Postpartum Depression and Eating Disorders

Many new parents experience a rollercoaster of emotional highs and lows, new unexpected challenges, and changes to self-care that can have an impact on their mental health. Many suffer in silence when the severity of their symptoms increase due to shame, fear of judgement, not being believed, or perhaps not noticing just how bad things have gotten. According to Postpartum Support International, Postpartum Depression (PPD) is a mental health condition that affects about 1 in 7 new parents, and 1 in 10 experience depression while pregnant. There is help out there and you don’t have to go through this alone.

When someone has a history of eating disorders, disordered eating, or chronic dieting, experiencing PPD can increase the risk of relapse back into these eating patterns. Some may return to old behaviors because their coping mechanisms may become overtaxed or they aren’t as effective in dealing with these new life circumstances. In general, people turn to various food behaviors to deal with difficult situations, strong emotions, life and identity changes, and navigating uncharted territories. These behaviors tend to serve a purpose until they eventually cause more harm than they help. It is important to find support with professionals who specialize in eating disorders and PPD as soon as possible.

Postpartum Eating Disorders

Eating disorders are influenced by a variety of factors including genetic, psychosocial, environmental, and physical changes. The postpartum period can create a “perfect storm” for those susceptible to developing eating disorders as risk factors are experienced through dramatic physical, emotional, social, and psychological changes.

Physically, someone may be learning to accept a transformed body. This is no easy task due to cultural messages and internalized pressure to “get your body back”, “lose the baby weight”, the belief that weight loss is desirable in order to “feel better”, and that diet products are a solution to “fix” a postpartum body. These types of messages add to internalized shame and body dissatisfaction. Social media can also amplify the tendency to compare yourself to other new parents which can increase the urge to diet and exercise. It can make it difficult to connect with and listen to their body’s needs. This can reinforce behaviors that can be triggering during this vulnerable time period, especially for people predisposed to eating disorders and/or mood disorders.

New parents may be experiencing a sudden shift in hormones and sleep deprivation, taxing the body in new ways. Many are distanced from their social circles and close relationships are sometimes strained by the demands of a newborn. Psychologically, a history of trauma, abuse, loss of income, or other mental health issues can increase the risk of postpartum eating disorders. This can all be a sudden and drastic change, and it’s understandable why so many develop various eating and mood disorders at this time.

Eating Patterns or Behaviors to Look Out For

  • Restricting calorie intake
  • Restricting types of food for non-medical reasons (carbohydrates, sugar, processed foods)
  • Following a diet program
  • Obsessing over weight
  • Frequently weighing in
  • Rigidly tracking and/or counting calories, macronutrients, points
  • Binge eating food
  • Compulsive and/or emotional eating frequently
  • Attempting to “get rid” of food after eating, such as through self-induced vomiting or overexercising

Postpartum Depression

Likewise, having a history of an eating disorder has also been shown to increase the likelihood of developing postpartum depression. This is particularly true for women with histories of bulimia nervosa or binge eating disorder. Transitioning into postpartum can bring to light many vulnerabilities that influence abnormal eating habits related to an eating disorder. New parents may face a combination of unique psychological stressors and body image concerns that can exacerbate both eating disorder symptoms as well as postpartum mood disorders, like PPD. Research has found that body dissatisfaction at nine months postpartum has been associated with ‘overeating’ or poor appetite, decreased mental health, and fewer immediate family relationships.

In the face of isolation, shame, guilt, and postpartum depression, an eating disorder can be like an old friend that provides temporary relief, distraction, or comfort. Like any toxic relationship, the consequences resulting from engaging in an eating disorder can be damaging, even fatal. Yet a new parent who feels like they have nowhere to turn for help or support and is stigmatized by mental health challenges may turn inward, internalizing their own pain and struggle. You don’t have to go through this alone, there is help and support out there.

Signs and Symptoms to Look Out For in the First Year

  • Crying and sadness
  • Guilt, shame, and hopelessness
  • Loss of interest or pleasure in things you used to enjoy
  • Lack of interest in the baby
  • Irritable or angry
  • Appetite changes and trouble sleeping
  • Thinking about harming the baby

Reaching Out For Help and Support

In the face of a healthcare system that offers so little resources for new parents during the postpartum period, it is important to be aware of and advocate for help and care when needed. Given the lack of professional support for women postpartum, many mothers go under the radar with severe mental health issues. This can create long-lasting complications and it is not your fault. Screening for eating disorders among those who are identified to have postpartum depression or vice versa can be helpful with early intervention.

For a new parent transitioning into postpartum, it is critical to be aware of any red flags that indicate something might not be right. Be an advocate for yourself by reaching out for help and support. If you have a history of an eating disorder, consider setting yourself up with a multidisciplinary support team during pregnancy if possible and especially when postpartum. This might include a therapist and dietitian who specializes in eating disorders, a psychiatrist, and/or support group.

Some treatment approaches that may be helpful for postpartum mothers struggling with both PPD and an eating disorder may include the following:

If you find yourself experiencing urges to engage in eating disorder behaviors or are having any signs/symptoms associated with PPD, reach out for immediate help and care.

 

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Additional Reading

Eating Disorders And Pregnancy
Why Dieting Doesn’t Work
Eating Disorders and Dual Diagnosis or Co-Occurring Disorders
The Media And Body Image
Trauma and Eating Disorders
Support Groups For Eating Disorders
The 8 Keys To Recovery From An Eating Disorder – By Carolyn Costin
Intuitive Eating – By Evelyn Tribole and Elyse Resch
Sick Enough – By Dr. Jennifer L. Gaudiani
Postpartum Support International

References

Mazzeo, S. E., Slof-Op’t Landt, M. C.T., Jones, I., Mitchell, K., Kendler, K. S., Neale, M. C., Aggen, S. H. and Bulik, C. M. (2006), Associations among postpartum depression, eating disorders, and perfectionism in a population-based sample of adult women. Int. J. Eat. Disord., 39: 202–211. doi:10.1002/eat.20243

Astrachan-Fletcher, Ellen, et al. (2008), The Reciprocal Effects of Eating Disorders and the Postpartum Period: A Review of the Literature and Recommendations for Clinical Care. Journal of Women’s health. 17(2): 227-239.

Gjerdingen, D., Fontaine, P., Crow, S., McGovern, P., Center, B., & Miner, M. (2009). Predictors of Mothers’ Postpartum Body Dissatisfaction. Women & Health, 49(6), 491–504.

About The Author

Crystal Karges, MS, RDN, IBCLC, is a Registered Dietitian Nutritionist, Board Certified Lactation Consultant, and mother of five. With an online nutrition practice, Crystal helps mothers and their families nurture a peaceful relationship with food and their bodies to experience the abundance of motherhood and truly thrive in life.

Written – 2020

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