How do I know if I have Postpartum Depression?

We all know of the dreaded PPD, but knowing if you are suffering is tricky, because if you are, you might not know it.


My PPD Story


I thought I was immune to postpartum depression. I ate the paleo diet for almost a year before I became pregnant and worked out enough to keep moving through pregnancy. I had a baby, felt great, enjoyed motherhood and couldn't wait to quit my job and hang out with him all the time. Fast forward 3 years to baby number 2. Working out didn't happen, I was about 80% Paleo, and avoided all foods I didn't tolerate, so mostly doing the "right thing" food wise. I had a baby in the comfort of my own home, a truly supported home birth. I felt empowered beyond description after my son was born, I had a great postpartum recovery plan yet by his 6 month birthday I no longer enjoyed anything. Anything. I was caught completely off guard and was in denial that I was suffering from depression. I had done everything right, hadn't I? Even if I had, which I'm not sure of, PPD can come out of nowhere. The best preparation is being aware that I can happen even if you think you've done everything you can do prevent it.


It took a few months to realize I had PPD and a couple months to do anything about it, because, well, I was depressed. I know for many others, it takes even longer than it took me. I am writing to help you figure out if it's time to get help, because it was really tough for me. My baby was almost a year old before I started enjoying life and feeling genuinely happy again. Now, several months past his first birthday, I am seeing more light in my life, it's a slow process. While that lost time haunts me, I am happy to be happy once more. If you are suffering, know that you can feel happy and hopeful again too. I am not saying I'm "cured" I'm saying I'm better.


In addition to talking to someone, there are many things you can do to support your body as you climb your way out of PPD

Photo credit: Katie Kolbrick Photography


Is it PPD or just baby blues?


Understanding the difference between depression and hormonal mood shifts is tough. Of course you are going to have bad days. If you have a day where you are in a funk, your kids or baby are screaming and you give up on household chores because it's too much, that is OK. It does not mean you have depression or anxiety. We all go a little crazy sometimes, it does not mean you have a problem. We all scream at the top of our lungs just to clear the air in the morning. Just me? Ok.


Are there more bad days than good, though? Do you find yourself physically in the world, but emotionally, you just can't keep up? Do you feel unable to enjoy the most basic things in your life? Is it "too much" to just go to the store? It may not start that way. It can start with anxiety, where you find yourself worried or overwhelmed with basic tasks, like washing dishes, changing diapers, reading a story, even watching TV. The smallest things can seem too stressful or scary. The slope into depression can be steep, meaning it happens all of a sudden, or it can be gradual, meaning, you don't even realize you are going down, until you can't see up. This is why we need tools to help us find out when to get help.


Edinburgh Scale


My favorite tool is the Edinburgh Scale. It's used in OB's offices at the 6 week follow up after birth to screen women for Postpartum Depression. However, if a woman scores high on it at that one visit, she may not seek help. After all, there is usually no follow up visit to that 6 week check up. So, I challenge that if a woman feels PPD may be something she is dealing with, take the quiz on her own, at home. Then take it a week later. If her self identified score is still high enough to seek help, then seek help. Here is a link to the quiz. If you know you need help and don't feel like taking a quiz, keep reading.


Professional HELP for PPD


There are many ways to get help for PPD. First, is to talk to someone who understands this area. This could be a mental health counselor, a psychiatrist, a social worker, your doctor or naturopath. Spouses/partners can be a great support, but sometimes, they are just as scared as you are and don't know how to help. If this is the case, talking to a professional will give you the tools you need to ask for help from your loved ones. Searching for a nearby therapist on Psychology Today is a great place to start if you have no idea where to start. Call Postpartum Support International 1-800-944-4PPD and they can hook you up with local resources. Talking to someone is a very valuable resource, don't overlook it.


Physical Help for PPD


In addition to talking to someone, there are many things you can do to support your body as you climb your way out of PPD.


A great thing to do for your body and brain is move. Movement releases endorphins which make your brain feel sunshiny. Movement also moves around lymph in your body, which stimulates the immune system and helps your body deal with any unhealthy invaders. Moving is medicine.


Moving can look like a lot of different things. First, you can just step outside for 5 minutes, the next day, make it 10 and gradually increase your time outdoors until you're doing at least a 30 minute walk outside every day. Moving could look like yoga in your living room, a workout DVD, or even just walking up and down the stairs or hallway. If you're in a place physically and mentally where it's easy to workout, go take a workout class a couple times a week or go for a run. The most important thing to do here is move your body. The most important thing is NOT to burn calories, not get muscle tone, not lose weight, just to move. Think of your movement as healing, not as a goal to attain.


Eating your way out of PPD


What does a mom eat when she feels like cooking is impossible? Starbucks snacks? Dollar menu burger? Kids macaroni? Just coffee? I have been there and go back there often! Just being real. Luckily there are some easy to prepare foods that will nourish you, your gut wall, and therefore your brain.


Bone Broth


When you don't feel like eating, drink! All kidding aside, this beverage is more hydrating than water and contains proteins glycine, collagen and gelatin for building healthy brain and gut tissue. It's the perfect foundation for a healthy brain diet. Brands that you can buy are Kettle and Fire, SunFed Ranch, Bare Bones Broth or Bonafide. If you can get organic grass fed bones from your butcher, making it is pretty simple as well. Check out my Bone Broth Recipe. If you make a big batch, you can drink multiple mugs a day for a snack or as a base to soup or stew. Making bone broth can seem like a huge hurdle, so don't feel bad about buying it before you take the effort to make it. Once you make it, you'll wonder why you haven't done this before. Drinking it will make a huge difference, trust me!


Cod Liver Oil


Fat for your brain! This oil provides Omega 3 fatty acids which are crucial for brain health and immune function and building your cell walls. It also provides Vitamins A and D, which the body needs for a sunny disposition. My favorite brands of Cod Liver Oil are: Nordic Naturals or Rosita. My family loves the Nordic Naturals brand best, but I'm itching to get my hands on some Rosita because it's like, the best, apparently. It's best to just consume it by itself cold alongside food.


Fish


Protein and more Omega 3 fatty acids (are you seeing a pattern here?) are crucial for our cells, including those in our brain. I recommend this Super Easy Baked Salmon recipe. It's so easy to prepare and delicious. If baking salmon is too much, you can also purchase pre-packaged smoked Salmon or canned sardines or tuna. Brands that I love are Wild Planet and Safe Catch because when eating fish we should pay attention to keeping mercury intake at an absolute minimum. Ideally zero mercury is best, but unrealistic in the world we live in.


Vegetables


Eat the rainbow like carrots, zucchini, cauliflower, bell pepper, spaghetti squash, beets and sweet potatoes to name a handful. Go for colorful organic fresh veggies. This will bring the most nutrients possible to your body. I recommend cooking most vegetables before eating them, since that will help the body digest and use all the vitamins and minerals contained in each veggie. Cook them in butter, ghee or an animal fat like tallow or lard from an organic or grass fed source or cook them in broth.


Pro-tip: Make a stew of your bone broth and veggies and animal meat of your choosing and you will check off every nutritional box your body needs.


That's nice, but what about drugs?


Don't get me wrong, I don't think all women can workout and eat their way out of Postpartum Depression. That is about the furthest thing from what I think. I am posting this for the women who want to hear about some solutions to try. I am not prescribing anything. I agree with doctors that prescription drugs have their place. You can read about the potential side effects of most prescription drugs here if you are interested. I believe that lives have been saved from the right prescription at the right time, so please know that I am not advocating that women avoid all drugs all the time. Talk to your doctor regarding prescription drugs.


Finding the right healing solution for you


Healing from Postpartum Depression is possible. I'm just going to say that. It is not the same for any two people in that everyone will swear something was the "best thing" for them, but it might not be for you. It's not a one way road either, there will be setbacks, there will be roundabouts, u-turns and all the other road analogies you can think of. I love the quote "healing is not linear." You won't set out on a path of healing and magically become a new person right away. It's sometimes a complicated maze, but honor the journey and accept that you are healing and you aren't healed yet. My suggestions are partly what has helped me and what I have seen help others. I would love to know what has helped you.


Links to more PPD Resources


Postpartum Support


When the Bough Breaks Documentary Film


Postpartum Doulas in Washington State


NaProTECHNOLOGY for Postpartum Depression


Motherhood Understood Blog



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