Women’s Health Today

A guest post by Nicole Clarke from Maryland Recovery.

Why is substance abuse common during postpartum depression?

Having a baby is a joyous occasion. But every mother knows the first weeks are full of the highest highs and the lowest lows. This roller coaster of emotion, coupled with changing hormones after delivery, can make mothers vulnerable to depression.

After pregnancy, a little sadness is normal. Some moms describe feeling gloomy in the days or weeks following a delivery, and this isn’t uncommon. Doctors call it postpartum depression.

For most moms, the “baby blues” resolve quickly. However, when depression hangs on or is severe, it can be overwhelming.

Understanding postpartum depression

Even though the baby blues after delivery are common, many women are reluctant to discuss these issues. They might think they should only be happy after having a baby, but as many as 80 percent of postpartum women experience the baby blues.

When mothers feel as if they can talk about their depression, they are less likely to fall into drug or alcohol addiction. Knowing when to seek help during this fragile time is crucial.

To distinguish between the baby blues and clinical postpartum depression, consider the following symptoms:

• A depressed mood that is present most of the time and nearly every day
• A loss of interest in activities that were once pleasurable – a feeling that lasts most of the day
• Insomnia (inability to sleep) or hypersomnia (sleeping too much)
• Inability to concentrate or make decisions, including memory problems
• Recurrent thoughts about self-injury, including suicide ideations or attempts
• Fatigue, loss of energy, or appetite changes

Keep in mind that these changes are common after the birth of a baby, so discuss them with your doctor.

When a new mother experiences at least five of these symptoms for two weeks or more, she may need to seek counseling. These symptoms may indicate postpartum depression to a degree that significantly impedes her ability to function.

More advanced postpartum symptoms include:

• Anger directed at the child or a partner
• Not wanting to care for the child
• Resenting having a baby and/or becoming pregnant

The link between postpartum depression and substance abuse

When your life turns upside down, when sleeping becomes a challenge and when anxiety about doing things right become too much to bear, it’s not uncommon for a mother to seek substances to control these issues. She may use them to help relax after the baby goes to sleep or to stay calm during bouts of crying. Whatever the use, this course of action can open the doors to dependency.

In addition, postpartum depression can co-occur with other mental health issues. Before pregnancy, women may have these issues under control, but postpartum depression exacerbates them to a degree where they become dependent on drugs or alcohol.

National data from the Substance Abuse and Mental Health Services Administration (SAMHSA) reveals:

• Nearly 15 percent of women aged 15 to 44 in the postpartum period report binge drinking
• An additional 9 percent reported past-month illicit drug use

Those numbers may sound small, but each one represents a mother and at least one child whose life depends on her.

Studies show that depressive disorders and substance use disorders exacerbate one another. While reported alcohol and illicit drug use are lower in postpartum women in relation to the general population, the reported prevalence is as high as 49 percent for mothers who are battling a mental health disorder.

Risk factors for postpartum depression and substance abuse

Certain factors may increase a woman’s risk of developing postpartum depression. For example, women with a family history of psychiatric disorders may be more prone to experiencing depressive episodes, as are women with less support from family and friends. These circumstances may also contribute to the onset of a substance use disorder.

In other cases, a mother whose doctor prescribes narcotics after a difficult birth may find it difficult to stop taking her pills, or the stress of raising a young child may trigger a relapse in a mom who is recovering from a substance use disorder.

A few specific risk factors for substance abuse include:

A history of depression

If a woman suffered postpartum depression after a previous pregnancy, struggles with depression in general, was depressed during pregnancy, or if her mother had it, her risks are higher.

Poor support systems

Having a baby changes your life, and a support system is crucial. If there’s no partner to share responsibilities with, lean on friends and family. People want to help you, and it will benefit you and the baby if you let them.

Stressful environment

Whether it’s financial worries, fears about motherhood or relationship anxieties, stress after a baby’s birth is a risk factor for postpartum depression.

Sometimes, there’s no answer as to what’s causing the stress, but there are ways to manage it:

• Spend time outdoors. Birth depletes your body. Give it some vitamin D and go on walks to clear your head. A stroller can be a new mom’s best friend.
• Gentle meditation. If you’re too wound up to sleep when the baby sleeps, try meditating. It can reset your mind and help you sleep later.
• Talk it out. Considering how many women suffer from anxiety after a baby, it’s likely someone you know can empathize. Talking to a friend can help with stress management.

The importance of treatment for mom and baby

Some mothers think postpartum depression is a betrayal of their infant or themselves, which can lead to isolation and substance abuse. Drug or alcohol dependency presents a dangerous situation—for both a mother and her baby.

When there’s more sadness than joy after your baby’s birth and those feelings seem uncontrollable, find help. By seeking treatment, mothers can respond to their baby’s needs and feel better about their new roles as parents.

However, some medical professionals will treat one issue or the other, but not both and all without a full understanding of how these separate disorders can feed on each other.

The dual diagnosis approach

Recognizing both addiction and depression in a patient means a dual diagnosis. Co-occurring mental health disorders (like postpartum depression and substance abuse) require “integrated treatment.”

While there are well-established treatment protocols for both depression and substance use disorders separately, an integrated treatment approach is built on the philosophy that each patient is unique.

No two cases of postpartum depression are exactly the same, and while there are often real triggers for why a woman may feel sad, it’s important to remember that some of these emotions are due to chemical and hormonal changes in the body. No amount of positive thinking can change that, which is why reaching out to a professional is crucial.

Here are some prime treatment options for women struggling with co-occurring postpartum depression and substance abuse:

• Help with overcoming withdrawal symptoms
• Non-habit-forming medications to ease depression
• Medical intervention for psychological conditions
• Individual or group counseling
• Family counseling
• Educational services for relapse prevention
• Social support groups, such as 12-step programs

Compassionate help for postpartum depression and drug or alcohol dependency

Integrated treatment plans should involve a multidisciplinary team of professionals. Each individual will play a specific role in addressing a patient’s depression and substance abuse obstacles.

New mothers who struggle with both postpartum depression and a substance use disorder can rely on Maryland Recovery for help. Visit our blog to learn more about substance abuse and mental health issues.

References

The Connection between Post-Partum Depression and Substance Abuse. (n.d.). Retrieved June 29, 2017, from http://americanaddictioncenters.org/treating-depression-substance-abuse/post-partum/

The Link between Postpartum Depression and Substance Abuse. (2014, September 20). Retrieved June 29, 2017, from http://www.orchidrecoverycenter.com/blog/link-postpartum-depression-substance-abuse/

Post-partum Depression and Substance Abuse. (n.d.). Retrieved June 29, 2017, from http://www.alcoholicsoccermom.com/post-partum-depression-and-substance-abuse

Chapman, S., & Wu, L. (2013). Postpartum substance use and depressive symptoms: a review. Women & Health, 53(5), 479–503. http://doi.org/10.1080/03630242.2013.804025 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3742364/

Postpartum Depression and Substance Abuse. (2016, September 30). Retrieved June 29, 2017, from http://www.drugrehab.org/postpartum-depression-substance-abuse/

Postpartum Depression and Substance Abuse Brought to Life. (n.d.). Retrieved June 29, 2017, from https://addictionresource.com/addiction/postpartum-depression-and-substance-abuse/