Postpartum Depression and Paternal Postpartum Depression
Mental Health Awareness Month is also
Maternal Depression Awareness Month
So let’s stamp out the stigma and talk about mothers and Postpartum Depression. Treating postpartum depression requires fast-acting treatments because there’s so much at stake. Pregnant and breastfeeding moms are targets for anxiety and depression for so many reasons — and are more vulnerable to developing anxiety and depression than at any other time in their lives.
Brain and Behavior Research published a study in the November 7, 2017 issue of Brain, Behavior, and Immunity about pregnancy.
They discovered that pregnancy and the postpartum period actually reduce the immune response in the brain. Which may explain why some women are more susceptible to anxiety and depression during this time.
Women with postpartum depression carry shame and anxiety about being a “good enough” mom to their babies.
Brain and Behavior Research displays this hashtag for May and I like it: #BreaktheSilence
So we’re going to break the silence about postpartum depression and continue to celebrate mothers today by talking about something too many moms go through.
Think about this for a moment:
Your friend is pregnant — which is a glorious time of joy for a mother … or is it?
You want to talk about her baby, shop for baby clothes with her, plan her shower. But she doesn’t seem to be responding like you thought she would. In the first few months, she’s noncommittal and has nothing much to say. In case something goes wrong. You hope it’s because she’s just tired and nauseous. Maybe her excitement will build when she feels the baby’s movement.
But the second trimester is anything but exciting for her. As her baby grows, you begin to see a vacancy of sorts in her eyes. She becomes more and more listless.
Your friend’s once bright and sparkling personality has dulled. She seems to just trudge through the days. Then, late one evening, you get a call from her husband. He says she’s screaming and crying that she can’t be a good mother … she’s terrified of going into labor.
Postpartum Depression, Panic Attacks, and Anxiety
In less than 20 minutes you arrive at her house and try to help her calm down. You listen, you reassure her…though she seems inconsolable…then finally sobs and sobs. The next morning she tells you she’s sorry for her outburst. But you know there’s more to this than “normal” pregnancy.
When her baby is born you’re sure the cloud over her will dissipate as she looks into the face of her beautiful child, and enjoys the wonder of this miracle.
But unfortunately, she hardly wants to even see the baby in the first few days. And finally, when she does, she holds the baby and stares vacantly into space. What can you do..?
What IS Postpartum Depression..?
Women with postpartum depression experience the symptoms of depression anyone with depression experiences. Symptoms such as listlessness, feelings of emptiness, loss of interest, muscular and skeletal aches and pains, reduced energy, hopelessness, and withdrawal, for starters.
But, the new mom also experiences other symptoms that are unique to her situation. She focuses on her baby, her ability (or feared inability) to care for him, or financially support him.
Women with postpartum depression can suffer with feelings of anxiety, panic attacks, feelings of extreme inadequacy, and overwhelming sadness.
Postpartum depression doesn’t always follow depression during pregnancy. But the likelihood a woman will experience postpartum depression is much higher if she was depressed during pregnancy.
In fact, 1 in 7 women are affected by postpartum depression, and fully 25% of cases of postpartum depression began during pregnancy.
But what about the other 75% of cases? What sets those off postpartum?
More Causes of Postpartum Depression
There’s quite a variety of things that contribute to postpartum depression. Things like severe financial distress or multiple births can be behind it. Family problems such as separation or abandonment by the baby’s father, which can include heartbreak and financial crisis together.
There’s also a sudden drop in estrogen and progesterone that can trigger it for some women. When the baby is in the NICU for a prolonged period of time, that can interfere with maternal-child bonding, and can result in depression in the mom.
But for many moms–moms with support, with resources, with help… it’s so frustrating. There’s nothing that seems to precipitate it and no one to blame. The depression comes out of nowhere.
Serious Consequences of Untreated Postpartum Depression
It’s during this early period after birth that mothers and babies bond. When that period is interrupted, it can cause a cascade of suffering in both mother and child. The cooing and cuddling a mother does with her newborn stimulates the growth of neurons and synapses in the brain.
When the newborn misses this opportunity, neurocognitive deficits can be the result.
Or in straight English, it can interfere with the baby’s memory, ability to think and process, and make decisions as she gets older. Because of this, it can reduce her academic performance, too.
If a mother is depressed during pregnancy, we believe this has a direct impact on the wellbeing of her baby. Researchers report these babies are sometimes born irritable, lethargic, and have sleeping and eating problems. They can grow to be slow learners who are underweight and emotionally unresponsive. And later in life show behavior problems like aggression.
The same is true of babies of moms with postpartum depression. These babies are more likely to have excessive crying, behavioral and emotional problems, and later Attention Deficit Hyperactive Disorder, or ADHD.
This Mom is Suffering
For the mother, if depression takes hold, not only does she miss the rewarding connection with her infant, and the hormones that help her “feel” like a “good mom” but she often tends to blame herself as a “bad mother.” More than likely she’ll think about all the ways she believes she’s failing her child, or causing damage. Sometime to the point of developing recurrent, intrusive, and unwanted thoughts about this — obsessive thoughts.
And those obsessive thoughts are fueled to be even more intense by depression.
Dads Get Postpartum Depression, Too
Then, there’s the dad. He can also be heavily affected by her postpartum depression. It’s common enough for the father to become depressed also that they have a name for that too: Paternal Postpartum Depression. In fact, new fathers are at increased risk of postpartum depression due to the immense changes they experience with the birth of a baby.
And if the new father has a history of mood disorder, his risks are even higher. Newborns and infants depend on the loving interaction with both parents to thrive. When that interaction is absent, the baby suffers.
Mom’s Depression Is Tough on Baby
A study was conducted where mothers of 3-month-old infants were told to imitate depression symptoms for 3 minutes. They did this by speaking in a monotone, maintaining an expressionless face, and avoiding touching the baby.
In only 3 minutes, the infants reacted to this change in their mother’s mood.
They turned away from their mothers, became irritable and distressed. Even after the 3 minutes of exposure to this change, when the mothers returned to their normal, nurturing demeanor, the babies remained upset for awhile, difficult to console.
Infants are extremely sensitive to their mom’s sadness, silence, and inattentiveness.
Sometime postpartum depression can spiral dangerously out of control — beyond depressive symptoms into mixed symptoms with agitation, or symptoms of psychosis with delusional beliefs or hallucinations. This is especially dangerous when delusional beliefs or auditory hallucinations are centered on the baby.
Treating Postpartum Depression
For all these reasons, it’s vital that the mom with postpartum depression be treated and relieved as soon as possible. If the mom is given oral antidepressants, it can be weeks or months before she experiences relief. And that critical period for bonding and nurturing for mom and baby can be interrupted while they wait for relief.
Ketamine treatment for depression, when administered according to best protocols, can bring relief in as little as a few hours, or within a couple of treatments.
It doesn’t take weeks to work.
This is a psychiatric treatment that’s been used very effectively for the most difficult-to-treat cases of depression, bipolar depression and anxiety. It’s often a treatment “AFTER everything else has failed.”
With postpartum moms and newborn babies, it can be a treatment “BEFORE everything else has failed.”
It can save you weeks … or months. It can prevent a missed-bonding opportunity for you and your baby. Quickly. Immediately. Hopefully this will minimize the damage that can arise from that, before it becomes established and fixed.
Has it been studied extensively in postpartum depression? No. Not yet.
But neither has anything else. The latest Cochrane Database review shows an impressive lack of significant new studies of antidepressants in postpartum depression over the past decade, despite all of the available antidepressants on the market. No real news, no new findings, no new recommendations.
We have several postpartum moms who came to us for ketamine treatment after weeks of failed treatment with antidepressants and psychotherapy, and who responded strikingly to IV ketamine. Sometime, we add 1-2 more infusions or use a larger or smaller dosage at a faster or slower rate to get symptoms to remit entirely.
Double Blind Study Shows Safety and Effectiveness of Ketamine
What’s more, researchers conducted a double-blind study published in the Journal of Clinical and Diagnostic Research. They included 92 women scheduled for caesarean section, to determine the safety and effectiveness of using a combination of ketamine and propofol to manage pain after surgery. Researchers hoped to address the problem of pain that delayed initial breastfeeding after caesarean section. (Stay with me here — it’s relevant.)
In addition to pain, the nausea, vomiting, and shivering that occurs in more than half of women following C-section also interferes with breastfeeding, walking, and caring for the newborn.
Researchers divided the women into 4 groups, and treated each group with either propofol, ketamine, ketofol (a combination of ketamine and propofol) or a placebo.
Those who were treated for pain with the placebo required an average of 58 minutes before they were stable enough to breastfeed.
Those whose pain was treated with propofol alone required 42 minutes before they could breastfeed.
Ketamine was most effective for pain and required only 31 minutes. But there were some surgery-focused issues that propofol could resolve and ketamine couldn’t.
So, those who were treated with ketofol (a combination of propofol and ketamine) required only 25 minutes after surgery to breastfeed.
This study determined that the ketofol combination was most effective. And it also found ketamine and propofol are safe for infants through breastfeeding.
Ketamine is Safe – Plus – Postpartum Depression Puts Mother and Child at Risk
Ketamine has shown its safety in treating people from infants to adults as well as the elderly for 50 years. One of the greatest risks to a baby born to a mother with depression is the mom’s untreated depression. Other medications are being tested to find more medicines that act quickly like ketamine does. In the future, we may find that they can be used postpartum to bring a mom to remission quickly so she can bond with her baby.
At this point, ketamine is the safest and fastest-acting depression-smasher for women, or men, suffering from postpartum depression.
If you’re pregnant or postpartum and are finding no joy in your pregnancy or in your life with your baby, know that you can feel better.
Call us, and let’s talk about what can be done to help you find joy again in your baby’s, and your own, future.
We’re here to help you find your life again. To enjoy your family and relationships, your new baby and your most enjoyable interests.
To the revealing of your best self,
Lori Calabrese, MD