Note: All information provided is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

Introduction

Having a baby is stressful no matter how much you’ve looked forward to it or how much you love your child. Considering the sleep deprivation, new responsibilities, and lack of time for you, it’s no surprise that a lot of new moms feel like they’re on an emotional rollercoaster. Postpartum depression is when these feelings don't go away after about 2 weeks or make it hard for a woman to take care of her baby. Postpartum depression is said to affect 1 in 7 women who have just had a baby. It can have an adverse effect on the well-being of both the mother and child; yet 1 in 5 women do not report their symptoms and therefore remain untreated.

In fact, mild depression and mood swings are so common in new mothers, and is termed"baby blues".

Baby blues

The majority of women experience at least some symptoms of the baby blues immediately after childbirth. It’s caused by the sudden change in hormones after delivery, combined with stress, isolation, sleep deprivation, and fatigue. You might feel more tearful, overwhelmed, and emotionally fragile. Generally, this will start within the first couple of days after delivery, peak around one week, and taper off by the end of the second week postpartum.

The baby blues are perfectly normal, but if your symptoms don’t go away after a few weeks or get worse, you may be suffering from postpartum depression.

What is Post-Partum Depression?

“Postpartum” means the time after childbirth. Feeling hopeless or empty after childbirth is not a regular or expected part of being a mother.

Postpartum depression is a serious mental illness that involves the brain and affects your behavior and physical health. If you have depression, then sad, flat, or empty feelings don’t go away and can interfere with your day-to-day life. You might feel unconnected to your baby, as if you are not the baby’s mother, or you might not love or care for the baby. These feelings can be mild to severe.

 

What is the difference between “baby blues” and postpartum depression?

Many women have the baby blues in the first few days after childbirth. If you have the baby blues, you may:

  • Have mood swings
  • Feel sad, anxious, or overwhelmed
  • Have crying spells
  • Lose your appetite
  • Have trouble sleeping

The baby blues usually go away in 3 to 5 days after they start. The symptoms of postpartum depression last longer and are more severe. Postpartum depression peaks 3-4 weeks after delivery, and can last for months.

What is postpartum psychosis?

Postpartum psychosis is rare. It happens in up to 4 new mothers out of every 1,000 births. It usually begins in the first 2-4 days after childbirth and peaks in 2 weeks. It is a medical emergency. Women who have bipolar disorder or another mental health condition called schizo-affective disorder have a higher risk of postpartum psychosis. Symptoms may include:

  • Seeing or hearing things that are not there
  • Feeling confused most of the time
  • Having rapid mood swings within several minutes (for example, crying hysterically, then laughing a lot, followed by extreme sadness)
  • Trying to hurt yourself or your baby
  • Paranoia (thinking that others are focused on harming you or the baby)
  • Restlessness or agitation
  • Behaving recklessly or in a way that is not normal for you

Causes of Post-Partum Depression

There’s no single reason why some new mothers develop postpartum depression and others don’t, but a number of interrelated causes and risk factors are believed to contribute to the problem.

 

  • Hormonal changes: 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 rapid hormonal changes along with the changes in blood pressure, immune system functioning, and metabolism that new mothers experience may trigger postpartum depression.
  • Physical changes: Giving birth brings numerous physical and emotional changes. You may be dealing with physical pain from the delivery or the difficulty of losing the baby weight, leaving you insecure about your physical and sexual attractiveness.
  • Stress: The stress of caring for a newborn can also take a toll. New mothers are often sleep deprived. In addition, you may feel overwhelmed and anxious about your ability to properly care for your baby. These adjustments can be particularly difficult if you’re a first-time mother who must get used to an entirely new identity

What Are the Signs & Symptoms of Postpartum Depression?

Symptoms of postpartum depression can vary from woman to woman. But common signs include:

  • Feeling sad, hopeless, or overwhelmed
  • Feeling worried, scared, or panicked
  • Blaming yourself unnecessarily
  • Crying a lot
  • Feeling moody
  • Anger
  • Sleeping too much or too little
  • Eating too much or too little
  • Trouble concentrating
  • Not wanting to be with friends and family
  • Not feeling attached to the baby
  • Not wanting to do things that usually are enjoyable

Although it is very rare, some women have very serious symptoms such as:

 

  • Thoughts of hurting the baby or themselves
  • Hearing voices, seeing things that are not there, or feeling paranoid (very worried, suspicious, or mistrustful)

Risk Factors

  • You may be more at risk of postpartum depression if you:
  • Have a personal history of depression or bipolar disorder
  • Have a family history of depression or bipolar disorder
  • Do not have support from family and friends
  • Were depressed during pregnancy
  • Had problems with a previous pregnancy or birth
  • Have relationship or money problems
  • Are younger than 20
  • Have alcoholism, use illegal drugs, or have some other problem with drugs
  • Have a baby with special needs
  • Have difficulty breastfeeding
  • Had an unplanned or unwanted pregnancy

What can I do at home to feel better while seeing a doctor for postpartum depression?

Here are some ways to begin feeling better or getting more rest, in addition to talking to a health care professional:

  • Rest as much as you can. Sleep when the baby is sleeping.
  • Don’t try to do too much or to do everything by yourself. Ask your partner, family, and friends for help.
  • Make time to go out, visit friends, or spend time alone with your partner.
  • Talk about your feelings with your partner, supportive family members, and friends.
  • Talk with other mothers so that you can learn from their experiences.
  • Join a support group. Ask your doctor or nurse about groups in your area.

Don’t make any major life changes right after giving birth. More major life changes in addition to a new baby can cause unneeded stress. Sometimes big changes can’t be avoided. When that happens, try to arrange support and help in your new situation ahead of time.

It can also help to have a partner, a friend, or another caregiver who can help take care of the baby while you are depressed. If you are feeling depressed during pregnancy or after having a baby, don’t suffer alone. Tell a loved one and call your doctor right away.

How Is Postpartum Depression Treated?

Treatment for postpartum depression can vary. It might include:

  • Counseling
  • Improving self care (getting enough sleep, eating well, exercising, and taking time to relax)
  • Getting more support by joining a group or talking (by phone or online) with others going through postpartum depression
  • Taking medicine. There are medicines that are safe to take while breastfeeding.

References

  1. Postpartum Depression – Difference between the baby blues and postpartum depression. (KidsHealth)
  2. Depression During and After Pregnancy – Including possible causes. (Womenshealth.gov)
  3. https://kidshealth.org/en/parents/ppd.html
  4. Sit, D.K., Wisner, K.L. (2009). The Identification of Postpartum Depression. Clinical Obstetrics and Gynecology; 52(3): 456–468.
  5. Alhusen, J.L., Alvarez, C. (2016). Perinatal depression. The Nurse Practitioner; 41(5): 50–55.
  6. Korhonen, M., Luoma, I., Salmelin, R., Tamminen, T. (2014). Maternal depressive symptoms: Associations with adolescents' internalizing and externalizing problems and social competence. Nordic Journal of Psychiatry; 68(5): 323–332.

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