The last patient I saw on Friday was less than two pounds when she was born. Delivered 3.5 months early, she spent nearly that much time in the neonatal ICU, overcoming life threatening issues that preemies face- a bleed in her head, a gut that started to die off, lungs that were not ready to breathe air.
Now at 9 months old, she was nothing short of a miracle- already doing all the things that full term babies her age were doing, without the luxury of spending the third trimester inside.
Her dad brought her into clinic that day- I hadn’t seen him since visiting with the family early on in the NICU. As I marveled at all of her amazing accomplishments- eating solid foods; pulling to stand; saying mama and dada! I watched her dad force a smile.
“I can’t help but notice that you seem really quiet today- how are you feeling?” I asked.
Looking down at the ground, he told me that ever since his daughter came home from the NICU, he had been feeling worse than he had ever felt before- having headaches and chest pain nearly every day; not sleeping or eating; overwhelmed at work and at home. A week ago, he had such extreme chest pain that he went to the emergency room, thinking that he was having a heart attack. When all of the tests came back negative, the ER doc asked if the chest pain could be related to something else- stress at home? Anxiety? Depression?
He paused. “I didn’t even think that was even possible. But after she said that, all of this started to make sense…I felt this way when I was a kid. And I’m feeling it all again now, with mine.”
We talked some more. He had no thoughts of self harm or harm to others. He already made an appointment to see his primary care provider. He talked about it with his partner, and she supports him, 100 percent.
Postpartum depression is very real, and can happen in all parents, moms and dads. While feeling emotional after a child arrives is common, the symptoms of postpartum depression are more persistent and severe. Postpartum depression not only affects parents, but their children as well- feeding difficulties, language delay, behavioral issues- all can result from untreated parental depression and can have lasting effects.
There’s a lot we can do to help:
Recognize: All parents can suffer from postpartum depression. Symptoms may include: feelings of sadness or depressed mood; change in appetite; difficulty with sleep; feelings of worthlessness; loss of interest in activities; inability to bond with the baby. Postpartum depression can start from a few weeks up to a year after the baby is born. Remember, continuing to feel down after baby is born is not normal.
Ask: If you are concerned about a friend or family member, please ask. Your baby’s pediatrician will ask too: the Edinburgh Postnatal Depression Scale is a useful screen for postpartum depression that should be administered to parents at their child’s well visits in the first six months of life.
Support: Parents with postpartum depression do better when they are supported by their social network and their medical providers- offer it however you can.
Earls MF, Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032–1039