As many as 20% of employees experiencing pregnancy and childbirth will also endure the debilitating—and potentially life-threatening—impact of postpartum depression (PPD). Even more concerning is that the 2020 pandemic is amplifying the challenges of PPD as new parents try to cope with the stress of isolation from family and friends, the fear of contracting COVID-19 and spreading it to their newest family member, and new economic anxieties borne of the pandemic.
The result: America now faces a PPD crisis hidden inside the pandemic. And some of those coping with this exacerbated mental health issue are your employees.
It’s no secret that mental health issues deal serious blows to employee productivity, extract tolls on a company’s bottom line, and can even present workplace safety issues. PPD is no exception, which is why it’s more important than ever for HR personnel, benefits directors, and supervisors to identify who may be struggling and assist in mitigating PPD’s negative effects.
PPD: What It Is and How to Spot It
As with most mental health concerns, the stigma surrounding PPD can result in women not seeking treatment or talking openly about symptoms. Some mothers might believe they’re experiencing “baby blues” and that the symptoms are just part of motherhood.
Similar to PPD, baby blues occur typically 4 to 5 days after delivery, and symptoms can include feelings of sadness, irritability, tearfulness, mood changes, and anxiety. Unlike PPD, baby blues occur in up to 80% of women, resolve on their own within several days or weeks, and don’t typically have a significant long-lasting impact on daily functioning or relationships.
Women also might not understand or identify the symptoms of PPD and will normalize their symptoms or believe they will resolve on their own. Symptoms of PPD can occur any time during the first year after the baby’s birth and can include feeling depressed and sad, anxious, or nervous; feelings of low self-worth; loss of appetite or excessive eating; sleep disturbances, including insomnia; or sleeping excessively.
Severe PPD symptoms include suicidal thoughts or an attempt to die by suicide. Severe symptoms can result in the inability to function at home or work and may require hospitalization. Other manifestations of mood disorders occurring after pregnancy include postpartum obsessive compulsive disorder (OCD), whereby a woman has unwanted and disturbing intrusive thoughts, and postpartum psychosis, whereby a woman may have paranoid thoughts, or psychosis, such as hearing voices or experiencing visual hallucinations.
It is important to note that PPD is not postpartum OCD or postpartum psychosis. Postpartum psychosis is a psychiatric emergency and warrants immediate medical care.
The COVID-19 pandemic piles on these challenges. Stay-at-home orders and social distancing rules further restrict a new mother’s already limited support network. And relationships with a significant other can be doubly strained by working at home while sharing responsibility of caring for the baby. Single mothers may be especially challenged by not having a partner to provide support.
On top of these factors, a woman’s self-identity and self-confidence are often impacted by motherhood. The driven career woman may now see herself as primarily a mother rather than a devoted executive and may feel unsettled about her new role. Her expectations of motherhood may not be consistent with how she is feeling, and she may doubt her ability to be successful in her new role as mother. Unresolved childhood trauma may also unexpectedly come to light, as she is now a mother caring for a child.
How HR, Benefits Personnel, and Supervisors Can Help
First and foremost, don’t dismiss any reports that an employee is feeling depressed. Listen to her complaints, and if you believe PPD may be at the root, refer her to your company’s employee assistance program (EAP) or other well-being resource.
Of course, the signs an employee could be struggling with PPD aren’t always purposefully dismissed. It’s easy to see PPD symptoms or behaviors yet not acknowledge that they’re red flags. Rather, a supervisor might think the employee simply is unmotivated or having temporary performance issues. That’s why it’s important to take into account the timing when symptoms or behavior changes began. Compare the employee’s pre-maternity leave and post-maternity leave behavior and performance before jumping to any conclusions.
Speaking of timing, it’s especially important during this new age of working virtually that supervisors pay attention to a returning mother’s tone of voice during conference calls (upbeat versus monotone, for example), her personal hygiene during video meetings (is she dressed and groomed for work?), and her quality of work. Any changes in these areas could be a sign she’s experiencing PPD.
To successfully manage employees with PPD, supervisors and HR professionals should receive education on the symptoms and training on how to help. Tap into expert resources such as local mental healthcare providers or www.postpartumdepression.org to create training materials.
Above all, remember that PPD is common, and although they’re not clinicians, HR professionals can be mindful that it happens and watch for it. If you think you spot it, explore with the employee what’s going on, and then refer her to your EAP or other resource.
Identification and immediate treatment of PPD are critical to a women’s health, her family, her career, and her relationships with others. And creating a supportive corporate environment—especially during this trying time—will enhance all of your employees’ well-being, not to mention their trust, productivity, and loyalty.
Valerie M. Kading, DNP, MA, MSN, PMHNP-BC, is CEO of Arizona-based mental health center Sierra Tucson. HR professionals can learn more at https://www.sierratucson.com.