Postpartum depression is not uncommon. According to the Centers for Disease Control and Prevention, 11 to 20 percent of women who give birth each year have postpartum depression symptoms. Sarah Guy, a doctoral student at the UT Austin School of Nursing and a 2016 recipient of the Hogg Foundation for Mental Health’s Frances Fowler Wallace Memorial Award for Mental Health Dissertation Research, suggests that those statistics are underestimated because postpartum depression too often goes unrecognized or is not discussed.

Guy’s dissertation, “Understanding Women’s Perspectives of Mental Health Literacy Regarding Postpartum Depression,” sets out to better understand women’s personal experiences with postpartum depression. In particular, Guy seeks to identify the ways women recognize and relieve the symptoms that often cause much suffering for themselves and their families.

As in many areas of health care, the mental health aspects of the postpartum period are often neglected. Many women report feeling abandoned after the baby is born.

“We don’t understand the etiology of postpartum depression,” Guy explains in reference to postpartum depression and major depressive disorder in the general population. “There are theories related to massive hormonal shifts that are different from any other time in a person’s life.”

She suggests the context is unique—especially for first-time mothers—as are the symptoms, with anxiety and obsessive-compulsive behaviors playing a much bigger role.

“When you try to assess your own mental health in the midst of an experience you’ve never been through before, you have no reference point. You ask yourself, ‘Is this normal?’ But you don’t know what normal is,” Guy says.

Postpartum depression often is unrecognized for weeks or months, and it’s usually the primary health care provider who steps in.

“When becoming a new mother, there’s a fine line between tiredness and emotions and full-blown depression,” Guy says. “Women and their families should be able to recognize
postpartum depression when the first signs and symptoms begin to appear and know where to seek help that suits their needs.”

Guy believes that while health care providers have a duty to assess mental health concerns in new mothers, there should be more general public health education as well.

“We need multiple ways of reaching women, including health care providers and public information, as well as accurate, reliable information online,” she says. “A lot of women are turning to social media, which is not always helpful and can alter the reality of early motherhood.”

Looking forward, Guy hopes to develop tools that can be used in the postpartum unit at hospitals to evaluate the risk of postpartum depression during the critical time before a woman goes home. By evaluating certain factors that can occur during pregnancy, the birth experience and the postpartum experience—including familial support, complications during delivery and trauma at birth—health professionals can better identify and address postpartum depression.

“I want women to feel informed and armed but not scared,” Guy says. “We can do a better job in helping women recognize where they’re at without frightening them.”