Postpartum Depression

The weeks and months after having a baby, while portrayed as a blissful, sweet and joyful time, often more resemble a boot camp for mothers. Hormonal changes, a life that now revolves around feedings, diaper changes and crying compounded by a lack of sleep can make this experience difficult for the most patient of mothers. Postpartum depression can make adjusting to motherhood even more difficult. It is estimated that approximately 10-15% of women will develop a major depression during the postpartum period. This can be effectively treated but if the symptoms are not recognized they can worsen and persist.

Postpartum blues is a common and mild condition affecting many new mothers. It is characterized by sudden mood changes from extreme happiness to intense sadness. The symptoms may last for hours or for a couple of weeks after delivery. Mothers may note crying for no reason, irritability, anxiety, impatience, low self esteem, sadness, loneliness and increased sensitivity. The symptoms of post partum blues are mild and resolve without treatment.

Post partum depression is characterized by similar symptoms as post partum blues but they are much more severe. Intense feelings of sadness, despair, anxiety and irritability are severe enough to interfere with daily functioning. Women with postpartum depression may have changes in eating habits, loss of appetite or overeating, difficulty sleeping, extreme exhaustion, difficulty concentrating or making even simple decisions and a lack of pleasure in any activities. Physical symptoms such as headaches or unexplained abdominal pain may also be a sign of depression. Mothers suffering from postpartum depression may show an excessive concern over the baby or conversely appear disinterested in caring for the baby. Thoughts of suicide or homicide occur in approximately 30% of women with postpartum depression.

Postpartum psychosis is a less common form of postpartum depression. Women with postpartum psychosis lose touch with reality experiencing hallucinations or delusions. They may exhibit bizarre feelings and behaviors. The delusions may involve the newborn and tragic outcomes have occurred in women with untreated or inadequately treated postpartum psychosis. If post partum psychosis is suspected women should get immediate medical care, hospitalization is usually required to treat and protect the affected mother.

The causes of postpartum depression are likely a combination of hormonal, physical, psychological and environmental factors. After a baby is born levels of estrogen and progesterone plunge to even lower levels than before pregnancy. Fatigue and inadequate rest are almost universal among new mothers. Mothers may find their new responsibilities to be overwhelming. Stress is far too pervasive in our culture, either that from home, work and societal pressures or a perceived need to be the "perfect mother." Despite the gain of a desired baby, many mothers have feelings of loss, which can be of their former identity, of control, their figure, their time or physical attractiveness.

Although any woman can develop postpartum depression women with a prior history of depression (postpartum, during pregnancy or before pregnancy) or a family history of depression are at increased risk. Other factors that may contribute to postpartum depression include poor social support, family instability, young age, unplanned pregnancies, being a victim of abuse, low self esteem and having a baby with health problems or perceived as a "difficult baby."

Treatment for postpartum depression begins with its recognition. Women and their family members should be encouraged to call their physicians if they are experiencing any of the symptoms of depression or excessive anxiety. The postpartum checkup is a time when all new mothers can be screened for signs of postpartum depression. In fact, hospitals are having mothers set up their postpartum appointment before they are discharged from the hospital. Once postpartum depression is diagnosed it can be treated with counseling and/or medications. Peer support groups, group or individual therapy or psychotherapy may all be useful. Anti-depressant medications are also used.

Emotional support from husbands, partners, family and friends is important for all new mothers. Offers to help with household chores are usually appreciated. New mothers need to rest and should try to nap when their baby does. If typical amounts of support do not seem to be helping a new mother cope with the demands of the postpartum period depression should be considered. Contact Jordan Call 1-800-750-5343 for more information about the resources available locally for mothers suffering from postpartum depression.