POSTPARTUM DEPRESSION

OVERVIEW

Postpartum depression (also called postnatal depression) is a type of depression that certain women will experience after they have had a baby.  Onset of postpartum depression is usually within the first 6 weeks of giving birth, but some women may not develop it for several months.

Giving birth to a baby is a time of immense joy and happiness, and brings with it a deluge of emotions. Unfortunately, for some people, one of these reactions can be depression. Many new mothers may experience low mood, mood swings, crying spells and anxiety, understandably as childbirth is a difficult and taxing process. These changes and reactions are referred to as postpartum blues, and typically begin within the first 2-3 days after delivery, lasting up to 2 weeks in some cases.

For some mothers, however, the process maybe more severe and long lasting, with very low mood and severe anxiety. This spectrum falls under the category of postpartum depression. In very rare cases, an extreme mood disorder caused postpartum psychosis may occur after childbirth.

There’s no single cause of postpartum depression, but physical and emotional issues may play a role.

  • Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.

 

  • Emotional issues. When you’re sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity or feel that you’ve lost control over your life.

SIGNS AND SYMPTOMS

Signs and symptoms of postpartum depression may vary from woman to woman, but will mainly include the following:

Immediately after giving birth (2-3 days) low mood, crying without apparent reason, sadness, irritability, feeling overwhelmed and anxiety will surface. Although the signs resemble baby blues, they are much more severe and last longer.

Other symptoms may also include:

depressed mood with severe mood swings

excessive crying

difficulty bonding with the baby

withdrawing from friends and family

deviation from normal eating habits

sleeping much more or a lot less than usual

feelings of worthlessness, guilt, shame or inadequacy

thought of harming yourself or the child

recurrent thoughts of suicide

 

Postpartum psychosis occurs within the first week after birth, and signs and symptoms may be even more severe, including:

confusion and disorientation

obsessive thoughts about your baby

paranoia

delusions and hallucinations

attempts to harm yourself or the baby

postpartum psychosis is a medical emergency and immediate treatment should be sought by patient or relative/friend who suspects it in their patient.

 

MANAGEMENT

Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.

  • For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression.
  • For fathers. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s father may also increase. And new dads are already at increased risk of depression, whether or not their partner is affected.
  • For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and attention-deficit/hyperactivity disorder (ADHD). Delays in language development are more common as well.

Treatment and recovery time vary, depending on the severity of your depression and your individual needs. If you have an under-active thyroid or an underlying illness, your doctor may treat those conditions alongside the management of other symptoms.

Baby blues

The baby blues usually fade on their own within a few days to one to two weeks. In the meantime:

  • Get as much rest as you can
  • Accept help from family and friends
  • Connect with other new moms
  • Create time to take care of yourself
  • Avoid alcohol and recreational drugs, which can make mood swings worse

Postpartum depression

Postpartum depression is often treated with psychotherapy (also called talk therapy or mental health counseling), medication or both.

Psychotherapy. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health provider. Through therapy, you can find better ways to cope with your feelings, solve problems, set realistic goals and respond to situations in a positive way. Sometimes family or relationship therapy also helps.

Antidepressants. Your doctor may recommend an antidepressant. If you’re breast-feeding, any medication you take will enter your breast milk. However, some antidepressants can be used during breast-feeding with little risk of side effects for your baby.

Dr. Annie

Physician, mom and wife

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