Postpartum depression (PPD) is a serious mood disorder that affects some women after the birth of a baby. While many new mothers experience temporary emotional ups and downs known as the "baby blues," postpartum depression is more severe, lasts longer, and can significantly impact a mother's ability to care for and enjoy her child.
As a Christian counselor, I believe that it is important to approach postpartum depression with both compassion and wisdom. We must recognize the physical, emotional, relational, and spiritual dimensions of suffering while offering biblical hope and practical support.
What Is Postpartum Depression?
Postpartum depression typically develops within the first few weeks or months after childbirth, although it can occur anytime during the first year. According to Karen Kleiman, author of This is Not What I Expected, there are similarities between postpartum depression and the “baby blues” in that the mother is sad and cries with both conditions. However, the baby blues (confusingly, also called “postpartum blues”) is not actually an illness, and it usually will resolve on its own.
Postpartum Depression is a more serious illness. Its symptoms include: Persistent sadness or tearfulness, feelings of hopelessness, excessive guilt or shame, irritability or anger, anxiety and excessive worry, loss of interest in activities once enjoyed, difficulty bonding with the baby, fatigue and lack of energy, sleep disturbances beyond normal newborn-related sleep loss, changes in appetite, and difficulty concentrating. It can also include thoughts of self-harm or suicide.
Research suggests that approximately 10-20% of mothers experience postpartum depression, making it one of the most common complications following childbirth.
Understanding Postpartum Depression Biblically
Human beings are embodied creatures that consist of heart, mind, body and soul. Postpartum depression impacts all of these dominions. It is not simply a spiritual problem, but a psychological and physical problem as well.
Physical Factors- After childbirth dramatic physiological changes occur. Dr. Jennifer Payne, of Johns Hopkins University, writes that, "Postpartum depression is a biologically based illness that occurs in the context of dramatic hormonal change.” Payne says that sleep deprivation, the physical recovery from labor and delivery, nutritional deficiencies, thyroid changes and chronic exhaustion are contributing factors. These physical realities can significantly affect the mother’s mood, emotions, and thinking.
Psychological Factors- Many women feel trapped by the loss of previous routines and freedoms. They may fear motherhood or feel inadequate and unprepared for the responsibility of motherhood. In their new role mothers mayexperience isolation from friends and family or grief over unmet expectations. Some mothers feel tremendous shame because they expected motherhood to bring immediate joy and fulfillment but instead feel overwhelmed or emotionally numb.
Spiritual Factors- Postpartum depression can also create spiritual struggles. Mothers may feel abandoned by God,have difficulty praying and doubt God's goodness. They may fear failing as a mother or experience guilt for having negative emotions about the experience of motherhood.
Many Christian mothers wrongly conclude: "If I loved God more, I wouldn't feel this way." Or: "A good Christian mother wouldn't struggle like this." Neither statement is true.
Scripture is filled with godly individuals who experienced profound discouragement, despair, and emotional suffering, including Elijah (1 Kings 19), David (Psalm 42), and Jeremiah (Jeremiah 20). Depression is part of living in a broken world that is not the way God initially intended it to be.
Assessment from a Christian Counseling Perspective
When I counsel a new mother suffering with postpartum depression, I explore several areas of her life, which include her physical health, support system, thought patterns and spiritual condition.
Physical Health. I will ask the new mother about her sleep and nutrition, medical complications, thyroid issues, breastfeeding challenges and any hormonal changes that she may have experienced. I will also encourage her to have a medical evaluation when appropriate. I never assume symptoms are solely spiritual in nature. A medical consultation may be essential.
Support System- I explore the husband's involvement, family support, church support, friendships and practical help in the home. Isolation often intensifies postpartum depression. God designed us to live in community, and I try to find out what her community consists of.
Thought Patterns- I will ask good questions and listen to whether a client has distorted thoughts about herself. I may hear her say: "I am a terrible mother." "Everyone else is handling this better than I am." "My baby deserves someone better." "I should be able to do this on my own." These thoughts often increase guilt and hopelessness.
Spiritual Condition- I gently explore the new mom’s relationship with God and find out about her devotional life, church involvement and whether she understands the gospel of grace. My goal is to always to extend God’s mercy and grace as I help her experience God's comfort in her suffering.
Postpartum Depression Counseling
When counseling a woman struggling with postpartum depression, I believe that she most needs my compassionate presence, for me to come alongside, affirm that what she is experiencing is real, and convey that she is not alone. I see myself as an ambassador for Christ and I seek to show her that I care and, more important, that God cares and has not abandoned her.
Help Her Reject Unrealistic Standards
Many mothers believe they must live up to an unachievable standard, that they must be perfect. Scripture teaches otherwise. Her acceptance before God is based upon Christ's perfect righteousness, not on her performance as a mother. I remind her of what Romans 8:1 reminds all of us: "Therefore, there is now no condemnation for those who are in Christ Jesus." It is good to remember that a mother may be struggling greatly while still being deeply loved by God.
Practical Support and Rest
Sometimes spiritual growth requires practical support, so in our sessions we will assess the mother’s needs and how to best build support. I will encourage her to accept help from others and learn to delegate any tasks she does not have to do personally.
We will discuss ways the new mom can get sleep and be a good steward of herself. This will also include maintaining good nutrition and, if possible, getting outside, and taking short walks.
Connection to Christ
When energy is low, I encourage simple, realistic spiritual practices such doing a short devotional daily and listening to worship music.
Learn to Lament
Many women feel they must hide their pain. The Psalms provide a different model. In Psalm 43 King David demonstrates how believers can honestly bring their sorrow to God: "Why, my soul, are you downcast? Why so disturbed within me? Put your hope in God." Biblical lament allows sufferers to express grief while continuing to trust God. God wants us to know that he understands how hard it is to live in a broken world and he welcomes the prayers of his children who are suffering.
Mobilize the Church
The local church should be a source of practical and emotional support. If possible, I will ask my client to enlarge her circle, which includes getting her church to support her. This might include meal trains, childcare assistance or house cleaning. The women's ministry might be called upon to offer regular check-in times and prayer support; the church often becomes a vital means through which God provides care.
WHEN ADDITIONAL HELP IS NEEDED
If symptoms are severe, persistent, or include thoughts of self-harm, immediate medical and psychiatric evaluation is essential.
To take medication does not indicate a lack of faith it indicates wise stewardship of yourself and your baby. In some cases, antidepressant medication can be a helpful part of comprehensive care while counseling addresses emotional, relational, and spiritual concerns. The prescribing physician will determine whether a breast-feeding mother can take such medication consistent with the baby’s safety.
A Gospel Message for Mothers
Many women with postpartum depression feel like failures, but the gospel tells a different story. Your worth is not determined by how well you are managing motherhood this week. Your identity is not found in being a perfect mother but in belonging to Christ.
Jesus is a compassionate Savior who understands weakness. He says, "A bruised reed he will not break, and a smoldering wick he will not snuff out" (Isaiah 42:3).
Postpartum depression can feel like a dark wilderness, but it does not have the final word. Through God's grace, supportive relationships, wise medical care, and depression therapy, many women experience significant healing and renewed hope. The goal is not perfection but learning to walk through this difficult season with the help of Christ and His people.
You Do Not Have To Walk Alone
If you have a new baby and feel that you might be experiencing postpartum depression, I would like to walk through this dark wilderness with you. Please contact me, Beth Hastings, by clicking the link below. I offer a free 15-minute phone consultation. You will not regret it.