How to Plan for a Baby When You've Had Postpartum Depression Beforeby Robin Elise Weiss, Ph.D. Health Professional
Postpartum depression (PPD) affects about 5 to 25 percent of new mothers. That number is even higher in groups with a lower socioeconomic status. It’s a disease that strikes across all racial, religious, and socioeconomic barriers — anyone can experience it.
Having a form of PPD (the condition’s symptoms can go beyond just depression, including anxiety, obsessive compulsive disorder, and panic disorder) is not an ideal way to start motherhood — for you or your baby. Beyond impacting your health, PPD can hinder how you bond with your baby. This bond is important as you recover and your baby grows. If you have symptoms, getting help from your doctor or midwife is important in ensuring you stay on track to get better.
Some people’s PPD is so severe that they wonder if they should even consider another pregnancy for fear that they may experience postpartum depression again. If you have had PPD in the past, here’s what you should know as you move forward with subsequent pregnancies.
Lifestyle changes to prevent PPD
Truthfully, most research on prevention of subsequent PPD and related disorders has been done in high-risk groups, like mothers with bipolar disorder. But that doesn’t mean there isn’t something you can do to reduce your risk of PPD even if you aren’t in one of those high-risk groups.
One of the biggest things you can do to try to limit your risk of or prevent PPD is to look at the triggers and risk factors that may have led to your first experience with this condition. Some of these risk factors cannot be changed, like family history. But there are some things you can change.
For example, lack of sleep can contribute to PPD. While having a new baby in the house is never a recipe for great sleep, having a game plan is key. For example, having a postpartum doula can be helpful, whether they help you while you nap or stay overnight a few times a week in the early weeks after childbirth.
A postpartum doula can also be helpful when you are feeling overwhelmed. They can help you build self-confidence in your parenting skills and identify where you need more help.
Perfectionism can also fuel depression. Try to let go of the feeling that you have to do things one way and one way only or like everything has to be “just so.” Having realistic expectations of yourself, your baby, and your family is important. If shifting your thought patterns is harder than you anticipated, you can seek support from a cognitive behavioral therapist.
The role of medication in pregnancy and beyond
Medication is one tool that may be used to help treat PPD. Medication may be taken long term, or you may take a shorter course. Either way, some practitioners think using medication may help prevent future cases of PPD. Selective serotonin reuptake inhibitors (SSRI) are a common choice and have only minor side effects.
Things to consider when planning the next pregnancy
The timing between when you have your babies can also impact your risk of PPD. One study showed that if you have a pregnancy interval (the time between one pregnancy and another) of fewer than six months, you were more likely to have PPD. Spacing out pregnancies further may help.
You may also want to check your vitamin D levels. When vitamin D is low, you may be at greater risk of depression. Some have suggested that increasing your intake of the mineral selenium or the omega-3 fatty acid DHA may also provide benefit, but there is not enough proof to recommend that treatment in a general population.
Making a game plan
When you experienced PPD for the first time, you might have been blindsided. In fact, it may have taken a while for you to get an actual diagnosis. This delay was likely frustrating and caused you to suffer for longer than needed. A benefit of having been down that road before is that now you know what it feels like to have PPD, and you and those around you know what to watch for should it happen again. You also likely already have a team assembled to help you handle the condition. It can be comforting to know that even if it does happen again, you're ready.
Make sure to use the mechanisms you have in place to prepare for a new baby, and talk to your doctor or midwife about your personal risk factors. Having a plan in place for screening, treatment, and support can help you more quickly identify and treat anything that comes up, and hopefully with less stress than in your original diagnosis.