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Postpartum Depression
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Having a baby can be an exciting time and there are a lot of emotions involved. Women can experience joy, elation, fear and excitement. They can also experience depression, often called postpartum depression. Postpartum depression is a step further than the "baby blues" which are common feelings of sadness and mild depression that last a few days after the baby is born but pass quickly. Postpartum depression lasts longer than baby blues and is much more serious. Also very serious is postpartum psychosis-another related condition that involves psychosis as well as depression.
Postpartum depression isn't a mental weakness of any kind. It is just a complication of having a baby. If you have postpartum depression or think you might, you need to get prompt treatment so you can get management of your symptoms and take the best care of your baby that you can.
The signs and symptoms of baby blues include having mood swings, sadness, anxiety, irritability, crying spells, trouble sleeping and decreased concentration. The symptoms last only a few weeks or days.
In postpartum depression, it may look like baby blues in the beginning but the symptoms are more severe and last longer than baby blues. The symptoms can include insomnia, loss of appetite, fatigue, lack of interest in sex, feelings of shame, guilt or inadequacy, lack of joy in life, severe mood swings, problems with family and friends, difficulty bonding with the infant, feelings of wanting to harm the baby and symptoms that last up to a year or more.
In postpartum psychosis, there is confusion, disorientation, paranoia, hallucinations, delusions and attempts to harm yourself or harm the baby. It usually develops within two weeks after delivery and the symptoms are very severe.
You should see the doctor if you have symptoms that last longer than two weeks, symptoms that are worsening, symptoms that interfere with the care of the baby, thoughts of harming yourself or your baby and difficulty completing daily tasks. Seek care immediately if you are developing postpartum psychosis.
Doctors believe that the cause of postpartum depression has something to do with the quickly changing hormones that affect the body after you have a baby. Estrogen and progesterone drop quickly. Thyroid hormones also drop sharply after delivery. You often feel tired, depressed and sluggish. Emotional factors can play a role. You can be anxious about how to take care of a newborn and you may feel distracted and overwhelmed. You are often sleep deprived and these things can contribute to getting postpartum depression. If you have a really demanding lifestyle or difficulty breastfeeding, among other problems in your life, you can become easily depressed.
Some women are genetically more vulnerable than others to coming down with postpartum depression. If you have a first degree relative who has had postpartum depression, you may be at an increased risk of getting it yourself. Increased risk comes if you have had depression in the past. If you have had postpartum depression, you are at increased risk. If you have had recent stressful events or pregnancy complications, you can have an increased chance of having postpartum depression. If you are having relationship problems, you can become depressed after the baby is born. If you have money troubles or an unwanted pregnancy, you can have an increased risk of having postpartum depressive symptoms. If you have bipolar disorder, you can have a greater risk of postpartum psychosis. The symptoms need to begin before four weeks following the birth of the baby.
In order to diagnose baby blues or postpartum depression/psychosis, doctors use the Diagnostic and Statistical Manual or DSM to determine if you qualify as having the disease according to certain criteria. Blood tests are done to check out the status of the thyroid gland.
Treatment depends on whether you have baby blues, postpartum depression or postpartum psychosis. If the problem is baby blues, no treatment besides supportive management is needed in order to help the mother cope until the symptoms pass. In postpartum depression, therapy and medications are used to manage the symptoms. This includes psychotherapy and antidepressant medications. Sometimes estrogen replacement therapy is given to counteract the drop in estrogen after birth. Treatment lasts for several months.
In postpartum psychosis, hospitalization is required along with medications to control depression and psychotic thinking.