Who Is at Risk for Postpartum Depression and Addiction?
Postpartum depression and addiction are a tragically common pairing. The peak period for postpartum depression is from birth to three months. Researchers have discovered that women with postpartum depression are at a greater risk for substance abuse compared to postpartum women without depressive symptoms. Conversely, women with a history of substance abuse are more likely to show symptoms of postpartum depression. Between 19.7% and 46% of women with a history of substance abuse develop postpartum depression.
Women who are unemployed, unmarried, or cigarette smokers are more likely to have postpartum alcohol use disorders.
Following the birth of her child, a woman’s body undergoes intense hormone fluctuations. Estrogen and progesterone levels drop–in addition to an acute lack of sleep many new mothers experience–causing chemical changes in the brain that may cause mild to severe mental health-related and physical symptoms. Moreover, substance abuse can impair a mother’s ability to emotionally connect with and anticipate the needs of her child.
The Most Commonly Abused Substances by New Mothers
- Alcohol – used by 30% – 49% of new moms
- Marijuana – used by 6.6% of new moms
- Prescription psychoactive drugs (including opioids, stimulants, and benzodiazepines) – used by 3.6% of new moms
- Cocaine – used by 1.1% of new moms
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Why Do Some Mothers with Postpartum Depression Abuse Drugs or Alcohol?
Among the general population, depression is strongly linked to initial substance use. Also, because their brains are still developing, some studies indicate young mothers (under the age of 25) are at a greater risk for postpartum depression. Environmental factors (such as intimate partner use or economic status) may also leave young mothers more vulnerable to substance abuse. Postpartum substance abuse may be a continuation of drug or alcohol use that occurred prior to or during pregnancy, or the beginning of a new behavior. Studies suggest some women abuse substances following childbirth to:
- Elevate mood
- Relieve stress and anxiety
- Help her fall asleep
- Increase energy
Symptoms of Postpartum Depression
Up to 80% of women experience the “baby blues,” a range of feelings including worry, unhappiness, and fatigue. These feelings are normal and to be expected as caring for a newborn entails a great deal of work. However, when feelings progress to the point of interfering with a woman’s ability to care for herself or her family, she may have developed postpartum depression. Many symptoms of postpartum depression mirror those of a substance use disorder.
Symptoms of postpartum depression include:
- Feeling empty, hopeless, or overwhelmed
- Crying more frequently or for no apparent reason
- Feeling overly irritable or anxious
- Oversleeping or being unable to sleep
- Trouble concentrating, remembering details, and making decisions
- Moments of sudden anger or rage
- Losing interest in hobbies
- Physical aches like frequent headaches, digestive issues, and muscle pain
- Overeating or not eating enough
- Withdrawing from friends and family
- Having trouble bonding with her baby
- Persistently doubting her ability to care for her baby
- Thinking about harming herself or her baby
Source: National Institute on Mental Health
Because of differences in postpartum experiences between women, a healthcare provider is needed to differentiate postpartum depression from other possible diagnoses.
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Substance Abuse and Postpartum Depression Statistics
Postpartum depression affects up to 14.5% of women following childbirth.
In one study of newborn mothers, 38.7% of women who drank alcohol experienced a high level of depressive symptoms.
National survey data in the U.S. shows 9.5% of postpartum women reported use of illicit or nonmedical drugs in the past month.
Treating a Substance Use Disorder with Postpartum Depression
While some mothers may not be concerned about the risks to their own health, most are aware of the greater threat substance abuse can have on newborns. In several studies, women reported weaning babies off breastmilk earlier in order to resume drug or alcohol use. Likewise, national surveys report a decline in illicit drug and alcohol use during pregnancy, followed by an increase in use similar to rates of abuse among women in the general population. Healthcare providers suggest that this pause in substance abuse presents an important opportunity for addiction intervention. Thus, screening pregnant women and new mothers for a history of substance abuse, depression, chronic anxiety, and other mental health issues may be the best chance of preventing the onset of postpartum depression and substance use disorders.
Social stigma can be a difficult barrier for many women who need treatment. So, the support of family is vital for the success of new mothers.
Treatment for co-occurring postpartum depression and substance use disorder should include children, be specific to the needs of women, develop a woman’s ability to care for herself and her family as well as accomplish her own goals, and integrate some form of early-childhood parent training. Many addiction treatment therapies can be used to alleviate symptoms of postpartum depression as well. Cognitive behavioral therapy and individual counseling are proven methods of treating mental health issues.
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