As you know, my area of expertise is the time before women get pregnant, but women often ask me what happens to their hormones after they give birth and how best to take care of themselves to avoid postpartum depression.
After you give birth, your key sex hormones estrogen and progesterone drop dramatically to menopause-like levels. At the same time, there is a dramatic rise in oxytocin, the “love and bonding” hormone. So it’s not abnormal to feel super happy to finally meet your baby, but also a wide range of other emotions too.
In fact, it’s quite normal to have what’s known as the “baby blues,” which can be described as feelings of sadness, anxiety and worry, loneliness, moodiness, fatigue or weepiness.
If those feelings persist however, it’s possible that you might have postpartum depression—a real condition that affects more moms than you may think, and is also very treatable.
What is Postpartum Depression (PPD)?
Postpartum depression can look like the baby blues but the major difference is that it continues over several weeks and doesn’t resolve on its own. It can also show up months after you’ve had a baby. Left untreated, PPD can continue for several months, and even years (this is known as maternal depression or just plain depression).
Postpartum depression is also quite common. According to a 2013 study published in the journal JAMA Psychiatry, as many as 1 in 7 women have the condition. What’s more, for half of women diagnosed with PPD, this is the first time they have been diagnosed with depression, according to the American Psychological Association.
What Causes Postpartum Depression?
I don’t think there is one specific cause (because everything is connected), but here are the major risk factors. I’ve highlighted two of the biggest ones…
#1 Good old Hormones
Like I just said, your two key pregnancy hormones—estrogen and progesterone—which increase rapidly during the first trimester, take a nosedive, and that abrupt shift may play a role. Estrogen and progesterone play a pretty crucial role in stabilizing your mood, so when your hormone tank is suddenly empty you might not feel so great.
Additionally, (and this is a big one!), 3-8% of mothers develop postpartum thyroid disease (hypothyroidism, hyperthyroidism or both), which can also lead to depression and some of the other symptoms I mentioned a moment ago. Please go see your doctor if you think there is something wrong. If your doctor doesn’t believe you, then find a new one. This is your health, and your life that we’re talking about here.
#2 Sleep deprivation and new responsibilities
My friends often joke that they can’t believe the hospital staff let them leave the hospital with their newborn. I imagine it’s a mix of excitement and sheer terror! After a few days, they’re not really in the mood to joke because they are so sleep deprived.
The overwhelming responsibility of caring for a newborn combined with the worst sleep deprivation ever, can contribute to a mom’s risk for postpartum depression. You may experience low self-esteem and a diminished body image, have trouble coping with your new identity (I hear this often), find it challenging to deal with simple issues or feel like you have no control over your life.
Here are some other important risk factors for postpartum depression:
- A history of depression during pregnancy or other times in your life.
- A previous diagnosis of postpartum depression and/or bipolar disorder.
- A family history of depression or another mental illness.
- Stress in the past year like pregnancy complications, illness, death or a stressful event like a move.
- Having a premature baby or a baby with health problems or special needs.
- Breastfeeding problems.
- Having a baby who cries more than usual, is difficult to soothe or whose feedings and sleep patterns are irregular.
- Being a first-time mom or a young or older mom.
- Relationship problems.
- Isolation and lack of support from family or friends
- Job loss or financial worries
- An unplanned or unwanted pregnancy
What are the Symptoms of Postpartum Depression?
You may not have all of these symptoms to be diagnosed with postpartum depression, but these are the most common:
- A loss of interest in activities you used to enjoy, including sex.
- Eating less than usual or overeating.
- Anxiety and panic attacks.
- Racing “hamster wheel,” thoughts.
- Feeling guilty, worthless or hopeless.
- Feeling angry, irritable or agitated.
- Feeling sad or crying a lot.
- Feeling numb.
- Feeling overwhelmed.
- You don’t feel like you’re bonding with your baby.
- Fear of being alone with your baby.
- Fear of not being a good mom.
- Insomnia or problems sleeping.
- Having trouble concentrating, remembering or making decisions.
- Having trouble caring for your baby, or completing work or everyday tasks.
- Thoughts of harming yourself.
Postpartum Depression in Dads?
Postpartum depression doesn’t only affect new moms, but it can affect the health and well-being of other family members. Studies show fathers are at an increased risk for “paternal postnatal depression” after the birth of a baby. In fact, studies show men can experience a reduction in testosterone after the birth of a baby. Yet lack of sleep, stress, a family history of depression or another mental illness, relationship problems and of course, the transition to becoming a new dad can also play a role. If a mom has postpartum depression, dads are more likely to suffer as well.
Children of mothers with PPD are also more likely to have emotional and behavioral problems, speech delays and ADHD. In fact, according to a 2004 study in the journal Paediatrics Child Health, school-aged children and teenagers of moms with PPD are at an increased risk for anxiety disorders, learning disabilities and ADHD.
Postpartum Depression Treatment
Although there are fewer stigmas around postpartum depression in recent years thanks to celebrities and social media, moms are still not seeking treatment. In fact, a 2014 survey by BabyCenter.com found 21 percent of moms were diagnosed with postpartum depression and more than half said they felt sad, anxious or miserable after giving birth. Despite this, only 40 percent sought treatment.
If you suspect you have postpartum depression, please don’t suffer in silence. The time you and your baby lose to PPD cannot be given back to you, so it is imperative to seek treatment as soon as possible. Getting help is also important because women who have a bout of postpartum depression are 27 to 46 times more likely to have it again with subsequent births, a September 2017 study in the journal PLoS Medicine found.
Where to Get Help
- Call your doctor. I encourage you to work with a doctor who really understands. If your doctor dismisses your symptoms with a “oh you just had a baby, you’re fine” comment, please find a doctor who will listen and help you take action.
- Lean on your family and friends – ladies, it really does take a village. Ask family members or friends for HELP. And while you’re at it, ask for a referral for a mental health professional.
- PostpartumProgress.com has a list of programs and specialists.
- Postpartum Support International offers free help from volunteer support coordinators who can refer providers.
Habits That Help
As you know, I always advocate that you become the best expert on your own health. So, in addition to seeking professional help, here are a few of my recommendations:
#1 Food food food!
It’s easy to grab crackers, chips, or a piece of chocolate (or a whole bar lol) for a quick energy fix when you’re literally so exhausted you can barely think straight, but stocking your kitchen with nourishing foods will absolutely make you feel better.
- Ask friends and family to deliver meals.
- Sign up for a meal delivery service or a meal planning service like Real Plans.
- Focus on one-pot meals like soups, sautés, chilis and stews that are super easy to make and freezable. An Instant Pot will likely become your new best friend!
- Do your best to include bone broth every day, which should be at the top of your list for postpartum hormone healing. The Instant Pot can make bone broth too 🙂
- You’ll also want to have lots of protein, healthy fats like avocado and grassfed butter, and complex carbs like sweet potato and squashes. Also, foods like eggs, wild salmon, fava beans, turkey and cacao nibs may help increase dopamine and serotonin, two feel-good neurotransmitters in the brain.
#2 Make sleep a priority
I bet you’re probably laughing at this a little, but I am so serious. I realize that with a new baby, getting enough sleep sounds unrealistic but it’s key for your energy and your mood. If possible, ask your partner or a family member to help out, consider hiring a postpartum doula, a night nurse or a babysitter so you can get some rest. At the very least, try to rest while your baby naps.
Studies show breastfeeding may help ward off postpartum depression. In fact, a 2012 study in the Internal Journal of Psychiatry in Medicine found women who were breastfeeding at 2 and 4 months were less likely to be diagnosed with postpartum depression at 4 months.
Of course, you should consider weaning your baby if you’re having problems with breastfeeding or you don’t want to breastfeed, which can worsen postpartum depression.
With a newborn baby, I get that you’re not gonna be hitting up the gym for an hour each day, but keep in mind that a good sweat session can give you a boost of endorphins—those feel good chemicals in the brain that are released after an orgasm. If the gym isn’t a possibility, put your baby in the stroller and go for a walk, put an on-demand fitness video on while your baby naps or do a few yoga poses.
#5 Find people who get it
Look for a new moms support group, invite another mom over for coffee or call a family member or friend to talk about how you’re feeling. Sisterhood is SOOO important during this time.
#6 Ask for help
I feel like we’ve collectively forgotten that raising a child is not a two-person job. Regardless of how strong your support system may be, ask for help and don’t feel guilty about it. Whether it’s a babysitter who can come over so you can nap or a friend to watch your baby so can take a shower, all moms need help.
This is actually how my good friend and fellow Women’s Health Coach Caroline Zwickson came up with her Well Mama Program. Her experience after the birth of her first child two years ago led her to create this 8-week health and life coaching program for new moms, because she really had to learn how to take excellent care of her health & hormones and figure out how to not lose herself as a new mother.
Caroline has all the tools for you in this program. She’ll show you how to…
- Eat to support your hormones after having a baby
- Have less anxiety and improve your emotional wellness.
- Strengthen your relationship with your partner.
- Reconnect with the woman you were before having kids.
- Find support from other real moms who understand
What makes Well Mama so unique is that Caroline teaches moms everything they need to know to take care of their bodies, AND she also gently guides moms through profound exercises to make navigating life as a mom easier and more intuitive.
- American Psychological Association, Mayo Clinic, PostpartumProgress.com