Postpartum Depression

By Alison Heyerdahl

Most new mothers or mothers-to-be have heard of postpartum depression.  We always think it’s something that will happen to other women, but not to us.  As a result, we are often unprepared for the emotional turmoil that comes with being a new mother. After all, isn’t it supposed to be a blissful and bonding time with our baby?   

Postpartum blues have been reported in up to 85% of mothers in the first 10 days after giving birth, reaching a peak on the fifth day.  Symptoms associated with this condition include mood swings, anxiety, irritability, tearfulness, confusion, and fatigue.  The baby blues are a typical consequence of giving birth and are associated with dramatic hormonal changes.  Furthermore, it is normal to feel tired or overwhelmed sometimes, because babies require 24-hour care.  While the baby blues usually resolve within the first 2 weeks after birth, symptoms that are more severe and that last much longer may be indicative of Postpartum Depression.

Although the symptoms of baby blues and postpartum depression appear to be similar, they are fundamentally different.  Postpartum depression is a serious disorder that affects a mother’s ability to care for her baby or herself.  Furthermore, it will not get better unless the mother receives treatment.  It is important to note that postpartum depression is not a character flaw or weakness; it is sometimes just a complication of childbirth.

Who gets postpartum depression?

According to the DSM 5 (the manual used to diagnose mental disorders), postpartum depression occurs within the first 4 weeks after delivery.  It can affect any mother, regardless of age, race, culture or education, and is not triggered by anything the mother has done.

Studies have found that although the dramatic shift in hormones after birth may elicit postpartum depression, it is not the only factor.  As mentioned previously, hormonal changes contribute to the baby blues, which resolves shortly after birth, while the following factors may predispose a woman to postpartum depression:

• A previous major depressive episode.

• Stressful life events.

• A family history of mood disorders.

• If you were depressed during your pregnancy.

• Having relationship or financial problems.

• Having difficulty with breastfeeding.

• Having unplanned or unwanted pregnancy.

• Having a baby with special needs.  

According to the Office on Women's Health, postpartum depression is thought to affect 1 out of 10 women after birth, while postpartum psychosis (an extremely serious condition that requires immediate medical intervention) occurs in 1 to 2 out of 1000 women. 

What are the signs of postpartum depression?

Postpartum hormonal changes can leave moms feeling moody, irritable, anxious, and depressed.  You may also experience difficulty sleeping, appetite changes, and excessive fatigue.  While these are commonplace emotions that subside in the first week or two after birth, if they get worse or persist much longer, it could be a sign of postpartum depression.  Tell-tale symptoms that distinguish postpartum from the baby blues include:

• An extremely depressed mood.

• Loss of interest in activities that were previously pleasurable.

• Thoughts of death or suicide.

• Feelings of hopelessness, helplessness, or worthlessness.

• Thoughts of harming yourself or others.

• Not feeling connected to your baby, or as if it could be somebody else’s baby.

• Lack of interest in caring for your baby or yourself.

Many new mothers feel guilty or ashamed about feeling depressed after having a baby, and often don’t tell anyone about these symptoms.  After all, isn’t it supposed to be the happiest time of your life?  Remember that any woman can become depressed after having a baby.   It does not mean you are a bad mother! 

What is postpartum psychosis?

Postpartum psychosis is a rare condition that affects around 1 - 2 out of 1,000 new mothers in the first 1 – 4 weeks after childbirth.  Mothers with the condition develop paranoid or bizarre illusions, have severe mood swings and display disorganized behavior and thinking, all of which are vastly different from their previous states of being.  These symptoms can lead to devastating consequences, endangering the mother and her baby.  Symptoms of postpartum psychosis include:

• Paranoia (thinking that other people are watching you or have the intent to harm you).

• Rapid mood swings (for example, crying uncontrollably, then laughing hysterically, followed by an extremely depressed state).

• Hearing or seeing things that aren’t there.

• Feeling confused most of the time.

• Reckless behavior.

Postpartum psychosis nothing to feel embarrassed about.  It is a medical emergency that requires immediate intervention.  Visit your doctor if you suspect you may have this condition.

What should I do if I experience symptoms of postpartum depression?

As mentioned before, many mothers experience postpartum depression.  You should call your doctor, pediatrician, nurse or midwife if:

• Your baby blues last longer than 2 weeks.

• Your depressive symptoms become more intense.

• You are unable to function normally or look after your baby.

• You have thoughts about hurting yourself or your baby.

Reach out to close friends or family to make the call for you.  Doctors are adept at testing for postpartum depression and will refer you to the relevant mental health professional.

What can I do at home to relieve the symptoms of postpartum depression?

In addition to receiving medical treatment, you can try the following strategies:

• Sleep as much as you can.  Sleep is an important factor in relieving depression, and so you should try and sleep when your baby does.

• Take care of yourself.  Exercise, meditation, reading a good book, spending quality alone time with your partner, or seeing friends can really help to energize and recharge your batteries.   

• Don’t try and do everything yourself.  Ask for help from your partner or spouse, close friends, and family. 

• Talk about your feelings with your partner or a close friend you can trust. 

• Join a support group.  Ask your healthcare provider about groups in your area.

Don’t make big life changes after giving birth. If possible, wait a few months before moving house or to a new country. This can cause huge stress at a time when you don’t have the emotional resources available to deal with it.

Take-Aways

Postpartum depression is a serious condition that affects around 1 in 10 women after birth and occurs 1 – 4 weeks after delivery. It can affect any mother, regardless of age, race, culture, or education. Postpartum depression is not triggered by anything the mother has done, but she could be predisposed to the condition if she has had a previous major depressive episode, a family history of mood disorders, has experienced an extremely stressful or traumatic life event, is having difficulty feeding her baby or has a baby with special needs. Symptoms of postpartum depression include a severely depressed mood that persists for more than 2 weeks after delivery, feelings of hopelessness, helplessness or worthlessness, a lack of interest in your baby and not wanting to care for yourself or your baby. You should seek medical care for this condition. Postpartum psychosis affects 1 in a 1000 women after birth and is typified by psychotic delusions and a severe loss of normal function. This condition requires urgent and immediate medical intervention.