Postpartum Depression: One Size Does Not Fit All

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You may have heard the news this week that autism has been linked to obesity in mothers. When I heard it, the very next thing I thought about was all of the mothers I know who have children on the autism spectrum and are skinny.

That’s research for you. I see tons of it every day. They often use words and language that I don’t understand. There’s one in my inbox right now about hair cortisol and another about dissociative subtypes of PTSD. (Huh?) I see studies that are meta-analyses, double-blind, random controlled, using a placebo, quantitative, qualitative … studies that have 8 people in them that make me wonder why they would be reported on since there’s only 8 PEOPLE in them. I see studies that contradict one another.

Last week there was a widely-reported study that a key risk factor for postpartum depression is domestic violence. This may make sense to some of you and it may not for others of you. I’ve never been assaulted or experienced domestic violence, so it didn’t apply to me. When I saw the media covering it all over the place, I felt both happy and worried about that. Happy, because people need to know what the various risk factors for postpartum depression are. Worried, because people need to know what the VARIOUS risk factors for postpartum depression are. There is not just one. It’s not just women who have been through domestic violence that get PPD. There are many risk factors, including but not limited to:

  • previous history of depression or anxiety
  • family history of mental illness
  • previous postpartum depression
  • antenatal depression
  • infertility treatment
  • previous miscarriage or stillbirth
  • lack of partner support
  • domestic violence
  • recent trauma (death in the family, house move, job loss, etc.)
  • childhood trauma
  • poverty or financial problems
  • teenaged mothers
  • lack of social support
  • diabetes
  • teenaged mothers
  • older, first-time mothers
  • mothers of multiples
  • difficult pregnancies (best rest, hyperemesis)
  • babies born with health problems, babies in NICU

I could keep going. Some of you have several of these, but not all.

I’ve never been through infertility treatment. Never had a miscarriage. Am not suffering financially. Don’t have diabetes. No domestic violence. Easy pregnancy. One kid. No NICU. But I did go through plenty of childhood trauma, I do have a family history of mental illness, and at the age of 32 I guess I could have been put in the older, first-time mothers group.

Postpartum depression is not a one size fits all illness. It may be that there is something that ties all of those risk factors together. Something we don’t yet fully understand. The one thing that stands out to me when I look at all of them as a whole is stress – severe emotional stress at some point in one’s life, whether in childhood or more recently, that makes us — our brains — vulnerable to PPD.

Just know when you hear these studies reported that they may not be talking about you. They may be talking about other mothers who share your illness but not your risk factors. We are all so different. And yet the same.

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About Katherine Stone

is the founder & editor of Postpartum Progress. She was named one of the ten most influential mom bloggers of 2011, a WebMD Health Hero and one of the top 25 parent bloggers using social media for social good. She also writes the Fierce Blog, and a parenting column for Disney's Babble.com.

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  1. Katherine, this is wonderful. The wide range of risk factors and symptoms is one of the challenging aspects of educating/screening/connecting to care. I also love how you tied in research studies because I worry about their impact on people, including expectant and new parents.

  2. You forgot the biggest risk factors: being pregnant, giving birth, having a baby… :-)

    Sometimes there is no reason why.

  3. Great Blog, Katherine! Thanks for increasing awareness of postpartum depression.

  4. I wish there was less focus on "risk factors". The fact is that any woman who has had a baby can get PPD. I delayed treatment for almost a year because my life and my marriage are actually very functional, and I thought it couldn't be PPD. Every woman should be aware and screened for PPD because we are all vulnerable, risk factors or not.

  5. I think it’s so important to know these and even more important to be screened!!