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Introduction: With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.

Caitlin Whyte: Having a baby triggers, a series of emotions, ranging from excitement and joy to anxiety and depression. When it comes to the ladder. It's important to take those feelings seriously, not just try and tough it out and seek out help if necessary. Joining us to talk about postpartum depression is Jeana Boyd, a Licensed Clinical Social Worker at Pullman Family Medicine and Pullman Regional Hospital. And Jeana, tell us from the beginning, what is postpartum depression?

Jeana Boyd: Well, the term postpartum depression is really used to encompass any mental health problems that arise during pregnancy and after childbirth. So it's really kind of a broad umbrella type term. I do like to think about, you know, what is the spectrum? So what's the opposite of what we would think of as, you know, mental illness or not doing well with your pregnancy and childbirth. And kind of the opposite of that is wellness. And the World Health Organization actually provides us a definition of maternal mental health and they state that it is wellbeing in which a mother realizes her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to contribute to her community. So I feel like that can also give us kind of a gauge right. Of what wellness is. And so really how, if we're experiencing a mental health problem in one of those areas, is it making it that we're not feeling well? And then also, you know, we tend to use the term postpartum depression when it comes to women, but current research is also finding that men can experience postpartum depression, and they actually state that in 50% of the cases where women experience postpartum depression, their male partners will also experience symptoms of depression. So I just think that that's interesting to keep in mind too, that parenting is really a partnership when that's available. And when one person in the partnership is experiencing struggles, it can impact the other partner as well.

Host: So when it comes to postpartum depression, what are some warning signs?

Jeana Boyd: Well, the warning signs of postpartum depression are really the common symptoms of depression, you know, feeling sad and crying and being overwhelmed. And just in general, not feeling, you know, very much joy or involvement. I think the thing that also can kind of be indicative of the postpartum depression experience is that your worries and your fears and your stresses are regards to, you know, how you are as a parent, how you're bonding with your baby. And also there can be a lot of kind of hypervigilance around keeping your baby safe. You know, there's a lot of fears around sudden infant death. And how will I, you know, make sure my baby doesn't encounter any danger. And so sometimes there's impulsive thoughts or rumination about bad things happening that we want to try to prevent, and that can be really distressing to a new parent. There's also, you know, for men, their experience may be a little bit different, but they also report, you know, feeling burned out and really tired and having sleep difficulties. Men also tend to experience some irritability and anger at a little bit higher rate than women.

Host: Now, how is this postpartum depression different from so-called regular depression?

Jeana Boyd: Yeah. Like we talked about, there is some overlap in the symptoms. Some of the, you know, the more obvious definition is the onset, which, you know, regular depression can impact a person at any point in their life. But postpartum depression really is during pregnancy and the first year after childbirth. Now there is mood in the first two weeks after having a baby which is referred to as the baby blues where your hormones are really fluctuating. And so women will say like, you know, I'm so happy and, I don't know why I'm crying. And that's very normal when you're adjusting to the sleep deprivation and hormone changes with, you know, just the pregnancy hormones switching up, but postpartum depression can merge with that and then last longer. So really it's about mental health problems that start in pregnancy and lasts throughout like the first year after having a baby or can start, you know, within that first year of having a baby.

Host: So that leads me into my next question. I always thought postpartum only happened after the baby is born. And it sounds like that isn't true.

Jeana Boyd: Right. Yeah. You know, and that can even people can get postpartum depression if they've had the loss of a pregnancy, you know, had a miscarriage postpartum depression can happen. So anytime during the pregnancy, and then within the first year of when the baby's born is typically when the diagnosis of postpartum will be given.

Host: And how long would you say it normally lasts?

Jeana Boyd: Well, you know, they kind of give you that first year timeframe, but we do know, you know, women, there's complicated factors and we'll get into that, of what contributes to a woman or a man experiencing postpartum depression. But what we know is the earlier you get help and early intervention is going to shorten the intensity of what you feel and how long you feel it. So there's not really a cut and dry postpartum lasts this long, it's more like the diagnosis is given. And then, you know, hopefully treatment is received early and then symptoms will start subsiding. So after the first year, so like say you came in at, you know, your baby was like eight months and they diagnosed you with postpartum depression and they treated you for six months, and then your depression was continuing. And maybe some of the symptoms started shifting away from, you know, focus on bonding and baby and more about everyday stressors. At that point, they may, you know, start, re-diagnosing you with more of like a depressive disorder. So it's more about, you know, what are the thoughts and feelings that you're having and what are they about? And if that tends to be regarding your pregnancy and your mothering and your kids primarily, then that may be more related to postpartum.

Host: And you mentioned the factors that contribute in both men and women, what are some examples of those?

Jeana Boyd: Yeah. You know, again, it's sort of the perfect storm, but some, and it's not necessarily addictive, it's more correlated, right. But we know that if you have a genetic component, so if you've experienced mental health issues before your childbearing time, also, you know, those social determinants of health that we hear so much about now, you know, do you have access to healthcare? Do you have stable food supply? Do you have transportation? You know, those types of social determinants of health can also contribute to the experience of depression and postpartum depression, and then finally kind of family dynamics too. You know, what was your relationship like with your own family of origin? Was there any abuse or neglect in your history? What's your current family dynamic? Do you have a supportive spouse? You know, do you live with domestic violence? Are you undergoing really stressful financial situation? So all of those areas kind of can contribute to the postpartum depression experience.

Host: So now that we know some of the signs and factors, when should someone reach out to get help?

Jeana Boyd: Anytime you recognize, you know, when you have that kind of definition of maternal wellness in mind, anytime you recognize that you're not feeling well. And if you're recognizing those symptoms that we talked about of, you know, kind of obsessing about the fears that you have, or, you know, just sadness and crying and lots of worry and fear and shame, you know, definitely reach out. And it may be also that people within your support network are the ones who recognize that you're unwell. Because sometimes in that, especially early phase of having an infant, you know, you are just really tired and trying to figure out how to parent this new human being and what they need. And so you can, you know, sort of lose touch with yourself a little bit, and it might be that somebody else in your support network says, you know, Hey, I noticed that you're not really engaging with, with, you know, me like you used to, are you doing okay? Or, gosh, I really see you, you know, kind of irritable. Is there something I can help you with? So somebody else in your support network may say, you know, I think you should talk to your doctor. So any time you recognize that talk to your doctor or your children's pediatrician, I mean, anybody who you're having contact with it's okay to bring that up.

Host: Well, thank you so much for your time and this critical care, Jeana. I hope any struggling moms now have the information they need to get help. That was Jeana Boyd, clinical social worker at Pullman Family Medicine and Pullman Regional Hospital. Find out more about Pullman Regional, as well as more episodes like this at pullmanregional.org. This has been The Health Podcast from Pullman Regional. I'm your host, Caitlin Whyte. We'll see you next time.