Menu

The hidden risk of postpartum depression during quarantine (and how to get help)

Now more than ever, we have to take care of our mental health, particularly new parents.

The hidden risk of postpartum depression during quarantine (and how to get help)

Having a newborn is challenging at the best of times, but during forced isolation and in a climate of fear and uncertainty, it can become overwhelming.

The coronavirus pandemic is setting up our communities for genuine mental health concerns. This may be especially true for new parents. When will 'normal' life return? How will I pay for diapers and baby food? Will my mom be able to help us now? What if my baby or my family get COVID-19? Unfortunately, no one knows the long-term impact or answers just yet.

Most families have built a network of social support by the time they have their first child—if they don't already have a support system, they develop one through various baby classes and groups set up for parents. The creation of the village can be instrumental to the mental health of new parents. Social distancing, the lockdown of cities, and isolation will inadvertently affect the type of support available.


Now more than ever, we have to take care of our mental health, particularly new parents. Postpartum depression will likely rise during this pandemic, so people need to understand what it is and what can be done about it.

What is postpartum depression (PPD)?

Postpartum depression is a mood disorder that occurs among parents or the caretakers of a newborn.

Depression is an unseen illness, which is why it can often go undiagnosed. But certain clues can help identify someone who needs help. There is no one feeling that categorizes depression. Instead, a person can have a range of emotions that may include:

  • Sadness, unhappiness or a low mood for two or more weeks
  • Hopelessness
  • Lack of interest to do anything
  • A lack of interest in social life or work
  • Difficulty bonding with their baby
  • Difficulty concentrating or making decisions
  • Frightening thoughts, for example, about hurting their baby*
  • Decreased energy and feeling tired all the time
  • Sleep problems at night or feeling sleepy during the day
  • Irritability, increased emotional reactivity and feelings of guilt

*If you feel like you want to hurt yourself or someone else, call 9-1-1, 24/7 CRISIS Resolve Network (1-888-796-8226), or seek emergency care.

The presence of one of the above does not mean the person is definitely depressed, however. For example, sleep problems and tiredness may be due to taking care of the baby at night, rather than depression. Additionally, difficulty bonding may be due to problems the mom is experiencing with feedings.

It is important not to confuse or attribute these feelings to "just" the baby blues.

  • Feeling tearful, low or emotional
  • Irritability and moodiness
  • Feeling anxious

While the baby blues have overlapping symptoms, it is much more prevalent (80% of women will experience the baby blues), but it lasts only 10 to 14 days. If your baby blues symptoms last longer than that, it could be PPD.

(Check out this article for more information on the baby blues: Is it baby blues or postpartum depression? How to tell the difference.)

Ultimately, know that it is not your job to diagnose yourself. All you need to do is get on the phone with a therapist. They can help you figure out if what you are experiencing is typical or if concern is warranted.

What causes postpartum depression?

In short, we don't know exactly.

Researchers and providers have identified risk factors associated with postpartum depression and encourage proactive measures prior to birth for intervention.

Some of the most common associated risk factors are similar to those that have been put into place to keep us safe from the coronavirus:

  • Isolation
  • Lack of support from friends or family
  • Recent stressful life events such as bereavement or being diagnosed with Covid-19
  • A poor relationship with your partner
  • Experiencing the baby blues

People at most risk are those who already have a history of mental health problems, particularly depression, especially if it was present during pregnancy. Furthermore, many people have lost their jobs, paid leaves, and/or medical insurances that impact their postpartum experience for their families. This is an additional new high stressor for many parents with infants during the pandemic.

Why is postpartum depression awareness critical during the pandemic?

Identifying the presence of postpartum depression is essential because undiagnosed PPD will not fix itself or just go away—and it can have devastating consequences: Maternal suicide remains a top cause of death among mothers.

Diagnosis is also important because treatment options for postpartum depression are numerous.

While depression is still under-recognized in most countries, we are seeing some improvements. In recent times, there has been a significant effort to try and remove the stigma around mental health conditions. The fear of being perceived negatively, the fear of the child being taken away, and the societal stigmas, all contribute to why women hesitate to seek help.

If you are concerned that you may have PPD, please speak to a therapist today.

What's important to remember about PPD?

1. It's not your fault; postpartum depression can happen to anyone.

2. Being depressed does not make you a bad parent. Full stop.

3. Babies are only taken into care away from parents in very exceptional circumstances. Almost always, babies stay right with their family as a parent is getting treatment for PPD.

4. It's common. Worldwide, 13% of women will have PPD within the first year of giving birth.

5. It can affect fathers and partners, not just women who gave birth!

6. Depression is an illness like any other visible or physical illness.

What are the common treatment options for PPD?

Most people associate treatment for depression with medication. However, in most cases, medication is not the first line of treatment for depression.

Over the past 40 years, significant research has discovered evidence-based treatment options for depression, and we are now fortunate enough to have a range of very effective options used in the treatment of PPD.

Antidepressant medication

Medication usually takes one to two weeks to work and is continued for at least six months. The exact mechanism is unknown but is believed to work by increasing levels of chemicals, like serotonin and noradrenaline in the brain.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) focuses on challenging a person's thought process and patterns in order to avoid cognitive distortions (thoughts, beliefs and attitudes) as well as unhelpful behaviors, such as excessive worry, anxiety, isolation and detachment. This change in perception helps to improve emotional resilience, develop personal coping strategies, and avoid withdrawal.

A recent meta-analysis found no statistically significant difference in effectiveness between second-generation antidepressants and CBT.

CBT tools can be accessed online or face to face with a psychotherapist. CBT apps are also available, such as Catch It and MoodTools - Depression Aid.

Mindfulness-Based Cognitive Therapy

Mindfulness-Based Cognitive Therapy (MBCT) is a combination of CBT and mindfulness.

Jon Kabat Zins, the founder of the Mindfulness-Based Stress Reduction program, describes mindfulness as "moment by moment awareness, non-judgmentally." The aim is to interact and be aware of one's thoughts that may be unhelpful through meditation. Through mindfulness, a person learns to accept and see unhelpful thoughts, but does not engage with them; this empowers them to not get caught up in any one moment, past or future.

Too often, we get stuck in our past or have excessive worry for our future. Was this the right time to have a baby? Why did I change jobs? What will happen in the future? When will 'normal' life resume? This inadvertently has a direct effect on our present mood and wellbeing.

Evidence shows that people who practice mindfulness meditation report feeling calmer and free from their own emotional baggage. Most importantly, they feel free to be more compassionate to themselves and others.

MBCT was created by Zindel Segal and Mark Williams. Therapy is usually eight weeks long, with sessions once a week. There are six guided meditations that can be found on the mbct.co.uk website that have been recorded by Mark Williams. Alternatively, you can buy the book The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness, which includes the Guided Meditation Practices CD.

MBCT is particularly effective in providing people who previously have suffered from depression with the tools to prevent a relapse.

Interpersonal Therapy

Interpersonal Therapy (IPT) was a practice first developed at Yale in 1969 and is considered to be high-impact psychotherapy. Unlike CBT, IPT does not focus on thoughts but instead focuses on the belief that our relationships affect our moods. It is a highly structured program that has been shown to be as effective as medication or CBT.

The goal of IPT is to identify issues and problems in interpersonal relationships; this can be particularly relevant to new parents as 67% of couples see marital satisfaction decrease after having a baby.

IPT aims to teach the skills addressing this, thereby improving relationships, decreasing interpersonal distress, and alleviating depressive feelings.

Behavioral Activation

One of the most straightforward psychological therapies used is Behavioural Activation (BA). BA has been seen to be as effective as CBT but works differently.

Often during depression, people stop doing activities that they used to enjoy and become more withdrawn. This, in turn, reinforces low mood. BA aims to increase your contact with positively rewarding activities. This could be something as simple as returning to those activities that used to have a positive impact on mood. For example, scheduling in Zoom or WhatsApp dates with friends, putting aside time to read the books you enjoy, or taking time out for some self-care.

Self-help

Self-help often suits full-time parents and caretakers, as this does not require fixed appointments.

Self-help is learning done through workbooks, apps or computer courses—it can be guided by a therapist but doesn't have to be. The aim is to empower and provide you with the information and skills to be able to work on your thoughts in your own time.

Reframing expectations of parenthood based on your truths, acknowledging the difficulties of transitioning into a new stage, and giving yourself permission to take breaks can provide emotional relief. Reducing the amount of social media exposure temporarily can also decrease anxieties related to pressure, your mothering identity, and overall well being.

Self-help apps are available, as well as books like The Compassionate Mind Approach to Postnatal Depression by Roslyn Law, which is highly recommended.

Lifestyle changes

Getting enough sleep, eating healthy and exercising can all contribute to a healthy lifestyle and, in turn, our mental health. An unhealthy lifestyle with excessive alcohol consumption or smoking has been seen to contribute to worsening symptoms of depression.

Exercise helps to improve our mood through the release of endorphins. Walks or runs with your baby in a carrier or stroller are great ways to get a bit more exercise in the day. Depending on where you live, this may be difficult due to different responses to COVID-19, but if possible, parents or carers should try to get out of the house every day, at least for a walk. If not, find a way to get some movement inside.

How to get help for postpartum depression?

The hardest thing by far is making that first step, but once you have, know that we are there to help. Speak to your doctor or midwife, or find a therapist through your insurance company. There are also many telehealth services available. Even in these unprecedented times, most providers are quite apt at doing consultations over the phone.

Here are 5 ways to help friends with PPD during the pandemic

Even if you are not suffering from PPD, a friend might be.

If there is anything we have learned during this pandemic, it is that life and relationships do not just stop—they may look different, but our need for social connection can continue in other forms. Support can be virtual or from a distance.

Here are a few ways you can help:

  1. Phone calls, texts, Zoom, Houseparty, WhatsApp—anything that lets them know you are there for them.
  2. Offer to do their shopping while you do yours.
  3. Leave a homemade meal at the doorstep.
  4. Simply ask them how you can help.
  5. Regularly check up on them and their mental health. Having open discussions on mental health creates a safe space for someone to talk about their worries and concerns and may be more effective in achieving the same outcome.

Please remember that you are not alone in this. Help is available and effective, and you get back to feeling well very soon. For additional support and resources, the experts at Allegheny Health Network (AHN) are here to help.

This article was sponsored by Allegheny Health Network (AHN). Thank you for supporting the brands that support Motherly and mamas.

In This Article

    14 toys that will keep your kids entertained inside *and* outside

    They transition seamlessly for indoor play.

    With fall in full swing, most parents are fresh out of boxes to check on their "Fun Concierge" hit list. It's also the point of diminishing returns on investing in outside-only toys. So with that in mind, we've rounded up some of our favorite toys that are not only built to last but will easily make the transition from outdoor to indoor play. Even better, they're Montessori-friendly and largely open-ended so your kids can get a ton of use out of them.

    From sunny backyard afternoons to rainy mornings stuck inside, these toys are sure to keep little ones engaged and entertained.

    Wooden doll stroller

    Janod wooden doll stroller

    Take their charges on a stroll around the block with this classic doll stroller. With the same versatility they're used to in their own ride, this heirloom quality carriage allows their doll or stuffy to face them or face the world.

    $120

    Detective set

    Plan Toys detective set

    This set has everything your little detective needs to solve whatever mystery they might encounter: an eye glasses, walkie-talkie, camera, a red lens, a periscope and a bag. Neighborhood watch? Watch out.

    $40

    Sand play set

    Plan Toys sand set

    Whether you're hitting the beach or the backyard sandbox, this adorable wooden sand set is ready for action. Each scoop has an embossed pattern that's perfect for sand stamping. They're also totally suitable for water play in the wild or the bathtub.

    $30

    Water play set

    Plan Toys water play set

    Filled with sand or water, this tabletop sized activity set keeps little ones busy, quiet and happy. (A mama's ideal trifecta 😉). It's big enough to satisfy their play needs but not so big it's going to flood your floors if you bring the fun inside on a rainy day.

    $100

    Mini golf set

    Plan Toys mini golf set

    Fore! This mini golf set is lawn and living room ready. Set up a backyard competition or incorporate into homeschooling brain breaks that shift focus and build concentration.

    $40

    Vintage scooter balance bike

    Janod retro scooter balance bike

    Pedals are so 2010. Balance bikes are the way to go for learning to ride a bike while skipping the training wheels stage altogether. This impossibly cool retro scooter-style is built to cruise the neighborhood or open indoor space as they're learning.

    $121

    Wooden rocking pegasus

    plan toys wooden rocking pegasus

    Your little will be ready to take flight on this fun pegasus. It gently rocks back and forth, but doesn't skimp on safety—its winged saddle, footrests and backrest ensure kids won't fall off whether they're rocking inside or outside.

    $100

    Croquet set

    Plan Toys croquet set

    The cutest croquet set we've ever seen! With adorable animal face wooden balls and a canvas bag for easy clean up, it's also crafted to stick around awhile. Round after round, it's great for teaching kiddos math and problem-solving skills as well.

    $45

    Wooden digital camera

    fathers factory wooden digital camera

    Kids get the chance to assemble the camera on their own then can adventure anywhere to capture the best moments. With two detachable magnetic lenses, four built-in filters and video recorder, your little photographer can tap into their creativity from summertime to the holidays.

    $179

    Wooden bulldozer toy

    plan toys wooden bulldozer toy

    Whether they're digging up sand in the backyad or picking up toys inside, kids can get as creative as they want picking up and moving things around. Even better? Its wooden structure means it's not an eye sore to look at wherever your digger drops it.

    $100

    Pull-along hippo

    janod toys pull along hippo toy

    There's just something so fun about a classic pull-along toy and we love that they seamlessly transition between indoor and outdoor play. Crafted from solid cherry and beechwood, it's tough enough to endure outdoor spaces your toddler takes it on.

    $33

    Baby forest fox ride-on

    janod toys baby fox ride on

    Toddlers will love zooming around on this fox ride-on, and it's a great transition toy into traditional balance bikes. If you take it for a driveway adventure, simply use a damp cloth to wipe down the wheels before bringing back inside.

    $88

    Balance board

    Plan Toys balance board

    Balance boards are a fabulous way to get the wiggles out. This one comes with a rope attachment, making it suitable for even the youngest wigglers. From practicing their balance and building core strength to working on skills that translate to skateboarding and snowboarding, it's a year-round physical activity that's easy to bring inside and use between Zoom classes, too!

    $75

    Meadow ring toss game

    Plan Toys meadow ring toss game

    Besides offering a fantastic opportunity to hone focus, coordination, determination and taking turns, lawn games are just plain fun. Set them up close together for the littles and spread them out when Mom and Dad get in on the action. With their low profile and rope rings, they're great for indoors as well.

    $30

    We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.

    Shop

    Tips parents need to know about poor air quality and caring for kids with asthma

    There are steps parents can take to keep their children as healthy as possible.

    When wildfires struck the West Coast in September 2020, there was a lot for parents to worry about. For parents of children with asthma, though, the danger could be even greater. "There are more than 400 toxins that are present in wildfire smoke. That can activate the immune system in ways that aren't helpful by both causing an inflammatory response and distracting the immune system from fighting infection," says Amy Oro, MD, a pediatrician at Stanford Children's Health. "When smoke enters into the lungs, it causes irritation and muscle spasms of the smooth muscle that is around the small breathing tubes in the lungs. This can lead to difficulty with breathing and wheezing. It's really difficult on the lungs."

    With the added concern of COVID-19 and the effect it can have on breathing, many parents feel unsure about how to keep their children protected. The good news is that there are steps parents can take to keep their children as healthy as possible.

    Here are tips parents need to know about how to deal with poor air quality when your child has asthma.

    Minimize smoke exposure.

    Especially when the air quality index reaches dangerous levels, it's best to stay indoors as much as possible. You can find out your area's AQI at AirNow.gov. An under 50 rating is the safest, but between 100-150 is considered unhealthy for sensitive groups, such as children with asthma. "If you're being told to stay indoors, listen. If you can, keep the windows and doors closed," Oro says.

    Do your best to filter the air.

    According to Oro, a HEPA filter is your best bet to effectively clean pollutants from the air. Many homes are equipped with a built-in HEPA filter in their air conditioning systems, but you can also get a canister filter. Oro says her family (her husband and children all suffer from asthma) also made use of a hack from the New York Times and built their own filter by duct taping a HEPA furnace filter to the front of a box fan. "It was pretty disgusting what we accumulated in the first 20 hours in our fan," she says.

    Avoid letting your child play outside or overly exert themselves in open air.

    "Unfortunately, cloth masks don't do very much [to protect you from the smoke pollution]," Oro says. "You really need an N95 mask, and most of those have been allocated toward essential workers." To keep at-risk children safer, Oro recommends avoiding brisk exercise outdoors. Instead, set up an indoor obstacle course or challenge your family to jumping jacks periodically to keep everyone moving safely.

    Know the difference between smoke exposure and COVID-19.

    "COVID-19 can have a lot of the same symptoms—dry cough, sore throat, shortness of breath and chest pain could overlap. But what COVID and other viruses generally cause are fever, chills, vomiting, diarrhea and body aches. Those would tell you it's not just smoke exposure," Oro says. When a child has been exposed to smoke, they often complain of a "scrape" in their throat, burning eyes, cough, shortness of breath, chest pain or wheezing. If the child has asthma, parents should watch for a flare of symptoms, such as coughing, wheezing or a tight sensation in their chest.

    Unfortunately, not much is known about long-term exposure to wildfire smoke on a healthy or compromised immune system, but elevated levels of air pollution have been associated with increased COVID-19 rates. That's because whenever there's an issue with your immune system, it distracts your immune system from fighting infections and you have a harder time fighting off viruses. Limiting your exposure to wildfire smoke is your best bet to keep immune systems strong.

    Have a plan in place if you think your child is suffering from smoke exposure.

    Whatever type of medication your child takes for asthma, make sure you have it on-hand and that your child is keeping up with regular doses. Contact your child's pediatrician, especially if your area has a hazardous air quality—they may want to adjust your child's medication schedule or dosage to prevent an attack. Oro also recommends that, if your child has asthma, it might be helpful to have a stethoscope or even a pulse oximeter at home to help diagnose issues with your pediatrician through telehealth.

    Most importantly, don't panic.

    In some cases, social distancing and distance learning due to COVID may be helping to keep sensitive groups like children with asthma safer. Oro says wildfires in past years have generally resulted in more ER visits for children, but the most recent fires haven't seen the same results. "A lot of what we've seen is that the smoke really adversely affects adults, especially older adults over 65," Oro says. "Children tend to be really resilient."

    This article was sponsored by Stanford Children's Health. Thank you for supporting the brands that support Motherly and mamas.

    Our Partners

    Mama, all I see is you

    A love letter from your baby.

    Mama,

    I can't see past you right now, I'm so small and everything's a little blurry.

    All I see is you.

    When you feel alone, like the walls are closing in, remember I'm here too. I know your world has changed and the days feel a little lonely. But they aren't lonely for me.

    You are my everything.

    When you feel like you don't know what you're doing, you're making it look easy to me. Even though we're still getting to know each other, you know me better than anyone.

    I trust you.

    Keep reading Show less
    Life