Selected Podcast

I have my ‘Bundle of Joy’ so why am I so sad?

For new moms, having a baby can be the most exciting time of their lives, yet this can also be a very challenging time. If you are suffering from postpartum depression, you may feel overwhelmed. You may feel as if you are never going to be able to become the mother you want to be.

In this segment, Jill Brandl, mental health nurse practitioner at Bryan Heartland Psychiatry, joins the show to offer help to new mothers that are experiencing symptoms of postpartum depression and to explain the treatment options and support available at Bryan Health.
I have my ‘Bundle of Joy’ so why am I so sad?
Featured Speaker:
Jill Brandl, PMHNP, Bryan Heartland Psychiatry, part of Bryan Physician Network
Jill Brandl is a mental health nurse practitioner at Bryan Heartland Psychiatry.
Transcription:
I have my ‘Bundle of Joy’ so why am I so sad?

Melanie Cole (Host): For new moms having a baby can be the most exciting time of their lives. Yet, this can also be a very challenging time. If you're suffering from postpartum depression, you may feel overwhelmed. You may feel as if you're never going to be able to get that mothering thing exactly right. My guest today is Jill Brandl. She’s a mental health nurse practitioner at Bryan Heartland Psychiatry. Welcome to the show, Jill. Who’s at risk for postpartum depression?

Jill Brandl, PMHNP (Guest): Melanie, that’s a great question, and really, anyone can be at risk who’s had a baby, but there are certain risk factors that make a woman more predisposed to it. For example, this can affect up to one in seven moms. So, it's fairly common, but women who have had previous depressive episodes; women who have had postpartum depression with a previous pregnancy and birth; those who may have a family history of postpartum depression – perhaps their mother had it or a sister had it. In addition to that, women who maybe don’t have as much social support from a partner or those around them, and finally, women whose infants may have some health problems or were born prematurely – those women tend to be at increased risk as well due to the stress and worry about the well-being of their baby.

Melanie: So, Jill, people hear about baby blues and postpartum depression, and, I mean, a lot of women experience that feeling of anxiety and insecurity when they first have a baby. How do we know which one it is – that it really is a depressive situation as opposed to just baby blues which may kind of go away on its own?

Jill: That’s an excellent question, and that’s so true. It is important to recognize that pretty much every mom who has a new baby is going to experience some self-doubt – you know, changes in their energy, things like that. But it's good to look into what specifically does constitute postpartum depression. So, the postpartum period is any time in the first year after having had a baby. So, these symptoms can affect moms not just immediately after having had a baby, but anywhere in that first year. And so some of the symptoms of postpartum depression – we’ll just run through those here. So, sadness, irritability – the woman may have crying spells – sometimes even crying for what seems like no reason. Not enjoying things that they once enjoyed. Some may have feelings of worthlessness – maybe feeling like they're not a good mom, or they're not meeting the expectations of motherhood. Many tend to blame themselves unnecessarily as things are going wrong either in the household or maybe with the baby. There’s some normal changes in energy level after having a baby, of course, but if postpartum depression is present, women may struggle with low motivation, just feeling like they're not able to get things done around the house, not able to meet those expectations and also some trouble making decisions or concentrating. I've heard from women who feel like it's just difficult even to make small decisions. Anxiety, worry, feeling scared or panic for no reason – they may have difficulty sleeping even when the baby is sleeping. We do know that with new babies – they’ll awake in the night and need to be fed and changed and things like that; however, with postpartum depression, even if the baby’s asleep, the mother may struggle to fall asleep because she’s perhaps feeling overwhelmed or worrying about things.
Finally, and this is a serious one, is some may have thoughts of wanting to die or thoughts of wanting to harm others and in that case, immediate intervention would be necessary. Now those are symptoms of depression, and we can see sometimes even with mom that it can be geared more towards the infant. So, some may have excessive anxiety about the health of their infant or concerns over their ability to care for the infant even though they’re, in reality, doing a great job. And lastly, we may see some increased use of alcohol or drugs as a way to cope with some of the stress or anxiety, so that would be another warning sign.

Melanie: So, Jill, do you think that there’s still a stigma – oh it's just hormones, you know, you’ll get past it – and so some women may be hesitant to seek treatment? And if so, when is it time to seek professional treatment?

Jill: Yes. There absolutely is a stigma associated with that. It’s time to seek treatment when five or more of those symptoms that we reviewed have been present for more than two weeks. So, you know, baby blues tends to be maybe one or two of those symptoms. So, maybe some, you know, low motivation or intermittent sadness or irritability, but if someone’s got five or more of those symptoms, and they’ve persisted on for two weeks or more, it's definitely time to at least have a professional evaluation.

Melanie: So, speak about some of the treatment options that are available for women who suffer from postpartum depression and some of these symptoms that you’ve described?

Jill: Yes. So, coming in for an evaluation is important so we can see exactly what the symptoms may be and look at the woman’s unique circumstances. There’s different treatment options available. Psychotherapy can be a very beneficial option for women who maybe are not interested in taking medication. Becoming a new mother can be very overwhelming, and it’s a time in life when the woman and her family have to kind of step back and re-evaluate their roles in the family and figure out where everything fits in together, and therapy can be a great way to get some emotional support and help the woman problem solve some of her challenges. It can also help with learning healthier ways of thinking and just help with coping with stress. So, in addition to psychotherapy, medication is an option. There are antidepressants that are safe with breastfeeding mothers; so, they're safe for the baby, and the women that I have worked with who have struggled with postpartum depression – those who have been stabilized on medication – may come back smiling. They tell me, I feel like myself again, and so it really can be helpful.

Melanie: So, Jill, what about women at home? So, if they're dealing with medication, therapy, getting some social support and interventions, what else can they do? Lifestyle things that you might recommend that they can do at home or with friends to help them, you know, kind of work through this?

Jill: Yes, that is a great question. Many times in our society, women are almost expected to kind of do it all – juggle it all and even look good while doing it. It’s just very important to seek out social support from others. You know, if you think back to earlier societies before our modern society, women and families kind of raised children together as a community, but now women are more isolated with their infant, maybe staying at home, not having that social support. So, it's important to understand that it's okay to ask for help. It’s ok to ask for that support from those around you. In addition to seeking out some help and social support, it's very important that the woman take some steps to take care of herself. So, things like eating healthy foods, getting outside to get some fresh air and take a walk, meeting a friend for coffee, and, of course, getting enough sleep – as much as they're able to with a newborn. So, those things are things that they can do, kind of on their own, in addition to some professional treatment to get to feeling better.

Melanie: And, Jill, what about community resources? What’s available for women?

Jill: Absolutely. So, Postpartum Support International online is postpartum.net. If someone wants to go online and check out that website, there is a list of local postpartum support resources on that website. And then, of course, there is always the Suicide Prevention Hotline for those who may be immediately concerned about the well-being of a woman or the woman herself if she is not feeling safe.

Melanie: So, that is how I would like you to wrap it up. If someone is concerned about a woman who’s showing these symptoms, what can be done to help her? What would you like loved ones to do and to notice and give your best advice for the women that are suffering about getting the support and the help that they need?

Jill: Yes. So, if someone’s concerned about the well-being of a woman, concerned about postpartum depression, mood, or behavior changes, I think the first step is to just sit down with that woman and talk with her – listen to her – listen openly to what she may be going through without judgment and let that woman know that her feelings and her struggles are important and that they are real. It can be helpful to gently share observations, you know, what you may be seeing with this woman – like, hey, I've noticed that you just aren’t yourself anymore – what’s, you know, what's going on? Ask what you can do to help rather than just offering advice and offer to maybe care for the baby so she can take some time to herself to maybe go for a walk or take a nap. It's important to reassure the woman that there's no shame in seeking help. Encourage her to seek out some professional evaluation and treatments if those symptoms are present, and obviously if there’s immediate concern about her safety, it's important to seek immediate medical attention. So, those are some tips for someone who may be concerned about a woman in their life struggling from these symptoms. And for the women out there who may be struggling with this – I would just like to let them know that they are not alone. Again, one in seven moms struggle with this. It’s a very treatable condition. There’s no shame in reaching out and seeking out support. Women can always get in touch with us and know that we are here to help.

Melanie: Thank you so much, Jill, for being with us today. If you have concerns about postpartum depression, you can schedule an appointment with Jill Brandl. Just call 402-483-8555. That’s 402-483-8555 or for additional information, you can visit bryanhealth.org. That’s bryanhealth.org. This is Bryan Health Radio. I’m Melanie Cole. Thanks so much for listening.