Navigating postpartum blues in winter

It’s estimated by the American Pregnancy Association that 70–80%¹ of women experience negative feelings and short-term mood swings as their bodies and hormone levels adjust after childbirth – regardless of how much you love your child. The ‘baby blues’ usually set in three to five days after birth and resolve in about 10–14 days. “It is signalled by mild sadness, tearfulness and irritability, but is not so bad that it affects your ability to function,” says Tamryn Sprunt, a Pietermaritzburg-based counselling psychologist with a focus on women’s mental health and postpartum issues.

For about 10% of women, however, the feelings are prolonged and intense, and include hopelessness, low energy, difficulty concentrating or making decisions, anxiety or panic, loss of interest or pleasure in activities, and sometimes, thoughts of harming the baby or yourself. “This is much more than the blues,” says Sprunt. “It is postpartum depression (PPD) or postpartum mood disorder, which includes anxiety symptoms. It can set in as long as a year after giving birth, and last even longer, growing worse unless you get diagnosed and find treatment and support.”

PPD is rooted in hormonal, psychological and social factors, from financial stress and lack of support, to the disruption of thyroid functions and the pathways of feel-good hormones in the brain. A genetic predisposition, difficult pregnancy or birth, and poor nutrition can also contribute, says Dr Eugene Allers, a psychiatrist based in Benoni. 

How winter increases the risk of postnatal depression

Both the ‘baby blues’ and PPD can be more difficult to handle in winter, especially in the Cape, where days are shorter and darker, with more rainfall, making it difficult to get outdoors with baby and socialise. Some women also experience seasonal affective disorder (SAD). The reduction in sunlight disrupts melatonin (which regulates sleep) and serotonin (which regulates mood), making them more prone to depression, says Sprunt.

With SAD, you feel miserable, with low-grade depression, lethargy, irritability, difficulty concentrating, and changes in appetite and sleep. Sufferers tend to overeat and gain weight, and to oversleep. For a SAD diagnosis, symptoms must persist for at least two weeks in winter for at least two consecutive years, and resolve completely in summer.

Warning signs you should never ignore

If you have symptoms of these conditions, it’s important to know when to get help. These are urgent warning signs:

• Inability to bond: feeling detached, resentful or numb towards your baby.

• Severe isolation: withdrawing from your partner, family or friends.

• Extreme mood swings: alternating between intense irritability and rage, and frequent, uncontrollable crying.

• Impaired functioning: struggling to complete daily hygiene or baby care routines, or make basic decisions.

• Intrusive thoughts: having scary, repetitive thoughts about something bad happening to your baby, or about harming yourself.

Seek immediate crisis support: reach out to a loved one or your healthcare provider, or contact the South African Depression and Anxiety Group. For free 24-hour telephonic support call 0800 456 789, SMS 32312 or visit www.sadag.org.

Tips to manage postpartum blues in winter

1. Prioritise exposure to light

Fight winter gloom by opening curtains as soon as you wake and spend 15–20 minutes sitting near a bright window. “Take a short daytime walk to absorb as much natural daylight as possible,” says Sprunt. “Exercise also helps get feel-good endorphins flowing.” 

2. Accept or ask for practical help

Delegate chores, meal preparation and nappy changes to your partner, family or trusted friends so you can maximise your rest.

3. Connect with others 

If cold weather keeps you indoors, meet with friends in baby-friendly cafés, malls or museums, schedule regular WhatsApp chats or video calls, or look into online support groups (SADAG runs several).

4. Ask about professional therapy and medical care

Light therapy (phototherapy) is the most common first-line treatment for SAD, and involves sitting beside a light therapy box or wearing a special light visor for a while each morning. “It would be done through a medical doctor,” says Sprunt. Psychotherapy, such as cognitive behavioural therapy, can be highly effective. Your GP or a psychiatrist can safely evaluate you and may also prescribe anti-depressants, such as SSRIs, that are compatible with breastfeeding. 

“As mental health professionals, we look at a three-pronged response to PPD: personal psychotherapy, medication, and mothers’ support groups or community groups,” says Sprunt. “Another precursor to PPD is mothers and fathers needing to lower their expectations of getting back to their pre-baby lifestyle. Whatever the season, new parents need to be aware that the first 18 months of their baby’s life is known as an adjustment period, and the family is finding a ‘new normal’. It takes time and patience.”

References

1. https://americanpregnancy.org/postpartum/baby-blues/