Major Depressive Disorder with Peripartum onset

Management and Resources

At home

When people are depressed, it is extremely difficult to make changes to their behavior. In fact, getting out of bed might feel daunting. Even so, small tweaks to the daily routine can accelerate recovery. Behavioral changes, when added to medications and therapy can be a powerful combination:

Avoid smoking

Smoking increases the risk for depression.

Regular exercise

Try to get some regular exercise. While many people are aware of the vast, proven benefits of diet and exercise, taking these steps can be particularly difficult while depressed. However, the body needs movement, sunshine, and non-processed foods (especially vegetables and fruits. Starting small is often helpful. Eat one vegetable or fruit per day; Walk one lap around the block. Tiny changes, over time, can make a real difference.

Avoid drinking alcohol

According to the CDC, about 14 percent of pregnant women continue to drink during pregnancy, and 5 percent are binge drinkers. However, alcohol has a direct effect on the fetus, and will not improve depressive symptoms.

At work

New parents often take advantage of family and medical leave but eventually it may be time to return to the workplace. This may be difficult for the new mother, who worries if her child will be safe and well-cared for with childcare providers. Trying to “do it all” and worrying about not succeeding can be daunting for many women, especially in the first month of their child’s life. These thoughts and fears are common but they can become overwhelming, and if this situation occurs, it should be reported to the healthcare provider.

When depressed, it is important to remember that getting treatment might make work feel more manageable. In the meantime, there are a couple ways individuals can move forward:

Check with the human resources person or team at the company to find out whether they have an employee assistance program or partner that offers mental health services. This is a benefit many organizations have begun to offer.
Give oneself grace: while depressed, simply keep in mind that everyone needs a break every so often, or perhaps a day off in order to maintain their spirits. While taking breaks can seem disruptive, this strategy may be effective in protecting one's wellbeing and providing perspective.
Individuals do not ever need to tell anyone at work about having depression, nor do they need to keep it a secret. The amount of information shared is a personal choice, though some people find it useful to share that they are having a rough patch with a colleague or supervisor. Well trained managers understand that individuals experiencing depression might need a modification in their work responsibilities for a period of time.
Find support: Having a friend, preferably at work, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share individual stories in a confidential and dignified way.

Some people find themselves in an unsupportive work environment, where continued productivity is inconsistent with protecting mental health. In such cases, individuals may wish to consider whether a job change in the future is right for them. It can be difficult to make life-changing decisions one is ultimately happy with while they is depressed. If possible to treat the depression before making a move, one can be sure the decision was made with a clear mind. This applies to work and personal relationships.

At school

Depression tends to affect all parts of one’s life, including life at school when individuals are furthering their education as adults. When depressed, it is important to remember that getting treatment might make a school scenario feel more manageable. In the meantime, there are a couple ways to move forward:

Colleges likely offer student counseling services. Given the abundance of stress related to exams, and school performance,in addition to the challenges faced by a pregnant woman or new parent, it is common to feel overwhelmed, depressed, and in need of support. Reach out to a dean or student services for information if needed.
For some with depression, it may help to recall that everyone makes mistakes, and goes through rough patches at some point or another.
Find support: Having a friend, preferably at school, can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share individual stories in a confidential and dignified way.

Individuals do not ever need to tell anyone at school about having depression, nor must they keep it a secret. The amount shared is personal choice, though some people find it useful to share that they are having a rough patch with a professor or teaching assistant (TA). Teachers often understand that individuals experiencing depression might need a modification in their coursework for a period of time.

In relationships

Depression affects relationships with both friends and family, but there are ways to improve the situation. Relationships can be vulnerable to stressors during the perinatal period, particularly when one or both partners experience emotional distress. Having a partner with depression is a risk factor for depression, thus depression in one partner may exacerbate the mood difficulties in another.

Depression can have a significant impact on personal relationships in many ways. If a partner or friend does not have depression, it can be difficult for them to understand what a depressed person is going through. They may expect the individual to be able to “snap out of it,” which can add to feelings of loneliness or sadness. They may assume that. In addition, they may assume pregnant women or new mothers should be grateful and happy and not be depressed. Some open up about their experience can help bridge the gap in understanding -- although, sharing struggles is not always easy. Some pregnant women or new mothers may feel like they are burdening others with their sadness or complaints, but this may not be the case. Sometimes being open during these struggles can fortify relationships.

The symptoms of depression may also bring challenges to a relationship. If someone is depressed, they may be less likely to want to plan activities together or socialize with others; They may want to sleep more and eat less. It is important to recognize that one partner may make these choices because of their depression and not because they are choosing to withdraw from the other one.

It is critical that both parties in the relationship focus on treatment, and to remember that this lack of interest is temporary. In most cases, the right combination of therapy and medication restores a person. Depression can cause impaired self-esteem, which can also challenge relationships. Some people may find themselves needing reassurance or outside validation during these episodes. Keep in mind that periods of depression will require tenderness in relationships.

Organizations

National Institute of Mental Health

American Psychological Association

American Psychiatric Association

MotherToBaby

National Postpartum Depression Warmline: 1-800-PPD-MOMS Postpartum Support

International Warmline: 1-800-944-4773 (English and Spanish)