It's not the same as other forms of depression! The loss of time for oneself is incredible--especially if one is used to having time to do yoga, meditate over washing dishes--the screaming of a little baby can unravel all of that in less than two minutes.

No question, it's the biggest adjustment most of us will ever have to make. The loss of sleep alone is huge. The disruption of time, relationships, work identity... believe me, I get it. But that's not depression - that's the circumstances surrounding the depression, the context that makes it tougher than usual. But depression is still depression - flat affect, hopelessness, helplessness, self-hatred, anger turned inward, loss of energy, mental fogginess, impaired memory and a dulling of the senses and of the emotions. And that's what the Depression imagery addresses.
The loss of time is something that you just have to live with 'til the baby gets older or you get more help from your husband, friends or family or you find a way to hire some help - even once a week can make a big difference, although of course it's not enough. It's one reason why spacing the next one can be so important.
BR

The unfortunate reality is that maternal depression and post-partum depression are not well understood - even by the medical professionals women rely on during this critical and vulnerable period. I urge any woman feeling this or who is concerned that she may have maternal or postpartum depression to seek help and if your medical professional is not helpful, keep looking. A mental health professional can help you in the adjustment, make an accurate diagnosis and assist you in finding other forms of support. There are standardized screeners (CES-D for example) that can be helpful Here are some of the facts associated with maternal depression:
1) 1 in 5 pregnant women suffers from depression. 80% of them do not receive appropriate diagnosis and only 4% receive adequate treatment. America has one of the worst maternal-infant mortality rates among developed nations. (SHAME ON US!!)
2) There are several forms of post-partum depression, some more serious and severe than others. Belleruth mentions these but what may seem like malaise today can escalate quickly to psychosis tomorrow. PPD can be diagnosed anytime during the first YEAR after the birth of the baby. The sooner help is sought the safer and better.
3) If a woman experiences postpartum depression with one pregnancy she has a 50-80% higher risk in subsequent pregnancies - one of the best reasons to seek help early.
4) When the mother experiences postpartum depression, the incidence of postpartum depression for the father is 10% higher. Children of these fathers have increased emotional/behavioral problems and increased rates of hyperactivity.
5) Maternal depression is associated with higher rates of pre-term birth, low birth weight babies, SGA (small for gestational age) infants, maternal substance use and suicide/homicide rates. These outcomes are costly, not only to families, but to taxpayers as well since there are often long-term consequences associated with each of these impacts.
6) Maternal depression affects not only the mother, but the infant is also be affected. This is independent of whether or not the mother realizes she is depressed and/or whether she perceives her infant to have been impacted. These impacts can include delays in developmental milestones, impairments in cognitive and emotional development, impairments in bonding and attachment, increased rates of depression and psychiatric problems in their own lives and disruptions in family functioning. The impairments in attachment and bonding ARE frightening. Attachment is known to be the single most influential element of brain development and has long term ramifications when attachment does not go smoothly. We are all imperfect parents. That does not negate the importance of critical brain development. I live in Nebraska where 36 adolescents and pre-adolescents were dropped off under the Safe Haven law. The majority of these children had early disruptions in their attachments. I have worked with children whose early attachment needs were not met, and what I can tell you is that seeking help now and taking preventative measures now will be a lot less difficult than the later consequences of poor bonding and attachment. I might disagree with Belleruth on this:) You might be interested to look at the video at www.traumaresources.org from the Neurons to Neighborhood workshop.

"Put your own oxygen mask on first." You can't water the fields with an empty pitcher. Take care and be well. Louise

These statistics are very informative, but could unnecessarily frighten people, as they're skewed toward the pathological end of teh spectrum.
Do you have any recommendations for differentiating pathological depression from the more frequent, commonplace and self-correcting varieties, and for how to find a heaslth practitioner who knows the difference?

Belleruth, thank you for your interest. My intent certainly is not to frighten anyone unnecessarily, but as the first blogger points out, PPD really IS different. If we listen to what Kerry is saying, she has been suffering for MONTHS (!!) and has not felt benefit from tools that had been helpful in other circumstances. Bless her heart, this is no way to begin one of the most meaningful new stages of one's life. To my way of thinking, that is what is frightening - trying to cope with something that is not well understood and therefore minimized when one is feeling desperate for help. I would much prefer that women and their families have the information about these presentations and not need it, than need it and not have it. None should feel alone or pathologized as they enter motherhood. To the best of our knowledge today, depression whether PPD or otherwise is a chemical imbalance affecting the brain much as diabetes is a chemical imbalance affecting the pancreas - no one's fault. In post-partum women there are the added stressors/challenges of rapidly changing hormones, bodily changes, increased demands of caregiving 24/7, etc. which all by themselves can be pretty overwhelming. First time mothers often don’t know what is “normal”. Diagnosis of depression when pregnant or postpartum is confusing because symptoms such as sleep disruption, appetite changes, low energy, etc. are also “just part of the territory”leading to so many going undiagnosed. Women who experience postpartum depression often do not seek help because it is supposed to be a “happy” time and they are ashamed that they are not happy. A big barrier to seeking help is the perception (sometimes pretty reality based!)that one’s healthcare provider is not knowledgeable or receptive to concerns about depression. While the information I gave is straightforward, I don’t think it is skewed to the pathological end of the spectrum. I did not mention post-partum obsessive compulsive disorder ,which occurs in 3-5% of postpartum women, 60% of whom also develop a secondary major depressive disorder 2-3 weeks following onset of the OCD. OCD symptoms are more treatment resistant when depression accompanies it. This disorder is characterized by repetitive, intrusive, persistent thoughts (possibly including thoughts about harming oneself or one’s infant; horror and disgust at these thoughts, attempts to manage the thoughts through anxiety reducing behaviors (hiding knives, avoiding bathing the baby, etc); and repetitive behaviors such as counting, checking, etc. I also did not mention post-partum psychosis, which occurs in 1 or 2 women per thousand but onset can be as early as 2-3 days postpartum and which may be accompanied by hallucinations, suicide/homicide/infanticide ideations, delirium, mania, and/or delusions such as denial that the birth or pregnancy occurred. I submit that these are the more pathological end of the spectrum.

If any of the following risk factors are present, and a woman experiences symptoms of depression, OCD, or PPD psychosis as outlined above, I strongly encourage them to seek help quickly:
1)Personal or family history of mental illness in any form.
2)Stressors associated with the pregnancy, delivery or transition to motherhood that impact the woman significantly
3) personal history that complicates identity, sexuality, role development, etc. This can include but not be limited to sexual abuse, domestic violence, substance use, etc.
4)History of PMS, endocrine disorders, etc.
5)Hormone changes

In seeking help, if a woman senses that her medical provider is not receptive or knowledgable about depression, particularly PPD, keep looking! I am a big believer in consumerism. Women need to know it is okay to ask a provider, “How would you rate your expertise in addressing maternal depression/PPD?” “Does your office use standardized screeners such as CES-D, Zung, Edinburgh and/or who do you refer patient with mental health needs to? A mental health provider can make the diagnosis and can assist the woman and her family in finding support, resources, reducing stressors, medication evaluation, etc. I hope this helps. Be glad to answer any further questions. Louise