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- What is Postpartum Depression?
- Diagnosing Postpartum Depression
- What Causes Postpartum Depression?
- Help for Postpartum Depression
- More Information on Postpartum Depression
What is Postpartum Depression?
Generally, women expect that the birth of a child will be a blissful and joyous time, and most often it is. Meeting their new baby and bringing this new little life into their home is an exciting event.
However, the period following child birth does not always conform to this happy and expected picture. In reality, feelings of sadness and periods of melancholy can affect a new mother, without warning.
Although this can happen to any woman from time to time after the birth of her baby, sometimes these feelings are sustained and begin to affect normal functioning.
New mothers experiencing lasting feelings of depression may be suffering from Postpartum Depression. Postpartum affects approximately 13% of new mothers and if left untreated, can have detrimental consequences.
Different Types of Postpartum Depression
There are three types of depression that can follow childbirth and they vary in onset, duration and severity: baby blues, postpartum depression and postpartum psychosis.
The Baby Blues
The baby blues are a common occurrence among new moms and research suggests that it affects as many as 50% of all post-birth mothers. This type of depression usually occurs between 1 and 5 days after the birth of a baby and it tends to only last between a few days or at most two weeks.
During these days, signs of postpartum depression usually include feeling overly emotional, tearful, tired and suffering from fluctuating mood swings and inexplicable sadness. It is thought that the "blues" are caused by the fluctuation of the various hormones after birth, although sudden changes in sleep patterns and daily routines may also play a role.
For most moms, some well needed rest and a little time to adjust to all things new is all the treatment necessary for a full recovery. A little help with household and baby duties will also go a long in assisting a speedy recovery!
Postpartum Depression and Anxiety (PND)
Postpartum Depression is a more serious condition than the "baby blues" and the depression symptoms are more severe and longer lasting. Approximately 10% of mothers diagnosed with postpartum depression have experienced some form of depression during their pregnancy.
This type of depression usually lasts at least two weeks, but can remain for months and even years if left untreated (tending to worsen with each subsequent pregnancy). Postpartum Depression can become very serious and should be treated as soon as possible.
Postpartum Psychosis is the most severe of all the postpartum depressive illnesses. However, although this is the most serious, it is also the rarest, affecting between 1 and 2 in every 1000 women after childbirth.
Onset generally occurs within the first three weeks after birth, but may begin as late as three months after the delivery. Signs of postpartum psychosis may include:
- Hallucinations and/or Delusions
- Illogical or irrational thoughts
- Heightened or reduced motor activity
- Sleep disturbances such as insomnia
- Changes in appetite
- Extreme feelings of anxiety and agitation
- Periods of delirium or mania
- Rapidly fluctuating mood swings that may range from deep depression to euphoria
- Obsessive thoughts of the baby (a type of OCD)
- Thoughts of harming oneself or baby
Duration of postpartum psychosis depends on the speed of diagnosis and appropriate treatment. If treated appropriately and promptly the prognosis is generally good.
Diagnosing Postpartum Depression
When Postpartum Depression hits, mothers often cannot understand why they are feeling depressed and low. Because it is assumed to be a happy time, they are often left feeling confused about why they are sad and may feel an overwhelming sense of guilt because of this.
What is often forgotten is that child birth and the dramatic changes in hormones and life routines can be both physically and mentally exhausting – add feelings of guilt and self-blame to this equation and depression is a fairly likely outcome. Whatever the cause, postpartum depression can be treated - but needs to be urgently addressed.
Not only do new mothers deserve to enjoy the wonders of their new babies, but babies need to be able to depend on and bond with their mothers. In extreme cases where postpartum depression is ignored, the results have been tragic. Although a rare occurrence, in moments of extreme desperation and exhaustion a few depressed mothers have hurt themselves or their helpless infants.
If you suspect you are suffering from postpartum depression, make an appointment to see a psychologist or your family doctor. You will be asked for a detailed description of your symptoms, when they began and how they are affecting you and those around you.
A medical examination may also be advised as signs of postpartum depression are similar to the presenting symptoms of other medical conditions such as hypothyroidism or Cushing’s disease. If your first appointment was with your medical doctor, you may be referred to a mental health practitioner who will be able to further assess the situation and inform you of your treatment options.
Symptoms of Postpartum Depression
Postpartum depression is essentially a type of depression that is experienced after pregnancy. Signs of postpartum depression include the loss of interest or pleasure in most previously enjoyed activities, as well as a depressed or sad mood felt most of the day, nearly everyday. The following physical and psychological symptoms may be experienced:
- Change in appetite
- Sleep disturbances. Difficulty falling or staying asleep (insomnia) or sleeping too much (hypersomnia)
- Fatigue or loss of energy, and no motivation
- Feeling physically slow, agitated, or restless to the degree that others begin to notice
- Physical complaints such as headaches, joint pains and stomach aches
- Low libido or diminished interest in sex
- Feelings of hopelessness, sadness or being overwhelmed
- Feeling restless or irritable
- Feeling tearful and crying a lot
- Feelings of guilt and worthlessness especially with regards to mothering ability
- Low self-esteem and feelings of inadequacy
- Difficulty thinking and concentrating
- Difficulty making decisions
- Suicidal thoughts, or continuous thoughts of death and self-harm
- Negative thoughts towards your baby
- Withdrawal from loved ones
Understandably, a large aspect of postpartum depression surrounds the new baby. Many of these new mothers may feel like they do not love their babies as they should or begin to resent the child as it constantly demands and needs attention. Anyone who has ever been depressed will relate to the fact that it is incredibly difficult to gain the momentum to look after your own daily needs, let alone the needs of a demanding new born! This leads to feelings of guilt, inadequacy and resentment that only worsen the depression.
What Causes Postpartum Depression?
There are a number of reasons why a woman may develop postpartum depression, although it is generally the result of a number of compounding factors rather than a single cause. Giving birth is a major life event and sometimes the stress of this huge change can be enough to trigger depression. Common causes may include a combination of the following factors:
- Hormonal changes
- Previous episodes or family history of depression
- Little support from family and/or friends
- Other life stressors such as marital problems or financial concerns
- Anxiety about the health of the baby
- Problems or complication during pregnancy or birth
- Exhaustion and lack of sleep or difficulty adjusting to disrupted sleep patterns
- Feeling overwhelmed by all the new responsibilities and demands or feeling doubtful of ability to make a good parent
- Feeling stressed by the sudden changes in home, work and personal routines.
- Feeling a loss of identity and definition as the role of mother becomes predominant and may seem all-consuming. This may include feelings of loss for other roles such as the role of the sensual woman, career woman, wife and lover, or the loss of the ability to be spontaneous, independent and "free".
Help for Postpartum Depression
There are a number of treatment options when trying to deal with postpartum depression. Medication is often prescribed although it is important to ask your physician about all precautions and side-effects related to the drugs especially as they relate to breastfeeding and the health of the baby.
Usually the most effective approach incorporates more than one mode of treatment and may include a combination of psychotherapy, group support, natural herbal or homeopathic remedies or other treatment options which may include acupuncture, yoga, or medication.
Treatment Options for Postpartum
Prescribed antidepressants are often viewed as a first option when treating depression. However, it is ultimately up to you, the patient, to make an informed final decision once you have explored all options. Ask your health care practitioner about all possible options and precautions and if you are in doubt, seek a second opinion.
The most commonly prescribed antidepressants are SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft; Tricyclic antidepressants such as Elavin and Tofranil; and MAOIs (Monoamine oxidase inhibitors) such as Nardil and Marplan. These all have various side effects which may be quite distressing to some and they are all required by the FDA to carry a warning about the increased risk of suicide, hostility, and agitation. According to many reports, withdrawal effects are often experienced when these prescription drugs are discontinued.
While antidepressants may work for some, they should be taken under medical supervision and will work best if used in conjunction with other treatment modalities such as cognitive therapy or an exercise program. In addition, it may not be recommended to use some of these drugs if you are breastfeeding and you should discuss this with your physician.
Psychotherapy has been shown to have significant and long lasting effects when treating depression. Various therapeutic approaches including cognitive-behavioral therapy, interpersonal therapy, and family therapy offer great insight as they strive to help the individual deal with any underlying factors that may be prompting the depression.
It also allows the individual personal time to reflect, express and face all the compounding emotions and stressors in an environment of positive guidance and support.
Meditation, yoga and deep breathing are some of the relaxation techniques that been shown to reduce anxiety and clear the mind.
Done regularly, these techniques can help alleviate some of the symptoms of depression. Join a class or make use of a CD especially composed by a professional specifically for this purpose.
More Information on Postpartum Depression
Tips for coping with your Postpartum Depression
- Get enough rest and sleep. While changing your sleeping patterns may be difficult at first it is important that you get enough sleep each day. Try to sleep when baby sleeps or ask your partner or other trusted person to watch baby for a short time while you nap.
- Remember that you are not super woman and are not expected to do EVERYTHING. Being a mom of a new baby is a lot of work and there will be days when you cannot manage everything on your plate. Simply do what you can and the rest can wait.
- Ask for help with household chores and baby duties. Get your partner involved in night-feeds (they can bring baby to you if breast-feeding), bath-time and diaper changes. If you still feel overwhelmed, consider hiring a professional child minder or house-worker to share the load.
- Communicate how you are feeling and express your emotions. Discuss your feelings with your partner or friend, or make an appointment with a licensed counselor. Postpartum depression can often lead to alienation from others and withdrawal. Remember to talk about what you are going through – and that you are not a burden on others!
- Remember to honor the person you were before baby arrived. Many new mothers become housebound and find they become isolated from adult company. Make an effort to leave the house and try being social. Even if it just a running a quick errand, making regular social visits or scheduling daily walks.
- Get together with other mothers. While this may be the last thing you feel like doing, you may find it really helpful to learn from other people’s experiences and benefit from the social interactions.
- If the idea of socializing with a group of mothers who "seem" to have it all sorted out and are now blissfully happy is just too daunting, consider joining a support group for depressed women.
- Avoid other life changing decisions. The birth of a child is incredibly life altering so take it step by step and hold off any other major life changes for the time being – you do not need the added stress!