What You Can Do About Postpartum Depression and Anxiety

What You Can Do About Postpartum Depression and Anxiety
Featured Speaker:
Teresa Tan, MD
Teresa Tan, MD is an Obstetrician and Gynecologist at Stanford Children's Health. 

Learn more about Teresa Tan, MD

Scott Webb: Having a baby is often a joyous time for new moms, but some could experience baby blues or worse, postpartum depression and anxiety. And joining me today to discuss postpartum depression and anxiety, the warning signs and how we can all support moms. Moms during their struggles with PPD is Dr. Theresa tan.

She's an OB GYN with Stanford children's health. This is health talks from Stanford, children's health. I'm Scott Webb, Dr. Tan. It's so nice to be on today. We're discussing postpartum depression and anxiety. And as we get rolling here today, what's the difference between the baby blues and postpartum anxiety or postpartum depression.

Dr. Teresa Tan: So the main difference between postpartum baby blues and postpartum depression is really a timing and intensity issue postpartum. Baby blues referred to a transient condition characterized by several mild depressive symptoms. Typically these symptoms developed within two to three days of delivery.

They peak over the next few days and then resolve within two weeks of onset without any treatment. In contrast, the diagnosis of major depression.

postpartum requires that the symptoms be present for at least two weeks. And typically these symptoms include intense feelings of sadness, anxiety, or despair that present a woman from being able to do her daily tasks and activities.

And typically postpartum depression, occurs within the first one to three weeks after childbirth, commonly within the first three months as well, and can occur up to a year after having a baby.

Scott Webb: Do baby blues just sort of fade away. Do they require any medical or psychological intervention?

Dr. Teresa Tan: Typically not baby blues. Typically are self resolving within a couple of weeks. And, there are several reasons for that. Baby blues typically resolve, Because, the mom gets used to her new normal routine. After having a baby, a mom can be very exhausted, new, normal, crying baby.

And So as these things, normalized for her, her mood can improve greatly.

Scott Webb: So when we talk about the symptoms of PPA and PPD, you know, postpartum anxiety, postpartum, depression, what are the symptoms?

Dr. Teresa Tan: The symptoms of postpartum depression,, include just extreme sadness, anxiety and exhaustion. After childbirth., specifically a mom can feel very sad or hopeless or. Empty or overwhelmed. She might be crying more than usual or for no apparent reason. She might have trouble concentrating, remembering details or experiencing significant anger or rage.

She might lose interest in activities that are usually enjoyable for her. She may start withdrawing from others, avoiding friends and family, or having trouble even bonding or forming an emotional attachment with her baby. When postpartum depression is very severe, she may have thoughts about harming herself or the baby. In contrast with anxiety symptoms?

A mom may feel just extremely nervous, anxious or on edge. She may not be able to control her worrying or stop the worrying. She may be worrying to an extreme level about various things. Often she'll have trouble relaxing and have racing thoughts that are very difficult to control.

She might have a sense of doom or a. Sense of being afraid as if something awful might happen. And she might just feel extremely restless or irritable, and those would be, symptoms of anxiety.

Scott Webb: Yeah, and really good to understand the differences between the two, between anxiety and depression. And for most of us, we just kind of know our selves, our families, our circle of friends. So I really have no sense of this. How common is PPD?

Dr. Teresa Tan: Postpartum depression itself with the actual diagnosis which means that severe, course that remains for more than two weeks is. Prevalent in about 10 to 15, even 20% of. New moms, by contrast postpartum blues are much more common and can occur in 50 up to 80% of new moms. And that's the kind that you know, is so common and does resolve itself.

So specifically postpartum depression, that severe kind of issue, is much less common.

Scott Webb: I guess I'm wondering, are there signs? The diagnosis is postpartum depression, but is there any, pardon the expression pre partum signs along the way during pregnancy that PPD might be unfortunately in a mom's future.

Dr. Teresa Tan: Personal experience with anxiety or depression. Or bipolar disorder,, combined with the event of pregnancy,, can precipitate a postpartum depression, or it can just, cause a woman to be at higher risk. So if she's had it before in a different kind of life experience, she might want to be on. Higher alert for this to happen.

If she has a family member who has been diagnosed with anxiety or depression, it can be a familial trait. And so she wants to be extra careful with that as well., if she's had stressful life events occurring during the pregnancy, such as the job loss, a death of a loved one personal illness, relationship change.

These stressful life events can also trigger, mental depression, medical complications during the pregnancy. Can also cause additional stress, which can put again an additional mental burden, the precipitating, depression as well. So these are things that can occur prior to the delivery that women can be aware of to start to think about their risk factors.

Scott Webb: Yeah. And good to know what the warning signs are. And I'm wondering, uh, during COVID-19, have you seen greater incidents of PPD?

Dr. Teresa Tan: I would say that in general, I've definitely seen higher incidents of generalized anxiety and depression during COVID-19 that's something that has been significant as far as moms. I would say that we've actually seen pretty stable rates. Now, of course, I have an end of a much smaller number than a real, a cohort study, but I would say the moms have been doing pretty well.

Now, whether they've had better support during COVID because a lot of partners has been at home and they've been at home or what it is, but our moms has tended to do quite well.

Scott Webb: You know, at least to anecdotally, that moms are doing well. And you've mentioned a couple of times the risks, so who is at the highest risk for PPD?

Dr. Teresa Tan: Women at the highest risk are women. Who've had a history themselves of depression or anxiety, previously, and especially if they've had depression during or after a previous pregnancy. So if one has had. Postpartum depression in the past, then we want to be extra careful And extra monitoring during the pregnancy.

And after,, as with other things, medical complications during the pregnancy or stressful life events during the pregnancy, whatever increases the baseline level of stress., would be significant risk factors for depression after the birth. Also if the baby is born with medical problems, needing extra medical clinic visits, needing extra support, that's stressful and exhausting for new parents and can also, precipitate that depression. Another different area is a lack of. Strong emotional and physical support,, for the mom, you know, for example, from her partner, spouse, family, or friends, moms who are isolated, are at much higher risk of postpartum depression, just with all the exhaustion and feelings of being overwhelmed.

Scott Webb: And those of us parents in the group, we understand that, uh, feeling overwhelmed and it's quite natural when a baby is born, that everybody's attention turns to the baby, right? All the love and all everything goes towards the baby. And sometimes moms get forgotten and especially for moms at higher risk, it's important that we not do that.


Dr. Teresa Tan: Yes. That's actually hits a very important point. The baby's super cute. But moms need attention too.

Scott Webb: Absolutely. Yes, babies are super cute, but moms need attention too. I love the way you put that. And you know, I know OB GYN is, are a great resource, but I'm sure there are many others as well. So what resources are available to people who think they may have PPD?

Dr. Teresa Tan: Well, if one thinks that she may have postpartum depression, yeah. Or if family or partners, are concerned that she does, it's important to see a healthcare provider often. This is the OB GYN as the woman has been seeing her OB GYN for many weeks on end, primary care physician is also a very important and useful resource as they will be connected with mental health specialists as well.

So seeing either. Their primary care or obstetrician gynecologist would be important. And what the provider would do at that visit would be to screen the patient for postpartum mental illness, using various screening tools. And they will be able to help identify. If there is the risk, or if it's actually a diagnosis and help identify resources in the local area.

And it's important not to wait until the routine postpartum checkup after six weeks as sometimes the symptoms can often have already begun weeks before that. And I have some additional resources. Local support groups can be very helpful for new moms to identify what's normal and what's not. And also gain resources and learn about resources in their community.

So support groups can often be found within local hospitals. For example, at the hospital that one delivered at a local clinic or even community centers. The hospital where you gave birth or your healthcare professional may be able to assist in finding these support groups. And also specifically, I highly recommend a website called postpartum support international, and this website helps link, counselors who are.

Experienced in talking and helping women who've experienced postpartum depression or anxiety and walking with them through the issues here at Stanford. We also have classes that support mom and babies, support groups.

Scott Webb: It is so great to know that there are so many resources and support out there and we know close to home is probably best. So what can family and friends do to support a new mom that they think may have postpartum anxiety or postpartum depression?

Dr. Teresa Tan: Well, first of all, it's wonderful to have family and friends nearby who can see it. And identify that in a new mom, so helping to care for the new mom and helping her to identify if her behavior is off or different from her normal behaviors. And if that's the case to encourage her to seek help through her health care provider's office for evaluation and screening and not to wait or think that this is just a normal thing and it's been going on for weeks.

So it's important for friends and family to reflect to a new mom. Hey, something might be helpful. And during this time, emotional and physical support are key. The new mom has just experienced a major physical and life change. Her hormone levels are changing. Her body can take weeks to regain her normal strength and energy after birth.

So supportive and encouragement and practical help with household tasks and childcare are useful ways to help a new mom get her much needed rest and transitioned back to her normal routine.

Scott Webb: And doctor, as we wrap up here today, anything else you want folks to know about part of the anxiety, postpartum depression, and what we can do to help.

Dr. Teresa Tan: Awareness is a very important thing. And to understand that this can happen to any new mom, it can happen to any partner. And if you're a partner of a new mom or a new mom to be your support is key to helping this new mom transition and have a wonderful., postpartum experience don't ever forget the importance of support, whether it's physical, emotional, or anything in everything, all you can do little or small is going to be so helpful for this new mom, as she experiences the joy of having a new baby.

Scott Webb: That's great doctor. This has been really educational today and a good to understand the difference between baby blues and PPA and PPD, and to really understand how important it is that PPD. Diagnosed that we all friends, families, doctors, everybody involved tries to help new moms get through this. And thank you so much for your time.

You stay well

Dr. Teresa Tan: Thank you.

Scott Webb: for more information, visit Stanford children's dot org, and we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is health Oxford, Stanford, children's health I'm Scott Webb stay well, and we'll talk again next time.