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Postpartum Depression is a Family Affair

At long last, people are talking about postpartum depression. Dismissed for years as no more than a touch of the baby blues (or else unheard of entirely), PPD has become an open subject. But despite this progress, postpartum depression remains misunderstood in one very critical regard: namely, that it's something that only happens to, and thus only adversely affects, mothers.
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At long last, people are talking about postpartum depression. Dismissed for years as no more than a touch of the baby blues (or else unheard of entirely), postpartum depression -- or PPD, as it is often known -- has become an open subject. Healthcare providers are aware of it, many nurses and physicians routinely screen mothers for it, and articles in parenting magazines and major newspapers have been written about it.

But despite this progress, postpartum depression remains misunderstood in one very critical regard: namely, that it's something that only happens to, and thus only adversely affects, mothers.

This assumption causes problems for two reasons. First, it ignores the fact that both men and women can suffer from PPD. Though more common in mothers -- affecting anywhere from 10 per cent to 25 per cent of them -- PPD also affects 10 per cent to 14 per cent of new dads. The symptoms for paternal and maternal PPD overlap considerably, including fatigue, irritability, and withdrawal, and they occur at the same point in time -- roughly a month after the baby is born.

What's more, the two groups appear closely connected. Among fathers suffering from PPD, a full half of them have partners who are suffering themselves. This means that in a significant number of households affected by PPD, both adults are suffering together.

This leads to the second problem: PPD's effect on children.

During the first two to three years of their lives, children grow millions of neural connections a second -- far more than they will ever need -- in order to allow their brains to develop in whatever way best suits their environment. This adaptability, called neural plasticity, decreases with age, as the most used connections thicken and strengthen and the neglected ones wither and shrink.

This brief window of phenomenal adaptability allows children to learn complex procedures, such as motor skills and language, at an incredible rate.

Unfortunately, it also makes them vulnerable to the anxiety, frustration and emotional strain caused by depression. These problems sink into their malleable minds like fingers into putty, leaving marks that may never fully disappear. Consequently, children of depressed parents have a heightened risk of many emotional, intellectual and behavioural problems -- especially when both parents are suffering.

Sometimes these symptoms take years to show up -- a recent study found that having a depressed mother at age two predicted a greater risk of anxiety at age 11 -- but when the symptoms do show up, they often stick around. PPD has been linked to anger issues and withdrawal in infancy, aggression, anxiety and lower IQ scores in school-age children; and drug use, alcoholism, and ADHD in teenagers.

These conditions often impact children's chances of long-term success, and can lead to lower levels of education, increased risks of poverty, and a host of mental and physical disorders.

Given such longstanding consequences, it's all the more vital that we develop a proactive support system for mothers and fathers afflicted with PPD. Comprehensive postnatal screening would allow training clinicians to spot individuals who may be suffering, and a network of professional counsellors and peer groups would help new parents manage the symptoms of PPD before they get out of hand -- and also help them feel less alone.

The benefits of such a program extend far beyond just helping parents. A solid prenatal and postnatal support system -- not just for those with PPD, but all parents struggling with poverty, addiction, or psychological problems -- would give otherwise at-risk children a chance to thrive.

Parents don't just raise children; they raise the next generation of workers, innovators, and leaders. By helping them, we help their children, our society, and ourselves.

PPD is not the only problem requiring a family first solution -- but it is a good place to start. Support for parents who are struggling is a down payment on a brighter future.

Nicole Letourneau is an expert advisor with EvidenceNetwork.ca and a professor in the Faculties of Nursing and Medicine. She also holds the Norlien/Alberta Children's Hospital Foundation Chair in Parent-Infant Mental Health at the University of Calgary. Justin Joschko is a freelance writer currently residing in Ottawa. Their co-authored book, Scientific Parenting, has just been released with Dundurn Press.

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