Postpartum: The Perfect Storm

Jennifer Payne | Provided

Researchers from University of Virginia(UVA) Health, John Hopkins Medicine and Weill Cornell Medicine discovered a potential contributor to postpartum depression (PPD).

When autophagy (according to the National Cancer Institute, the process cells use to break down old, damaged or abnormal proteins and other substances within cells) is reduced, there is a direct ink to PPD.

Exploring this link between autophagy and PPD might even help prevent postpartum depression before the baby is born.

“This is exactly why I study PPD, because you can look before people get sick and see what’s different between those who do get sick and those who don’t,” says Jennifer L. Payne, one of the  aforementioned researchers and vice chair of research in psychiatry at UVA Health.

“In women who went on to develop PPD, their cells were demonstrating decreased autophagy. They weren’t cleaning out debris from their cells.”

As a condition that affects mental health, PPD can feel scary and shameful to mothers who know they should feel happy about the birth of a child. It’s not always understood why it occurs for some mothers and not others—so being able to identify the propensity for postpartum in individuals would be significant.  Here is what we do know about  postpartum depression, including risk factors, related conditions and symptoms.

What is Postpartum Depression?

Postpartum depression is a type of depression that sets in after giving birth. The symptoms of PPD can include overwhelming fatigue, irritability, anger, feelings of hopelessness, restlessness, difficulty bonding with your baby and more, according to the Mayo Clinic.

Mothers are encouraged to seek medical attention if they see these symptoms worsening, or not fading within a couple weeks, if they are finding it hard to care for their baby or complete everyday tasks or  if  they are having thoughts of harming themselves or their baby.

“Postpartum depression is the most common complication of childbirth, and it has long-lasting repercussions for the mother and children,” Payne says.

At Johns Hopkins, Payne helped establish the Women’s Mood Disorder Center to study hormone-triggered mood disorders and their impact. Her expertise includes women’s mood disorders, PPD, premenstrual dysphoric disorders and perimenopausal depression.

PPD occurs in between 6.5% and 20% of women, most commonly within six weeks after childbirth, according to the National Institutes of Health. Payne says 10% to 15% of women get sick with PPD within the immediate postpartum period.

Postpartum depression can be compounded by other factors as well.

Anneliese Lawton, 33, felt defeated, overwhelmed and angry after combating PPD following the birth of her first two children, and during her pregnancy with her second.

Lawton’s second pregnancy was complicated by a tumor, which was wrapped around some of her facial nerves — risking paralysis.

It wasn’t until after the birth of her second child that she suffered a breakdown, but  Lawton says she survived, learned to love herself and allowed herself to be the mother she wanted to be.

The Perfect Storm

Jenny Yip, a psychologist and mother of 7-year-old twins, says the postpartum period can be a “perfect storm” for other mental health conditions as well. Factors typically thought to contribute to women developing postpartum depression, and other related disorders such as postpartum anxiety and OCD, include genetics, hormones and environmental stressors, explains Yip, who experienced postpartum OCD.

“I didn’t realize it was OCD in the beginning until one of my colleagues pointed out to me that it sounded like OCD,” Yip says.

Some of the early warning signs of postpartum depression, according to Yip, include changes in appetite or sleep and not feeling like yourself. Another early warning sign more specific to postpartum OCD is intrusive mental images or thoughts about catastrophic consequences or harm to you or your baby.

Through exposure therapy, in which “you expose yourself to the feared consequence so you get corrective feedback, so the fear isn’t as daunting,” Yip says, she found a way to manage her OCD. She now helps others through her book “Productive, Successful You” and through founding the Renewed Freedom Center and Little Thinkers Center.

‘You Can’t Self-Care Yourself out of Trauma’

According to Lawton, it’s important for mothers to get the help they need.

“You can’t self-care yourself out of trauma. A bubble bath and getting your nails done won’t fix it. It’s helpful in prevention and recovery, but there’s a point where you need the additional help. Don’t be afraid to ask for that help,” she says.

That said, taking steps to reduce external pressures can be beneficial. Social media is a major component of why mothers today feel so much pressure, she adds.

“We’re comparing ourselves to celebrities and the moms down the street and in our schools. I grew up in the 90s. We were bombarded with what the perfect woman was and what she looked like,” Lawton says. “I feel like so many of us pivoted and changed ourselves to fit a certain mold, stuff that we saw on TV.”

To avoid the social media blues, Lawton, who runs her own digital marketing, strategy and consulting business, recommends unplugging from the pages and profiles that don’t make you feel happy and instead looking for local community groups with people who have gone through similar struggles.

Now, Lawton and her husband have welcomed their third child from a healthier place.

“I loved being a mom after she was born. She came out in four pushes,” Lawton says, recalling the birth. “I was meditating, taking the right meds. I was able to embrace motherhood in a completely different way.”

Her other advice for mothers who find themselves on similar journeys is to be extra aware if you’re at risk or have experienced PPD. It’s “knowing what to look for when you’re starting to spiral,” she says.

Thanks to the research by Payne and others, there might be a day where mothers would  be able to address PPD earlier, and therefore lessen its intensity.

One of the benefits of Payne’s findings could be a screening tool to detect PPD risk early so physicians can help patients get support before becoming seriously ill, Payne says.

“We’re getting closer to understanding at least some of the pathophysiology of PPD,” she says. “It is my hope that my research will eventually eliminate most cases of PPD by establishing ways to
prevent the onset.”

View Payne and her colleagues’ research online at Learn more about Yip’s work at and follow Lawton’s journey at


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