Managing postpartum depression during a global pandemic

Motherhood is a time of many emotions and changes, and adding the COVID-19 pandemic to the mix can cause unexpected anxiety to even the most experienced mom. It is important, however, to note the differences between baby blues and postpartum depression—a major mood disorder—to help you decide what is normal and when you should seek help.

Baby blues

  • Very common
  • Feelings of worry, unhappiness and fatigue
  • Starts 2-3 days after birth
  • Usually gets better on its own within 2 weeks

Postpartum depression

  • Interferes with ability to do daily life activities
  • Intense feelings of sadness, anxiety and hopelessness
  • Loss of interest in activities, withdrawing from friends or family or thoughts of harming yourself or baby
  • Usually starts within 1-3 weeks after birth through up to a year after birth
  • Requires treatment from doctor

Dr. Kristen Plastino, Vice Chair of Clinical Operations in the Department of OB/GYN at UT Health San Antonio, says that of the moms her department treats, about 10% will develop postpartum depression. According to Dr. Plastino and the CDC, the onset of postpartum depression can happen any time within the first few weeks through up to a year after birth. While there are risk factors associated with postpartum depression such as a previous history of depression or pregnancy and birth complications, it can also occur among women who experienced a healthy pregnancy and birth.

“Isolation, or the feeling of being isolated, will contribute to how new moms will get support during the postpartum time.” Dr. Plastino said. While COVID-19 has changed how to get care, there are still many ways to get the help needed if you suspect you might suffer from postpartum depression. The first step that Dr. Plastino recommends is to find a doctor you trust. Be comfortable enough with your doctor to set up a telehealth appointment and tell them you are not feeling like yourself.

Use Telehealth

Technology today allows us to meet with our doctors over video chat and eliminates unnecessary trips to the office. Many doctors and patients are utilizing telehealth more due to the pandemic. “Telehealth is really important because there is so much a physician can get from a patient through the screen. When a doctor sees a patient in person, a majority of the time is spent taking the history and making a plan,” said Dr. Plastino. “A physical exam is a small part of the visit. Therefore, telehealth appointments are invaluable during this time of COVID-19.”

Making appointments and keeping them, even if they are virtual, is important during the postpartum period. You can always come in for a physical exam at a later date if there are no urgent physical health concerns. However, Dr. Plastino stresses that it is important to seek in-person care if you are experiencing any physical symptoms that need immediate attention such as mastitis or an incision site not healing properly.

According to the American Academy of Pediatrics, breastfeeding has been shown to have benefits for both mom and baby. It creates a unique physical and emotional connection between mom and baby and causes the release of good hormones that your body can utilize to combat postpartum depression. If you are having concerns about breastfeeding, breastfeeding education and lactation consultants have also begun to utilize telehealth during the pandemic. Dr. Plastino says a lactation consultant is able to assess latching and any other issues you might encounter during your breastfeeding journey via a video call. She recommends you reach out to a lactation consultant if you have any concerns regarding breastfeeding to set up a telehealth visit.

Create a support group

Dr. Plastino says that due to the pandemic, many of her appointments have become video visits. “I feel like I am more of a ‘gyno-chiatrist’ instead of a gynecologist these days,” she said. The stress of the pandemic has put her patients, both new moms and others, under tremendous amounts of stress and anxiety that they have never experienced before. “We don’t necessarily have coping mechanisms for it,” she said.

You might have had plans for a family member to come stay with you to help with your new baby but due to COVID-19 they are unable to travel. She recommends setting up a weekly zoom call to talk to that person for support. They might not be able to help in-person but being able to talk to them is critical during the postpartum period.

Dr. Plastino also recommends that if you will want help during the postpartum period you isolate with a group of designated support people. Create a “pod” of people that are COVID-19 negative and have quarantined for at least 2 weeks before the baby’s arrival. These individuals are allowed to be around your baby and help you during this time.

Ask for help

“Asking for help is not a sign of weakness. Mental health has come to the forefront during this pandemic,” Dr. Plastino said. The stress of having a child during a pandemic is a whole different ball game, especially for moms of multiples. Homeschooling, alternating schedules and working from home have added a new layer of unknown to our lives. “Just because you might not have been depressed the first or second child does not mean you won’t be this time. It is ok to ask for help,” Dr. Plastino said.

There are also steps that partners, friends and coworkers can take to ensure new moms are doing ok. If you notice a new mom is exhibiting signs of postpartum depression, don’t hesitate to reach out. Assist them in asking for help from their doctor. It is important that we watch out for each other now more than ever. “I tell the dads at the prenatal appointments that they will be a big part in looking for warning signs of postpartum depression. If you notice that she is withdrawn and experiencing symptoms of postpartum depression, encourage her to reach out to her doctor. If she won’t reach out, you might have to reach out for her,” Dr. Plastino said.

Every new mom should have a 6-week postpartum visit and take the Edinburgh Postpartum Depression Screening at least once in the postpartum period. If you score equal to or greater than 10 at any time you might have postpartum depression, and it is important you schedule a visit with your doctor.

If at any point you recognize the symptoms of postpartum depression in yourself or another new mom, seek help from a doctor right away. Asking for help is one of the bravest things you can do for yourself and your new baby.

 

Postpartum Support International is a great resource to help mothers get connected with professional support and to learn more about this common condition.

Take the Edinburgh Postpartum Depression Screen or a postpartum depression risk assessment to help you determine if you need to talk to your doctor about how you’re feeling.