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Postpartum Depression

Whether you're becoming a mom for the first time or the fourth, the days and weeks after your baby's birth can be as overwhelming as they are joyful and exciting.

Many women have feelings of sadness after childbirth, ranging from brief, mild baby blues to the longer-lasting, deeper depression known as postpartum depression.

Feelings of sadness and depression are more common after childbirth than many people realize. It's important for new mothers — and those who love them — to understand the symptoms of postpartum depression and to reach out to family, friends, and medical professionals for help.

With support and treatment, new mothers with depression can go on to be healthy, happy parents.

What Are the Baby Blues?

Most new moms have something called the baby blues, feelings of sadness and worry that begin in the first days after childbirth. With the baby blues, a woman might feel happy one minute and tearful or overwhelmed the next. She might feel sad, blue, irritable, discouraged, unhappy, tired, or moody. Baby blues usually last only a few days or a week or two.

Why It Happens

These mood changes are believed to be a natural effect of the hormone shifts that happen with pregnancy and childbirth. Levels of estrogen and progesterone that increased during pregnancy drop suddenly after delivery, and this can affect mood. These hormones return to their pre-pregnancy levels within a week or so. As they do, baby blues usually gets better without medical treatment.

What to Do

Rest, nutrition, and support are quite important because being exhausted, sleep deprived, or feeling stressed can make feelings of sadness and depression worse.

To cope with baby blues, new moms should accept help in the first days and weeks after labor and delivery. Let family and friends help with errands, food shopping, household chores, or child care. Let someone prepare a meal or watch the baby while you relax with a shower, bath, or a nap.

Get plenty of rest and eat nutritious foods. Talking to people close to you, or to other new mothers, can help you feel supported and remind you that you're not alone. You don't have to stifle the tears if you feel the need to cry a bit — but try not to dwell on sad thoughts. Let the baby blues run their course and pass.

When to Call the Doctor

If baby blues linger longer than a week or two, talk to your doctor to discuss whether postpartum depression may be the cause of your emotional lows.

What Is Postpartum Depression?

For some women, the feelings of sadness or exhaustion run deeper and last longer than baby blues. The symptoms of postpartum depression are triggered by childbirth.

Postpartum depression can start shortly before birth or any time up to 12 months after birth.

A woman with postpartum depression may feel sad, tearful, anxious, cranky, discouraged, hopeless, worthless, or alone. She also may:

  • have trouble concentrating or completing routine tasks
  • lose her appetite or not feel interested in food
  • feel like she is not a good mother
  • lack interest in her baby or feel anxious about the baby's health
  • feel overwhelmed by her situation and feel that there's no hope of things getting better

Feelings and thoughts like these are painful for a woman — especially during a time that is supposed to be happy. Many women are reluctant to tell someone when they feel this way. But postpartum depression is a medical condition that requires attention and treatment.

Why It Happens

Like baby blues, postpartum depression is thought to be related to the hormone changes that happen during and after birth. These rapid hormone shifts can lead to sadness, anxiety, and depression that is more severe and lasts longer than baby blues.

Postpartum depression can affect any woman — but some may be more at risk for developing it. Women who have a history of depression (including postpartum depression with a previous pregnancy) or who have a family history of depression are more likely to get postpartum depression.

Other things that might increase the chance of postpartum depression include serious stress during the pregnancy, medical problems during the pregnancy or after birth, and lack of support at home.

When to Call the Doctor

If feelings of sadness or depression are strong, if they last throughout most of the day for days in a row, or if they last longer than a week or two, talk to your doctor. A new mother who feels like giving up, who feels that life is not worth living, or who has thoughts of hurting herself or her child needs to tell her doctor right away.

Postpartum depression can last for several months or even longer if it not treated. With treatment, a woman can feel like herself again. Treatment may include talk therapy, medication, or both. In addition, eating a  healthy diet, getting exercise and enough rest, and finding social support can be very helpful.

It may take several weeks for a woman to begin to feel better once she is being treated for depression, though some begin to feel better sooner. Ask your doctor about how soon to expect improvements and ways to take care of yourself in the meantime.

What Is Postpartum Psychosis?

A more serious and rare condition is postpartum psychosis. It may include hallucinations, such as hearing voices or seeing things that are not there, feelings of paranoia, severe insomnia, and bizarre behavior.

With postpartum psychosis, a woman can have irrational ideas about her baby — such as that the baby is possessed or that she has to hurt herself or her child. This condition is extremely serious, and new mothers who have these psychotic symptoms need medical attention right away.

Why It Happens

Women who have other psychiatric illnesses, such as bipolar disorder or schizophrenia, may be at greater risk for developing postpartum psychosis.

When to Call the Doctor

Postpartum psychosis requires immediate medical attention and, often, hospitalization. If you or someone you know is having symptoms, get medical help right away.

How Can I Get Help?

Tell your doctor if you're having trouble with postpartum moods, thoughts, or feelings. Let someone else you trust know too. This might be your partner, a friend, or a family member. This is a time to reach out and accept help and support from people close to you.

Besides getting treatment for postpartum depression, small things you do can make it easier to get through a difficult time. You might find it helpful to:

  • Take time for yourself. Schedule a babysitter for a regular time. This way you'll be sure to get time for yourself and know that it's coming.
  • Focus on little things to look forward to during the day. This might be a hot shower, relaxing bath, walk around the block, or visit with a friend.
  • Read something uplifting. Depression may make it difficult to concentrate, so choose something light and positive that can be read a bit at a time.
  • Indulge in other simple pleasures. Page through a magazine, listen to music you enjoy, sip a cup of tea.
  • Be with others. Create opportunities to spend time with other adults, like family and friends, who can provide some comfort and good company.
  • Ask for help. Don't shy away from asking for emotional support or help with caring for the baby or tackling household chores.
  • Accept help. Accepting help doesn't make you helpless — by reaching out, you help yourself and your baby.
  • Rest. Give your child a quiet place to sleep, and try to rest when the baby does.
  • Get moving. A daily walk can help lift mood. (Check with your doctor before starting any new exercise program.)
  • Be patient. Know that it may take time to feel better and take one day at a time.
  • Be optimistic. Try to think of small things you're grateful for.
  • Join a support group. Ask your doctor or women's center about resources in your community.

How Can I Help Someone With Postpartum Depression?

If you're concerned that your partner or someone else you know has postpartum depression, it's important to encourage her to talk to her doctor and to a mental health professional. Sometimes a woman is reluctant to seek help or may not recognize her own symptoms right away.

Consider giving the new mom some information on postpartum depression, and offer to read through it together. You might offer to make an appointment for her and go with her if she wants.

Once she's receiving the care she needs, support, love, and friendship are good medicine, too. Here are a few things that you can continue do for her:

  • Check in with her regularly to see how she's doing.
  • Listen when she wants to talk.
  • Go for a walk with her.
  • Make her a nutritious meal.
  • Give her some breaks from housework and childcare responsibilities.
  • Let her take a nap or a relaxing bath while you care for her baby.
  • Be patient, be kind.
  • Believe in her — and remind her of her true qualities and strengths.

Looking Ahead

Like all forms of depression, postpartum depression creates a cloud of negative feelings and thoughts over a woman's view of herself, those around her, her situation, and the future.

With the right treatment and support, the cloud can be lifted. This can free a woman to feel like herself again, to regain her perspective and sense of her own strength, her energy, her joy, and her hope. With those things in place, it's easier to work with changes, to see solutions to life's challenges, and to enjoy life's pleasures again.

Reviewed by: Mary L. Gavin, MD
Date Reviewed: 05-01-2018

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