It is estimated that 1 in 5 women in the U.S. experience postpartum depression. In part one of our interview, we spoke with Quiana Wade, a PPD survivor who cares so much about the well-being of other moms that she wanted to share her story. In this interview, we caught up with Dr. Johannson for a deeper understanding about PPD.
Is there an under diagnosis of PPD?
The hard part is there is a grey line between postpartum blues (which is more common), and postpartum depression (which is much more serious). It can be hard to tell the difference and some people prefer not to expose that part of themselves. They don’t want to seem like they can’t handle it.
What is the difference between Postpartum/Baby blues (PPB) and PPD?
I think the biggest thing is the transient nature of the baby blues. Mothers have moments or days in which they feel down, unworthy or just overwhelmed. That’s a very common thing in the early parts of the postpartum period. But it’s interspersed with other parts of it that they enjoy. They still enjoy their baby and still get pleasure out of their child. There are up periods and not just downs. The ups will become more frequent over time.
Depression tends to be much deeper and lasts much longer. They don’t get pleasure in dealing with the baby and sometimes they either feel negative or violent. It’s hard sometimes for people to admit it because it seems like such a “bad mother” thing to feel negative towards your baby. PPD is also much more dangerous [to yourself and your baby]. Unlike the baby blues, PPD will usually take some type of intervention (not necessarily medication).
Are there any specific triggers that women can watch for?
I think of it in three different parts, and this is just from my experience:
- If someone has a biological trigger, they can almost see it coming. They’ve had problems with depression throughout their lives so it’s something they’ve battled with. It’s important to know that they are highly susceptible to having PPD; not only because of the physical and mental demands, but also due to changes in the hormones.
- There are some people who are just susceptible but have never really had problems with mental health. But they have been overwhelmed and dealing with stress; so that added to the hormonal triggers, will push people into PPD.
- Then, there are a lot of women who don’t have the proper source of support in place. They are having relationship issues, spousal issues or they don’t have a spouse there to help. Or, they have someone at home who is either abusive or just not helpful at all. They could also be socially isolated for one reason or another.
I always joke with my patients that when they go home, they should feed the baby, feed themselves, and sleep. That’s it. They shouldn’t have to do anything else — cook, clean, pay bills, pick up the kids — none of that. But unfortunately, that’s not part of our culture.
Our social situation is not ideal a lot of times. There are so many in our community that have very little of a social safety net. It doesn’t negate the fact that there’s a biological part to this, but it’s very clear that there is also a social aspect. The psychological burden tends to be higher in the African-American community. There’s also more of a stigma (in our community) in seeking out mental health care.
What advice do you have for spouses in terms of being able to recognize the warning signs, and offering their support?
If they know they have a problem already, have a conversation with her about starting to see a counselor during the pregnancy stage or immediately after delivery. If they don’t know they have a problem, it’s important for the spouse to understand that she is not expected to do anything. Just know that she’s going to have bad days, but she’ll have good days too. If they are all bad days and no good days, then there’s a problem and that’s the time to seek help. It’s the job of the spouse and family/friends to kind of be on the look out for these signs.
What are some of the long term effects when PPD is left untreated?
Long term effects are also on the baby because the baby needs emotional relations. Babies’ brains are developing so they are wired to relate at this point, and the mother is the most important person to relate with. For the baby, having a mother with depression is a bad thing. Mothers who are depressed do not take care of themselves, which can lead to an increased risk of engaging in alcohol, drugs, etc. The worse case scenario is that they can hurt the baby or themselves (even commit suicide).
What do you want readers to take away from this interview and from the importance of understanding PPB and PPD?
I want them to really understand that moms need help. It is absolutely vital for her psychologically, and for her to be able to get a good start with the baby. They have to be aware that this exists. Don’t just sit and wait for it to get better.
Dr. Joshua Johannson
Dr. Joshua Johannson is the Director of Cheaha Women’s Health and Wellness in Anniston, AL and specializes in OB/GYN. He is also the Co-Chair of the Alabama Breastfeeding Committee and founder of Northeast Alabama Baby Cafe.
BMWK: Why do you feel there is a stigma attached to mental health as it relates to the African-American community? Is it because we are too blessed to be stressed?