>> Postpartum Depression
Weepiness and mood swings are so common in new moms
that this emotional rollercoaster has its own name
- the baby blues. These feelings are perfectly normal
and usually dissipate after a few weeks.
Postpartum depression, on the other hand, is a more
serious condition that can interfere with your ability
to take care of yourself and your newborn child. But
with treatment, the support of your family, and attention
to your own needs, you can get back on the road to
healthy and happy motherhood.
THE BABY BLUES
You’ve just had a baby. You expected to be basking
in new mom bliss. You expected to be celebrating the
arrival of your little one with your friends and family.
But instead of celebrating, you feel like crying.
You were prepared for joy and excitement—not
exhaustion, anxiety, and weepiness. You may not have
been expecting it, but mild depression and mood swings
are common in new mothers. In fact, this post-delivery
depression is so common that it has its own name:
the baby blues. Up to 85% of new mothers experience
the baby blues. In addition to moodiness and sadness,
the baby blues can include difficulty sleeping, irritability,
appetite changes, and concentration problems. Symptoms
typically show up within a few days of giving birth
and last from several days to a couple of weeks.
The baby blues are considered to be a normal part
of new motherhood—probably caused by the hormonal
changes that occur following birth. If you have them,
there is no cause for undue worry. The baby blues
usually don’t last very long and will go away
on their own once your hormones level out. Aside from
the support of your loved ones and plenty of rest,
no treatment is necessary. However, if your symptoms
don’t go away within two to three weeks, or
they are severe (such as suicidal thoughts or an inability
to care for your newborn), you may be suffering from
a more serious condition known as postpartum depression.
According to the American College of Obstetricians
and Gynecologists, approximately 10% of women who
have just given birth experience postpartum depression.
SIGNS AND SYMPTOMS OF POSTPARTUM
In the beginning, postpartum depression can look like
the normal baby blues. In fact, they share many symptoms,
including mood swings, crying jags, sadness, insomnia,
and irritability. However, in postpartum depression,
these symptoms are either longer lasting or more severe.
Anxiety is also more prominent in postpartum depression.
If you have postpartum depression, you may worry to
excess over your baby’s health and well-being.
In addition to obsessing over the safety of your newborn,
you may be troubled by intrusive thoughts about harming
|Signs and Symptoms of
- Lack of interest in your baby
- Negative feelings towards your baby
- Worrying about hurting your baby
- Lack of concern for yourself
- Loss of pleasure
- Lack of energy and motivation
- Feelings of worthlessness and guilt
- Changes in appetite or weight
- Sleeping more or less than usual
- Recurrent thoughts of death or suicide
Postpartum depression usually sets in soon after childbirth
and develops gradually over a period of several months.
But postpartum depression can also come on suddenly,
and in some women, the first signs don’t appear
until months after they’ve given birth. Because
of the possibility of delayed onset, if you have a
depressive episode within six months of having a baby,
postpartum depression should be considered.
POSTPARTUM DEPRESSION CAUSES
AND RISK FACTORS
The exact reasons why some new mothers develop postpartum
depression and others don’t are unknown. But
a number of interrelated causes and risk factors are
believed to contribute to the problem.
The rapid hormonal changes that accompany pregnancy
and delivery may trigger depression. After childbirth,
women experience a big drop in estrogen and progesterone
hormone levels. Thyroid levels can also drop, which
leads to fatigue and depression. These hormone dips—along
with the changes in blood pressure, immune system
functioning, and metabolism that new mothers experience—can
all play a part in postpartum depression. It has been
theorized that women who are more sensitive to these
hormone imbalances develop postpartum depression.
Women who have just given birth are also dealing with
numerous changes, both physical and emotional. They
may still be coping with physical pain from the pregnancy
and delivery. They may also have difficulties losing
the baby weight, leading to insecurities about their
physical and sexual attractiveness. In addition to
changes to their body, they are also dealing with
lifestyle changes. The lifestyle adjustment can be
particularly difficult for first time moms, who must
get used to an entirely new identity. The stress of
caring for a newborn can also take a toll. New mothers
are often sleep deprived. In addition, they may feel
overwhelmed and anxious about their ability to properly
care for their baby. All of these factors can contribute
to and trigger postpartum depression.
Women with a previous history of depression are at
an increased risk of experiencing postpartum depression.
Your risk is also elevated if you have a history of
severe PMS or premenstrual dysphoric disorder, if
the pregnancy was unplanned, or if you had postpartum
depression following a previous pregnancy. According
to the National Institute of Mental Health, women
with a prior history of postpartum depression have
a 50% chance of recurrence.
Stressful events during pregnancy or birth also increase
the odds of developing postpartum depression. Stressful
events might include a difficult delivery, prenatal
problems, premature birth, or illness during pregnancy.
Finally, research has shown that women with marital
difficulties or a general lack of social support have
a greater chance of developing postpartum depression.
If you’ve recently given birth and have one
or more of these risk factors, it is especially important
to be on the lookout for any signs or symptoms of
HOW POSTPARTUM DEPRESSION
AFFECTS THE BABY
Postpartum depression can interfere with your ability
to function, including your ability to take care of
yourself and your child. If you have postpartum depression,
it doesn’t mean that you’re a bad mother.
However, when you’re consumed with symptoms
of depression such as fatigue, irritability, apathy,
and tearfulness, it is difficult—if not impossible—to
properly look after your newborn’s needs. Your
baby will be affected if the depression is left untreated.
|The Impact of Postpartum
Depression on Children
||Children of depressed mothers are more likely
to develop behavioral problems down the line,
including sleep problems, temper tantrums, aggression,
|Delays in cognitive development
||Development is often delayed in babies and
children who have depressed mothers. They may
learn to walk and talk later than other children.
They may also have many other learning difficulties,
including problems with school.
||Children of depressed mothers have difficulty
establishing secure relationships. They may
find it hard to make friends in school. They
may be socially withdrawn, or they may act out
in destructive ways.
||Studies have shown that children of depressed
mothers have lower self-esteem, are more anxious
and fearful, are more passive, and are less
||The risk of developing major depression early
in life is particularly high for the children
of mothers with postpartum depression.
If you’re suffering from postpartum depression,
there is no reason to feel guilty or ashamed. The
symptoms of postpartum depression are outside your
control, and they don’t make you a bad person
or a bad parent. However, the choice to get treatment
is in your control. Considering the impact depression
has on both you and your child, it’s important
to seek help right away.
POSTPARTUM DEPRESSION AND
Research has shown that depressed mothers interact
less with their babies. Women with postpartum depression
are less likely to breastfeed, play with, and read
to their children. They may also be inconsistent in
the way they care for their newborns. Depressed mothers
can be loving and attentive at times, but at other
times they may react negatively or they may not respond
at all. This inconsistency disrupts the bonding process
between mother and child. This emotional bonding process,
known as attachment, is the most important task of
infancy. As the Canadian Paediatric
states, “Attachment helps provide
a solid base from which a baby can explore the world.
It makes a baby feel safe and secure, and helps them
learn to trust other people.”
A secure attachment is formed when the mother responds
warmly and consistently to her baby’s physical
and emotional needs. When the baby cries, the mother
quickly soothes him or her. If the baby laughs or
smiles, the mother responds in kind. In essence, the
mother and child are in synch. They recognize and
respond to each other’s signals. But a depressed
mother is less likely to pick up on and respond to
her baby’s cues. This sets the stage for an
insecure attachment. A child who is insecurely attached
is at risk for multiple developmental difficulties
and delays, including behavioral, emotional, and social
TREATMENT AND HELP FOR POSTPARTUM
If you have postpartum depression, you should seek
professional treatment. Left untreated, postpartum
depression can last for a significant length of time—even
up to a year or more. Postpartum depression responds
to the same types of treatment as regular depression.
Therapy, medication, and support groups can all be
COPING WITH POSTPARTUM
- Psychotherapy –
Individual therapy or group therapy can
be very effective in the treatment of postpartum
depression. Psychotherapy is often the treatment
of choice because of concerns over taking
medication while breastfeeding. Interpersonal
therapy (IPT), which focuses on interpersonal
relationships and issues, is believed to
be particularly effective for postpartum
- Hormone therapy –
Estrogen replacement therapy sometimes helps
with postpartum depression. Estrogen is
often used in combination with an antidepressant.
There are risks that go along with hormone
therapy, so be sure to talk to your doctor
about what is best—and safest—for
- Marriage counseling
– If you are experiencing martial
difficulties or are feeling unsupported
at home, marriage counseling could be very
- Antidepressants –
For severe cases of postpartum depression
where the mother is unable to care for herself
or her baby, the use of antidepressants
should be considered. Antidepressants commonly
used for postpartum depression include tricyclic
antidepressants and selective serotonin
reuptake inhibitors (SSRIs) such as Prozac.
Please consult your physician before
beginning any medication.
The best thing you can do if you have postpartum depression
is to take care of yourself. Be sure to get enough
rest, get out in the sunshine each day, and eat a
healthy diet. Set aside quality time for yourself
to relax and take a break from your mom duties.
Self-help for postpartum depression
- Find someone you can talk to about your
- Find people who can help you with child
care, housework, and errands so you can
get some much needed rest.
- Make time for yourself every day, even
if it’s only for 15 minutes. Do something
relaxing or that makes you feel good about
- Keep a daily diary of your emotions and
thoughts. This is a good way to let everything
out and to keep track of your progress as
you begin to feel better.
- Give yourself credit for the things you’re
able to accomplish, even if you only get
one thing done in a day. If you aren’t
able to get anything done, don’t be
hard on yourself.
- Give yourself permission to feel overwhelmed.
- Remember that no one expects you to be
- Be honest about how much you can do and
ask others for help.
- Join a support group.
Source: American Academy of Family Physicians
It’s also important to stay connected to family
and friends. Don’t keep your feelings to yourself.
Share them with your significant other or a close
friend. Let your loved ones know what you need and
how you’d like to be supported.
Helping a loved one with postpartum depression
If your loved one is experiencing postpartum depression,
the best thing you can do is to offer support. Give
her a break from her childcare duties, provide a listening
ear, and be patient and understanding.
You also need to take care of yourself. Dealing with
the needs of a new baby is hard for fathers as well
as mothers. And if your significant other is depressed,
you are dealing with two major stressors.
Postpartum psychosis is a rare, but extremely serious
disorder that can develop after childbirth. It is
characterized by loss of contact with reality. Postpartum
psychosis should be considered a medical emergency.
Because of the high risk for suicide or infanticide,
hospitalization is usually required to keep the mother
and the baby safe.
Postpartum psychosis develops suddenly, usually within
the first two weeks after delivery, and sometimes
within 48 hours.
- Hallucinations (seeing things that aren’t
real or hearing voices)
- Delusions (paranoid and irrational beliefs)
- Extreme agitation and anxiety
- Confusion and disorientation
- Rapid mood swings
- Bizarre behavior
- Inability or refusal to eat or sleep
- Suicidal thoughts or actions
- Thoughts of harming or killing the baby
Early warning signs of postpartum psychosis include
an inability to sleep for several nights, agitation,
euphoria or irritability, and avoidance of the baby.
Women with a history of bipolar disorder are at an
increased risk of developing postpartum psychosis.
In fact, postpartum psychosis resembles a manic episode.
Women who have previously had postpartum psychosis
are also highly likely to develop it again if they
have another child.
Melinda Smith and Jaelline Jaffe, Ph.D. contributed
to this article. Reviewed by Jeanne Segal, Ph.D. Last
modified on 11/15/07.
Reprinted with permission from http://www.helpguide.org/.
C 2008 Helpguide.org. All rights reserved.
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