New moms may experience range of mental health issues

MACON, Ga. -- Hannah Waldrop remembers feeling not herself.

"I would be just so angry and just couldn't explain it," she said.

As a stay-at-home mom for a then three-year-old and two newly-born twins, she had reasons to be stressed, but this was something different.

"When I would lash out or be loud or yell or any of that, I was just like something is wrong," Waldrop said.

Hannah ended up talking with her OBGYN, Dr. Tiffany Stanfill Thomas, about it and screened positive for postpartum depression. At the time, Hannah said that she had heard about the disorder but didn't realize the big title fit her situation.

"I didn't really know that it was so local to me, like just little daily chores, just little reactions to people," said Waldrop.

According to the CDC, postpartum depression affects one in eight women in the U.S. Symptoms include crying more often than usual, feeling numb or disconnected or lacking enjoyment.

Dr. Thomas said it makes sense for most moms to feel some of those symptoms in the two weeks after giving birth because of a major drop in the hormones estrogen and progesterone.

"When you’re pregnant, those hormones are triple what they are before you conceive, and those are the hormones that are most likely to allow a patient to feel good during the second trimester, when most women say they are at their happiest when they’re pregnant," she said. "After delivery, these hormones plummet within the first 48 hours.”

Dr. Thomas said that some women feel empty or cry more than usual after giving birth, and that's natural. When the symptoms last longer than two weeks, it may be time to talk to your care provider. However, depression isn't the only possible diagnosis.

Jennifer Barkin is an assistant professor of community medicine and obstetrics and gynecology for Mercer University. She's also a mom of two who experienced what she calls postpartum anxiety.

"Walking past the baby swing thinking I'm going to have to live a long time; these kids are dependent on me. I was almost nervous being alone with just the two of them," Barkin said.

She said that when it comes to maternal mental health, it's not black and white.

"Postpartum depression is becoming synonymous with maternal mental wellness, and that's not all there is to it. It's a spectrum," Barkin said. "You don't have to be diagnostically depressed to feel like something's not quite right and I need to change something."

While many doctors use the Edinburgh Postnatal Depression Scale to screen for depression, there wasn't a tool that measured a new mom's overall mental state, until Barkin made one. When she was at the University of Pittsburgh, Barkin and her team created the Barkin Index of Maternal Functioning. With it, new moms can related to statements like "I feel rested," "I am able to take care of my baby and my other responsibilities," and "Anxiety often interferes with my mothering ability."

The BIMF is being used more widely for research worldwide. It also may soon be implemented in Bibb County, thanks to a grant. Barkin hopes it will help care providers see more nuanced results about new mothers' mental health, outside of postpartum depression.

Whether a new mom is clinically depressed or just feeling "off," Barkin said that social support, from her partner, to family members, to an online community, can be a major resource.

For Hannah, a lot of that support came from a Facebook group.

"That's almost like a safe-haven because those people really understand you," she said.

Barkin said that self-care is also important, something not a lot of moms think about.

"They tend to put the child first to a degree that they're sacrificing what they need for themselves," she said.

Hannah remembers that dilemma after having major abdominal surgery--a Cesarean section.

"It's kind of like I really have to take care of myself because that could get infected or open back up, not heal properly, but I have two tiny humans who are needing my attention all the time, so it's kind of like what's more important, and a lot of times it was the babies," she said.

Barkin said that even in the way care is distributed between a new mom and her child has connotations. She said that mothers typically only have one check-up with their OBGYN in a six-week period, whereas their babies have several.

"It sort of sends a message that you should just be able to do this," she said.

That attitude is something Dr. Thomas said is slowly changing.

“There’s certainly opportunity to grow and make stronger the postpartum care for mom, and I think that’s something that a lot of obstetricians have already realized and a lot of hospital systems are starting to focus more on how can we continue to take care of mom and make mom feel that she has the resources she needs after delivery. “

Barkin suggests new moms try to do something for themselves every day, whether it's baking, meditating or just a relaxing shower.

She said that she ended up "growing out" of' her anxiety. Hannah tried to move past her symptoms by herself but eventually found medication worked best for her. She said that it's still a journey to find normalcy sometimes.

"We're still on the track of finding the right one," she said.

She said that a big part of finding a solution was having a doctor who was willing to listen to her.

"If your doctor's not listening, find another doctor because it's important," she said.

Her message to other moms feeling "not themselves" is simple.

"You are not alone," she said.

Dr. Thomas and Barkin said that while the situation is getting better, rural areas often don't have many resources for new moms. If you feel something is wrong, talk to your care provider.

For more information or support check out Postpartum Support International.

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