The Vulnerable Mother: How Postpartum Depression Can Lead To Substance Abuse

baby feet

Pregnancy is considered one of the most significant milestones in a woman’s life. Giving birth signals her rebirth, too, as a mother.  However, pregnancy is filled with all sorts of challenges, from hormonal changes to bodily discomforts, including nausea, urinary frequency, fatigue, constipation, and lack of sleep.

Aside from the physical changes and challenges, a woman’s pregnancy also causes emotional changes during pregnancy and after giving birth.  Many are familiar with the term “baby blues,” which refers to a pregnant woman’s mood swings, feeling of sadness, anxiety, loss of appetite, lack of sleep, and occasional crying spells for no apparent reason.

The baby blues-which affects up to 80 percent of mothers-comes about due to the hormonal changes and disruptions occasioned by having to take care of a new baby.  Usually, these symptoms go away within a few days or two weeks, if they are not severe.

What is Postpartum Depression?

There is, however, a more serious condition from which about 10 percent of new mothers—roughly one in nine—suffer: postpartum depression(PPD), an extreme feeling of sadness, anxiety and other debilities associated with baby blues continue for a longer time and worsen.

Baby blues is a mild form of PPD. Full-on PPD may manifest later—usually within the first four-to-six weeks, though it even can begin during pregnancy—and last longer, sometimes several months.

The symptoms of PPD are broad and vary from woman to woman, but may include:

  • An overwhelming feeling of being trapped or helplessness
  • Low self-esteem that lasts more than a week
  • A feeling of rejection
  • A feeling of guilt
  • Irritability
  • Headaches
  • Upset stomach
  • Blurred vision
  • Loss of interest in sex
  • Fatigue
  • Panic attacks
  • Difficulty in decision-making, focus, and concentration
  • Lack of motivation
  • Lack of sleep
  • Feeling worthless
  • Loss of interest in taking care of the baby
  • Avoiding friends and family
  • Thinking about harming the baby or self

Only a health care provider can make the diagnosis that a woman has a postpartum disorder and prescribe the appropriate treatment.  Since PPD lasts longer and is more severe, women with PPD need to be treated right away.  If not, they may try self-medicating by using, misusing or abusing illicit and legal drugs or alcohol.

Are All Women Prone to Postpartum Depression?

Any woman, regardless of her age, race, ethnicity, economic status, educational background, and religion, can get postpartum depression, but some women are more prone to develop it than others. Risk factors include:

  • Symptoms of depression during or after a previous pregnancy
  • A prior experience with depression or bipolar disorder
  • Having a family member who was diagnosed with a mental illness
  • Mixed feelings about being pregnant
  • Medical complications during childbirth, such as delivering a premature baby or having a baby with a medical condition
  • The death of a loved one
  • The loss of a job
  • Domestic violence
  • Any illness that might have caused stress to the mother during pregnancy or after giving birth
  • A lack of support from family members
  • Alcohol or other substance abuse

There is, however, a more serious condition that about 10 percent of women—roughly one in nine—who just gave birth suffer from: postpartum depression (PPD).  This is characterized by an extreme feeling of sadness and anxiety.  The lack of sleep and loss of appetite, associated with baby blues, continues for a longer time and worsens.

The term postpartum refers to the time after the woman delivers her child.  Unlike baby blues which is mild and can last for only several days, postpartum depression lasts longer.

PPD usually develops within the first four to six weeks after giving birth, and even can begin during pregnancy.  However, sometimes it takes several months.

Some of its symptoms include:

  • Loss of appetite
  • An overwhelming feeling of being trapped or helplessness
  • Low self-esteem that lasts over a week
  • A feeling of rejection
  • Guilty feeling
  • Irritability
  • Headaches
  • Stomach upset
  • Blurred vision
  • Loss of sexual interest
  • Fatigue
  • Panic attacks
  • Difficulty in decision-making, achieving focus and concentration
  • Lack of motivation
  • Lack of sleep
  • Feeling worthless
  • Loss of interest in taking care of the baby
  • Avoiding friends and family
  • Thinking about harming self or the baby

The symptoms are broad and vary from woman to woman.  That’s why only a health care provider can make the diagnosis that a woman who has just given birth has a postpartum disorder.  Since PPD lasts longer and is more severe, mothers need to be treated right away.

Are All Women Prone to Postpartum Depression?

A study published in 2013 found that substance use and major depressive disorders among pregnant women and those who have just given birth, post significant challenges to public health.  The national data shows that 5 percent of pregnant women aged 15 to 44 use illicit drugs, while 9.4 percent use alcohol.  It was also found that 7.4 percent to 12.8 percent of pregnant and postpartum women have experienced a major depressive disorder.

Any woman, regardless of her age, race, ethnicity, economic status, educational background, and religion, can get postpartum depression.  However, some women are more prone to develop it than others, due to their exposure to risk factors including:

  • Depression symptoms during or after a previous pregnancy
  • A prior experience with depression or bipolar disorder
  • Having a family member who was diagnosed with a mental illness
  • Mixed feelings about being pregnant
  • Medical complications during childbirth such as delivering a premature baby or having a baby with a certain medical condition
  • A death of loved one, job loss, domestic violence, or illness that might have caused stress to the mother during pregnancy or after giving birth
  • Lack of support from family members
  • Alcohol or other substance abuse

The Causes of Postpartum Depression

Postpartum depression is said to be a result of a combination of different emotional and physical factors that a woman experiences after giving birth.
Her exhaustion—physical, from having to attend to the baby’s needs— and mental—from constant sleep deprivation—contributes to the symptoms. Childbirth also results in decreased levels of the hormones estrogen and progesterone in a woman’s body, causing mood-altering chemical changes in her brain.

When left untreated, postpartum depression prolongs the woman and her family’s suffering. It hinders her ability to take care of her child and herself.

This kind of depression occurs in nearly 15 percent of births and can last from one-to-three years.

In the review of clinical studies, it was found that 38 percent of women who suffer from postpartum depression experienced chronic symptoms. Meanwhile, depression among 50 percent of these women who were getting medical care lasted for more than a year, and of the women who were not receiving any clinical treatment, 30 percent were found to have depression up to three years after giving birth.

Postpartum Depression and Substance Abuse

A woman with postpartum depression finds it hard to cope with her daily life.  Without intervention, the depression can lead to substance use disorder, making the woman prone to severe health problems.

Since alcohol and opioid prescription drugs are available, a woman with postpartum depression can easily develop an addiction to these substances. She is more at risk of turning to them to help her get some sleep and keep her feelings of anxiety under control.

A study published in 2013 found that substance use and major depressive disorders among pregnant women and those who have just given birth pose significant challenges to the public health.  The national data shows that 5 percent of pregnant women aged 15 to 44 use illicit drugs, while 9.4 percent use alcohol.  It was also found that 7.4 percent to 12.8 percent of pregnant and postpartum women have experienced a major depressive disorder.

How to Treat Postpartum Depression?

It’s easy to know when a woman who has just given birth needs your help:

  • If the baby blues seem to last longer than two weeks

If the symptoms of depression are getting more intense, then someone in the family should immediately reach out to the new mother and offer her support, maybe call their medical service providers immediately.  Her doctor, nurse, or midwife may ask questions to test her, or suggest she contact a mental health professional to get help.  Medication may be prescribed.

If substance abuse has become a problem, the woman may have a dual diagnosis and require treatment for substance use disorder as well as postpartum depression.  Many drug or alcohol abuse rehab facilities are equipped to treat both on an inpatient or outpatient basis.

Among the health care service available are:

Counseling sessions

Counseling or talk therapy allows the woman to have a one-on-one talk with a mental health professional.

There are two types of talk therapy:

Cognitive behavioral therapy that teaches patients how to recognize and change the negative thoughts that lead to their negative behaviors.
Interpersonal therapy that helps patients understand and improve their problematic personal relationships.

Medication-assisted treatment

Women suffering from postpartum depression may be given antidepressant medications to target the brain chemicals that regulate their moods.  If a woman is breastfeeding, her medical health care provider should explain to her the risks and benefits of certain medications to her and her baby.

Dual diagnosis

When depression and alcohol or substance abuse are co-occurring in a woman who has just given birth, she needs both conditions to be treated. Therapies at luxury treatment centers usually are prepared to handle such co-occurring conditions.

Holistic treatment

  • Some women may respond better to or prefer alternative treatments to reduce anxiety and address depression, including:
  • Exercises such as tai chi, qi gong or Pilates
  • Massage therapy
  • Chiropractic spinal manipulation
  • Meditation
  • Homeopathy
  • Reflexology
  • Hypnotherapy or another type of alternative approach

The key to addressing postpartum depression is for the family or friends of the woman to give their immediate support.  The sooner after giving birth that the symptoms of depression and anxiety associated with the woman’s challenging new motherly responsibilities are recognized and reported, the better the chances that will not turn into a more serious condition.

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