This week, Alanis Morissette revealed that she has postpartum depression (PPD)-and that she felt it hit just "seconds" after giving birth to her second child, Onyx Solace, last year. And, on top of that, she says in an interview with People that her symptoms have lasted 14 months since then.
The singer also experienced PPD after having her first child, Ever Imre, six years ago. At that time, she tells People, she had trouble sleeping, felt lethargic, and began to have "horrifyingly scary" thoughts of her family getting hurt. However, she wasn't diagnosed with PPD for 16 months.
And, it turns out that having had PPD before-or any previous experience with depression-is "actually the biggest risk factor" for developing PPD in the future, Olivia Bergeron, L.C.S.W., founder of Mommy Groove Therapy in New York City, tells SELF.
Depression during pregnancy can make postpartum depression feel immediate.
Although Morissette's case sounds extreme, there are certain circumstances in which it may feel like PPD hits immediately. For instance, undiagnosed depression during pregnancy (a.k.a. "antepartum depression"), may be exacerbated when the baby finally arrives. "When women are depressed when pregnant it usually does convert into postpartum depression," Michael Silverman, Ph.D., assistant professor of psychiatry at the Mount Sinai Icahn School of Medicine, tells SELF. "Women don't snap out of it when they have a baby, and all the conditions line up for them to not snap out of it," he says.
Indeed, on top of the hormonal and immunological changes the body goes through after giving birth, Bergeron says the obviously significant life changes make it difficult to keep depression at bay. "In addition to the great gift of becoming a parent, you're facing a lot of losses in your life," she explains. You're spending a ton of money, losing the independence of having your own schedule, and giving up a fair amount of physical space. That, plus an unpredictable sleep schedule and the added stress of caring for a baby can certainly make you more susceptible to PPD.
And, of course, having previous experience with PPD would make it easier to recognize the symptoms if they come back, Bergeron says-especially if they're not obvious. Although Dr. Silverman says the symptoms of PPD are the same as those for major depression, Bergeron says that many of her patients are surprised to learn that irritability, anger, and restlessness are commonly among those symptoms.
There are ways to protect yourself from postpartum depression during your next pregnancy.
Ideally, doctors should be asking their pregnant patients if they have a history of depression, anxiety, or PPD, Dr. Silverman says, because there are steps you can take to lower your risk for PPD-even if you've had it before. "It's not a bad idea to touch base with a therapist," he says. "That doesn't mean you have to get back into therapy, but just have a plan." For instance, you might decide that if, two weeks after giving birth you're just not feeling like yourself, you'll set up a session with your therapist.
In addition, Bergeron says she tells people to "prepare as if they're going to have twins," meaning you should get more support than you think you need. Whether that's in the form of a postpartum doula or calling on extra family members to be available, "make sure you're not isolated," she says.
It may seem obvious, but getting good sleep and staying physically active when you feel up to it are both incredibly helpful here, Dr. Silverman says. "There's a strong correlation with sleep deprivation and depression," he says. So sticking to a steady sleep schedule as much as possible, avoiding screens for at least an hour before bedtime, and all those other sleep hygiene tips you probably already know are even more important to follow now. Dr. Silverman also suggests alternating nights of baby duty with your partner, so you know that you'll at least have one night of sleep without having to get up over and over.
And, even if you're not sleeping for as long as you'd like, getting regular exercise will help you get better quality sleep for the few hours of shut-eye you do get, Dr. Silverman says.
Stigma often keeps people from seeking help early on.
"The stigma remains in a really big way," Morissette told People, and Dr. Silverman says is one reason why patients don't come to him right away.
"They usually try to push through it, they mask it," he says. But the pressure to be seen as a "good mom" only serves to make the experience more miserable, especially because PPD is very treatable once people actually get that treatment. "The gold standard is talk therapy and medication," Dr. Silverman explains, but many patients only do therapy. And, he continues, they usually begin to feel better after their first session.
That's partly why Morissette is so open about her experience. "I just know that there's a light at the end of the tunnel and try not to beat myself up," she says.
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