Breastfeeding, Weaning, and PPD/A

Article by Kelley Allen

Postpartum depression and anxiety was something that I went into pregnancy very aware of. I worried about a family history of depression, sensitivity to hormone fluctuations, and moving to a different country three months after the birth of my daughter. Despite my worries I felt prepared as my husband and I met with a specialist before I got pregnant and made the decision to stay on a low dose of a safe antidepressant throughout pregnancy. I knew what supports were available and how to access them, if needed.

Once my daughter was born, I felt the hormonal fluctuations, stress, and exhaustion of motherhood, but was able to manage. After three months passed I relaxed a bit about PPD/A. After six months passed I breathed a huge sigh of relief.

My PPD/A didn’t hit me until my daughter was nine months old, and seemed to coincide with weaning her from nursing. It felt like I changed overnight. And for me the hard part wasn’t the depression, but the anxiety. I had never experienced it before. I couldn’t sleep. I couldn’t eat. I literally wanted to crawl out of my skin. My thoughts raced around in circles inside my head. I couldn’t catch my breath and I couldn’t stop crying. My heart raced and I couldn’t sit still. I felt so overwhelmed all of a sudden.  From the reading I have done since, it seems that the two hormones involved in breastfeeding (oxytocin and prolactin) dropped drastically, causing my body to experience a temporary hormone imbalance, which left me reeling. The scariest part of the whole thing was suddenly feeling like I was unable to be a mother to my child. I felt I had no control, over anything, and I had the urge to run. I believed that if I left, my husband and daughter would be much better off.

The idea that I was suffering from  PPD/A didn’t even cross my mind. From what I had been told PPD/A presents within the first few months after birth. Doctors and public health nurses screened for it during check-ups and it seemed that once I made it to three months with no symptoms, I was in the clear. I truly had no idea what was wrong. Even a basic Google search didn’t yield much of anything in terms of others experiencing the same thing. I felt truly alone. The doctors I saw in my panicked attempt to find an answer hadn’t heard of anyone experiencing something like this either. I finally came across this post. It illustrated perfectly what I was going through. Although, for me it wasn’t that I woke up one day and just felt better. It was a very long few months of attending support groups, taking medication, and calling Pacific Post Partum Support Society for someone to talk to. I remember sending the above link to my friends and family, almost with relief that I had found someone who had experienced what I was going through, and someone who could put it into words so well. I knew I wasn’t going crazy and I also had hope that it would end.

Friends and family said they had seen some signs of PPD/A in the months leading up to weaning my daughter, which makes me wonder if breastfeeding protected me from PPD/A directly following her birth. I don’t know. What I do know is that it was the hardest time of my life, the hardest thing I have been through. And going through it while also being responsible for a baby felt heavy. And unfair.

Although it doesn’t seem to be very common, I do think it is an important thing to talk about and be aware of. For mothers who are weaning their babies, and those of you who support these mothers, being aware that PPD/A can hit any time in the first year (and even beyond the first year) after birth is essential. If you have a similar experience, know that you are not alone. Reach out for support, it is essential.

Another good post about experiencing depression after weaning can be found here.

A Postscript from the Editor:

There is research to support Kelley’s experience as well. This article from the BBC suggests that breastfeeding can indeed be protective against PPD/A. The flip side is that women who want to breastfeed and are unable to for a variety of reasons have double the chance of getting PPD/A.

This article from the Massachusetts General Hospital Centre for Women’s Mental Health states that research on the issue is complicated and there haven’t been enough studies to provide strong evidence of a link between breastfeeding cessation and occurence of PPD/A though anecdotal evidence certainly suggests a link. This article further corroborates the fact that a woman’s plans surrounding breastfeeding are the biggest factor in predicting episodes of PPD/A. If a woman encounters major problems in relation to breastfeeding her risk for PPD/A goes up significantly. The article also points out that the seemingly protective nature of breastfeeding might be more related to other support structures since women who manage to breastfeed for a longer duration tend to also be in a better economic position and have a access to a variety of support structures.
Clearly it’s a complicated issue and Kelley’s experience is not isolated. My own PPD/A also intensified after weaning and while I can’t say why that is with any certainty, hormonal shifts seem like a likely culprit. Hopefully further research will help to clarify the connection between weaning and PPD/A.