression that you would recommend?
Postpartum Support International http://postpartum.net is an excellent source. Http://perinatalpro.com is another great site and http://DrShosh.com (my site) is also full of resources and links to helpful materials.
Are there any questions we missed that you would like Dr. Shosh to answer? If you’re comfortable sharing personal experiences please leave them in the comment section, or link to a post you have written.