An Interview With Jake Frankel
Postpartum depression affects approximately one in five women. Some women, including those with a history of depression and anxiety or lack of support in their lives, are at greater risk. Knowing that PPD is common is important, because we all need to be on the lookout for signs in our loved ones.
Postpartum depression affects millions of women worldwide, yet it remains a topic that is often misunderstood and stigmatized. Through this series, we aim to shed light on the various aspects of postpartum depression, including its symptoms, causes, treatment options, and the impact it has on individuals and families. As part of this series, we had the pleasure of interviewing Dr. Emily Guarnotta.
Dr. Emily Guarnotta is a licensed clinical psychologist and certified perinatal mental health specialist. She is the co-founder of Phoenix Health, an online therapy practice that specializes in treating maternal mental health conditions like postpartum depression and anxiety. As a mother herself, Dr. Emily understands the challenges that motherhood can bring and is passionate about supporting parents through every step of their journey.
Thank you so much for joining us in this interview series. Before we begin, our readers would love to “get to know you” a bit better. Can you tell us a little about yourself?
Of course! I am a psychologist with over 10 years of experience in the field. I specialize in working with families navigating reproductive concerns, including infertility, prenatal and postpartum stress, anxiety, and depression, as well as grief due to miscarriage and stillbirth. I’ve worked in a variety of settings and have had my own private practice for several years. During the pandemic, my phone was ringing off the hook and I couldn’t keep up with the demand for people that needed services. It got to the point that I realized in order to serve more clients, I needed to approach things differently. Either that or I needed to clone myself! I developed Phoenix Health, which is an online therapy practice that specializes in treating maternal mental health conditions. Our mission is to make treatment for maternal mental health more easily accessible to those who need it. We offer individual therapy provided by licensed maternal mental health providers, so individuals could get access to treatment and know that they are getting quality care.
Ok, thank you for that. Let’s now jump to the primary focus of our interview, about postpartum depression. Let’s start with a basic definition so that all of us are on the same page. Can you please tell us what postpartum depression is?
Postpartum depression (PPD) is a mental health condition that occurs during the postpartum period, which includes the first year after giving birth. The main symptom of PPD is a sad mood that lasts several weeks and occurs most days, nearly all day. On top of it, mothers may experience a loss of interest in things, low energy, changes in their eating and sleeping patterns, difficulty concentrating, and either restlessness or lethargy. Some women experience suicidal thoughts, which can be very scary and distressing.
Can you discuss some common misconceptions about postpartum depression and why they are harmful?
There are so many misconceptions out there about postpartum depression. One of the most harmful ones is that you’re a bad mother if you have PPD. Many people have a vision in their mind of what postpartum depression looks like. When I’ve asked people, they tell me that it’s a mother who can’t get out of bed and doesn’t want to take care of her baby. While these can be symptoms of PPD, the truth is that it can present in so many different ways. Many mothers with PPD are quite attentive to their babies and have a secure attachment. When it comes to mothers who do have trouble bonding or caring for their babies, it’s not a character defect. It’s a symptom of a very real mental health condition. Treatment can do wonders.
Can you explain the role of hormonal changes in postpartum depression, and how does this influence treatment approaches?
Hormones are one factor that influence postpartum depression. During pregnancy, estrogen and progesterone levels increase. After birth, these hormone levels drop drastically. At the same time, oxytocin and prolactin increase. These significant changes can trigger the baby blues, which is a period of mild sadness, anxiety, and irritability in the first few weeks after birth. For some women, these symptoms may be severe or get worse over time and develop into PPD.
Experts believe that hormonal changes do account for a portion of the cause of PPD, but not all of it. Other factors like genetics, stress, sleep deprivation, and existing mental health symptoms can also contribute to developing PPD.
Even though hormones play a large role in PPD, hormonal treatments are not usually a part of treatment. The most effective treatments to date are therapy, social support, and in some cases antidepressants.
How does postpartum depression impact the bonding between a mother and her baby, and what interventions are available to address this?
Some studies have found a link between PPD and bonding difficulties. While some mothers with PPD may find it difficult to form a bond with their babies, others don’t have trouble. And some mothers without PPD struggle with bonding. If you feel that you’re struggling to bond with your baby and are experiencing PPD or another PMAD, getting treatment is a good step. You can also do lots of skin-to-skin contact with your baby, which stimulates oxytocin, also known as the “love hormone.”
It’s important to also remember that bonding can take time. It does not make you a bad parent if you don’t feel instantly connected to your baby. You may need time to get to know them and feel comfortable in your new role.
What are some of the best ways to treat postpartum depression?
The recommended treatment for PPD is therapy. Some women may also benefit from medication along with therapy. There are specific types of therapy that have been shown to be effective for treating PPD, including cognitive behavioral therapy (CBT) and interpersonal therapy (ITP). CBT focuses on changing negative thought patterns, while ITP focuses on how relationships and role transitions contribute to depression.
In addition to therapy, it’s important to incorporate lifestyle changes that support a new mother’s mental health. For example, a mother may benefit from speaking with her therapist about how to get more rest. Social support is also critical, so finding time for connecting with friends and family or building new connections is also very important.
Based on your experience and research, can you please share “5 Things Everyone Should Know About Postpartum Depression?”
1 . It’s incredibly common
Postpartum depression affects approximately one in five women. Some women, including those with a history of depression and anxiety or lack of support in their lives, are at greater risk. Knowing that PPD is common is important, because we all need to be on the lookout for signs in our loved ones.
2 . There is a range of symptoms that a person can experience
While the main symptom of PPD is a persistently sad mood, mothers may not always look depressed. Some mothers with PPD may experience a lot of anxiety and appear overwhelmed. Others may feel irritable and be quick to anger. When mothers show these signs, people in their lives may be quick to judge them and blame it on hormones or even their personalities. There is no single blueprint of PPD.
3 . It can take up to a year to present
Many people think of the postpartum period as being just a few weeks. They think that once you are cleared at your six-week postpartum check-up, you are out of the woods. The truth is that postpartum lasts a year or more. It is quite possible to recover from the baby blues and develop PPD several months later. Some women experience depression after weaning off of pumping or breastfeeding. This is because of the hormonal changes that occur. While you shouldn’t live in fear of PPD, mothers and their families should be aware that it can develop at any point within a year of giving birth.
4 . It affects more than just birthing mothers
We typically think of PPD as affecting only birthing mothers, but fathers, non-birthing partners, and adopted parents can also experience PPD. When it comes to fathers, researchers have found that around 10% develop PPD, but it often presents differently than mothers. Fathers are more likely to experience irritability and anger. They are also prone to avoiding their emotions and self-medicating. Research on non-birthing partners and adopted parents is limited, but studies have shown that they too may struggle with the adjustment to parenthood.
5 . It may not go away on its own
PPD may not always resolve on its own. Treatment may be necessary to address the symptoms and help a person recover. It’s kind of like having a broken bone. Sure, there is a chance that the bone will heal on its own if you don’t get help, but there is also a good chance that it won’t heal properly. Getting treatment ensures that PPD is properly treated and managed in the future.
What are some practical strategies for supporting a partner or loved one experiencing postpartum depression?
This is a question that comes up often. Family, friends, and partners can play a critical role in helping to support mothers experiencing postpartum depression.
One way to do this is to educate yourself on the signs of PPD and other perinatal mood and anxiety disorders. Many people are unaware of the different emotional concerns that can develop during this time. You need to know what to look for in order to help.
If you think that your partner or a loved one is experiencing PPD, you should bring this up in a way that is very sensitive to their feelings. Mothers with PPD are often their toughest critics. If they perceive any judgment, they may shut down or beat themselves up more. I encourage loved ones to bring it up as an observation, like “I’ve been noticing that you seem sad a lot lately. How are you doing?”. From there it’s important to listen. I cannot emphasize enough the power of listening to a mother that is struggling. You don’t necessarily need to find a solution. Just listening is an extremely powerful way to help her feel seen.
You can also talk about the different treatment options, like therapy and support groups, with her. If she’s not open to it, you should respect her choices and let her know that if she changes her mind in the future, you are happy to help her. If you feel that she is at risk of hurting herself or her baby, then you should emergency help right away. But if you do not have these concerns, it’s rarely effective to push her to get help if she’s not ready.
What are some cultural or societal factors that may contribute to the prevalence and experience of postpartum depression, and how can we address these effectively?
Research on postpartum depression across cultures has found that women in Western cultures tend to experience higher rates of PPD than those from other cultures. It’s noteworthy that in cultures with rituals in place to support postpartum mothers, rates of PPD are much lower. For example, many Latin American cultures practice la cuarentena, where the new mother rests for 40 days after giving birth. Other women in the community help with housework and cooking so the new mother can focus on recovery and bonding with her baby.
In the United States, we do a very poor job of supporting mothers during the postpartum period. Many mothers have to go back to work much sooner than they feel ready. They are coming home after giving birth and cooking and cleaning. This could be a result of external and internal pressures, or both. We do a good job of celebrating the expecting mother by throwing her a baby shower and encouraging her to rest throughout pregnancy, but when it comes to postpartum, many mothers feel thrown to the wolves.
We need to remind postpartum mothers that it’s okay to rest and delegate. We need to offer help and support. We need to avoid putting pressure on them to ‘bounce back.’ They need to know that it’s normal to slow down.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
Becoming a parent and raising children is incredibly difficult. I would love to see a shift in my lifetime toward greater support for parents. There are so many angles that we can approach this from, including better leave policies for new parents, destigmatizing mental health, and making mental health treatment for parents more affordable and accessible.
How can our readers further follow you online?
You can also learn more about Phoenix Health and our services from our website and follow us on Instagram and Facebook. You can also follow my personal page on Instagram.
Thank you for the time you spent sharing these fantastic insights. We wish you only continued success in your great work!
Dr Emily Guarnotta Of Phoenix Health: 5 Things Everyone Should Know About Postpartum Depression was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.