You have a brand new baby to hold in your arms and as a mother, you should be beaming with pride, glowing with joy and happiness, waking up every morning (and feeding) feeling like you've never experienced this type of utter elation until now.
Or at least, that's what the movies and commercials say.
But you're not feeling that way.
You're anxious, sleep deprived, nervous, feeling overwhelmed, unexplainably depressed. You have bouts of isolation, crying fits and loneliness, like no one will understand what you're going through, or that people will think you're a bad mom if you confess your struggles.
But the truth is that you're not alone; in fact, the realities of pregnancy and postpartum depression are as misunderstood as they are common.
Today is Maternal Mental Health Awareness Day in Saskatchewan, designed to drive attention to antenatal and postpartum depression and extinguish the stigma that surrounds those conditions.
"They are much more common than people think but the truth is that, up until recently, women - mothers - didn't talk about it," said Dr. Marilyn Baetz, head of psychiatry for the Saskatoon Health Region and the University of Saskatchewan.
Baetz, who also founded the Maternal Mental Health Clinic in Saskatoon, said that these ailments are not just the "baby blues", which she estimates about 70 per cent of mothers experience after the birth of their child.
"It's very common to have a happy pregnancy but then have a couple of weeks after where you're feeling up and down, but that's just hormones settling down and it subsides soon after. That's not postpartum depression," Baetz said.
Postpartum depression is something of a biological phenomena, of which about 10 to 20 per cent of women will experience after giving birth, and can be much more prolonged and intense than the baby blues.
Baetz said it can affect both groups of women: those who have never experienced depression in any measure, and those who have.
Although Baetz does say that antenatal (depression during pregnancy) and postpartum depression are more likely to affect someone with a history of anxiety, depression or mood swings, it can absolutely pop up for those who never anticipated it.
And for them, it can be a shock.
"The number one thing to do before conception is to consider your mental health, especially if you're someone who's prone to anxiety or weepiness," Baetz said. If you are, Baetz explained, it's important to properly prepare.
For starters, talk to your doctor right away, especially if you're already pregnant.
"It's important to get mom treated immediately so she can enter into postpartum safely," Baetz said.
By treated, Baetz said it can be a number of things, from making sure the mother-to-be has a good support system at home or nearby who can help out when needed, to having the family doctor evaluate her risk factors.
For those experiencing signs of antenatal depression, such as extreme irritability to feeling emotionally "numb" or sad, medication should be considered, said Baetz.
"A lot of mothers are hesitant to take medication throughout pregnancy, for fear that it'll harm the baby," she said. "There are absolutely safe antidepressants out there that are shown to have no effect whatsoever on the baby, so again, it's important to speak to your family doctor about that. The stress hormones circulating through the mother's body can cause more issues than the pills prescribed to alleviate it."
Similar to antenatal, postpartum depression can range in symptoms, from severe depression and crying fits, to anxiety and unexplained nervousness, to feeling devoid of any attachment to your baby.
The symptoms are also prolonged, lasting weeks, even months on end.
Although hormonal changes and sleep deprivation are triggers of these illnesses, genetics can also play a role.
"If a woman's mother, grandmother, had postpartum depression than they're at a higher risk for developing it themselves," Baetz said.
Having a history of depression is also a risk factor of antenatal/postpartum depression.
In a very severe case, usually 1 out of 500, there's usually an underlying medical condition, such as bipolar disorder, or a significant genetic ailment.
However, the extreme spectrum of postpartum depression is rare, Baetz said.
For those already suffering from antenatal depression, it's unlikely that it'll subside once the baby is born; however, Baetz said the reverse happens all the time: women who have a perfectly happy, glowing pregnancy and develop postpartum depression soon after.
Again, Baetz recommends various things to alleviate the onset of these ailments.
Having a good support system, such as a partner to get up in the middle of the night to feed the baby, or a friend/family member to help out for a couple of hours while the new mom rests, can make a world of difference.
"A lot of the times, moms will feel like they have to do it all, like if they need help, they're not fit to be a mother," Baetz said. "And when you're already dealing with postpartum depression, that feeling of isolation and worry can deepen."
Baetz said in addition to this, it's imperative to speak to your family doctor the second any symptoms of postpartum depression arise, and be open to medication.
And to let your family members in on the issue.
"The mom may feel embarrassed to talk about it but it's crucial," Baetz said. "Let your family know, let your partner/spouse know too."
Another little suggestion Baetz had was to keep your expectations of pregnancy and child rearing realistic.
"You often see new moms in commercials or TV shows having this wonderful, blissful experience with their newborn but up until you have a child, it's impossible to understand the realities of it," she said. "It's hard to predict what it's like to be at someone's beck and call every hour - how exhausting and stressful that can be. For many women, the reality of having a baby sets in after the birth."
In fact, expectations play a key factor in contributing to a new mother's postpartum depression.
"Often times, they back themselves into a corner where they need help or support but feel ashamed to ask," Baetz said. "And that's because of the unrealistic expectations we put on women and new moms."
"Encouragement is everything. The baby will always do better when mom doesn't feel so stressed out or alone; a happy mother has a happy baby."
Baetz isn't saying that simple pat on the backs will alleviate postpartum depression; for that, seeking medical advice is always important. But sometimes making the mother not feel so critiqued can help them express the true issues they're struggling with.
"The stigma surrounding antenatal and postpartum depression is unnecessary because it's common and can affect any woman. Women are not at all bad mothers if they get it: they're human."
