The Hardest Adjustment: Recognizing Postpartum Depression in Teen Mothers

Anxiety, helplessness or anger might not seem like the typical experience of a new mother, but postpartum depression afflicts between 12 and 20 percent of moms in the United States. Symptoms usually appear within two months of giving birth, and it’s still hard for doctors to predict which women will suffer from them.

What’s more, teen mothers are almost twice as likely as adults to experience postpartum depression, according to the Centers for Disease Control and Prevention. Family and youth workers should therefore be able to recognize and treat postpartum depression in their pregnant or parenting clients.

Many of the risk factors for the condition overlap with those for teen pregnancy. “The risks associated with teen pregnancy are often associated with social circumstances and the complicated lives that teens live,” says Maureen Phipps, a lead researcher and obstetrician-gynecologist at Women and Infants Hospital in Providence, RI. Young women who become pregnant tend to have poor bonding with their own parents, limited access to health services and less-than-ideal medical care when they do obtain services. All of these are risk factors for postpartum depression.

Prevention and Warning Signs

Since 2007, Phipps has been leading Project Reach, a research program aimed at finding ways to prevent postpartum depression in this high-risk population. Trained interventionists meet with pregnant teens for five weekly sessions of interpersonal therapy, discussing topics such as communication, support networks, how to solicit support from friends and family, and goal setting.

Only 12.5 percent of participants receiving specialized counseling experienced postpartum depression during the program’s pilot period, Phipps says, compared with 25 percent in the control group. A second study is currently underway.

This approach rings true for Kelli Strickland, a facility social worker at Mary’s Shelter in Santa Ana, CA. During their intake process, Strickland and her colleagues try to attain psychological and medical histories from clients’ past providers and screen for existing depression. For any maternity group homes looking for an evidence-based screening tool, Phipps recommends the Edinburgh Depression Scale (EPDS).

Strickland and her colleagues look out for a few common symptoms of postpartum depression:

Lack of maternal attachment: “We look for how quickly they get up to help their baby in the night. And more generally, the depressed girls have a harder time meeting the needs of their baby.”

Isolation: “If they’re staying in their bedroom, that’s a concerning sign. If the girls start to insist that they want to feed in their rooms, it can be an indicator.”

Utilize the Group Setting and Teenagers’ Natural Resiliency

Indeed, Strickland says that the group setting and social activities in a maternity shelter can help ward off postpartum depression symptoms. Mary’s Shelter staff push the following activities:

Social Parenting:  The organization builds in several practices to help young mothers build comfort and confidence in their parenting skills. For example, “The girls have to come out to the living room to feed their babies to make sure that the babies are being fed often enough and correctly,” Strickland says. “They also take part in parenting classes together every week in addition to individual weekly therapy sessions.”

Resiliency: Strickland also praises the young mother’s ability to balance parenting with school, all while looking ahead to the life they hope to create for their family. “They keep hoping and planning for the future even when nothing about their childhood has been what a childhood should be,” she says. “And so many of them are such naturally wonderful moms, before they’re developmentally ready.”

Maureen Phipps agrees, saying that her goal with Project Reach is to build on teenagers’ emotional resiliency. “Pregnancy adds another dimension of risk for depression,” she says.  “But in teens, there’s a lot of resiliency there. We’re trying to help them build a social support network to lean on when things get hard.”