When the happiest time of your life…isn’t: Postpartum depression

| Posted On May 15, 2012 | By:

Pregnancy can be an exciting time, and the birth of a baby is often thrilling and joyful. This time in your life can also be stressful, involving many life changes. Hormonal changes and planning and caring for a new baby can take a toll on a mother’s well-being. It is quite common for a new mother’s mood to be low after the birth of a baby, but if it develops into symptoms of depression, it is important for both mother and baby that she seek treatment.

Postpartum blues, or the “baby blues,” occur within a few days of delivery and involves mild, but often rapid, mood swings from elation and joy to sadness, irritability, anxiety, trouble with concentration, inability to sleep, tearfulness, and crying spells.  Postpartum blues are very common: it is estimated that 40-80% of postpartum women develop these mood changes, which typically peak on the fifth postpartum day, last less than two weeks, and do not usually require medical intervention. Although the symptoms are mild, they could increase a mother’s chances of developing postpartum depression. Anxiety about caring for the baby, safety, and being a good mother is also very common and should improve with time. If anxiety is severe or continues over time, it can be associated with symptoms of depression.

Postpartum depression (PPD) is when a mother, in her first year after delivery, feels sad or uninterested in most activities, most of the day, every day, and also has:

5 or more of the symptoms above that last for 2 weeks or more may indicate depression.

Postpartum depression is common, affecting 10-25% of postpartum women at some point in their lifetime. It increases the chance that a woman will become depressed again in the future.

The causes of postpartum depression are not yet well understood, but likely involve biological, genetic, and psychosocial factors. A personal and family history of depression or postpartum depression can put you at increased risk, as can sensitivity to hormonal changes in pregnancy and the postpartum period, poor social support, relationship problems, and differences in coping style and temperament. Being within 5 weeks of delivering and having your first delivery are also risk factors.  Not everyone responds to stressful life events with symptoms of depression, but if you are at increased risk because of other factors, you may be more likely to become depressed after a stressor, like childbirth.

What should you do?  Talk to your doctor, nurse, or midwife.  Your OB, primary care, or mental health clinician can help identify symptoms of postpartum blues or depression. Because new mothers may be overwhelmed and not sleeping much, it can be hard to self-diagnose. One study showed most women with PPD did not realize they had depression, and most did not tell their doctors about their symptoms.  Some medical practices administer self-reporting scales which can help with early detection of depression.

Treatment for postpartum blues can include improving support systems and ensuring adequate nutrition and sleep for the mother. Brief use of anti-anxiety or sleep medication may also be helpful.

Treatment for postpartum depression can include individual talk therapy, group therapy, medications, light therapy, and mind-body-centered treatments. With effective treatment available, mothers with depression can reach the point where they feel completely better and more like themselves. It is important to be open with your clinicians about symptoms so that you can be guided to the proper resources.

Benefits of treatment

  1. For the mother: you deserve to feel good and enjoy your new baby.
  2. For the baby: Postpartum depression can have a negative effect on bonding with your baby. There is evidence that shows babies of depressed mothers are at risk of having more irritability, less activity, less attentiveness, fewer facial expressions, and developmental delays. Children of depressed mothers are also more likely to have behavioral problems.
  3. For the partner: a mother’s mood impacts her life with her family. Depression in fathers has been shown to be correlated to having a depressed spouse.

Paternal postpartum depression is a recently identified phenomenon in which fathers have been shown to be at higher risk for depression after the birth of a child, frequently in the 3-6 months postpartum period. It has been estimated that 1 in 4 new fathers suffer from depression, which is 5 times greater than the risk for other men. Having a history of depression and having a depressed partner can make paternal postpartum depression more likely.

Learn more about postpartum depression:

National Women’s Health Information Center: http://www.womenshealth.gov/
Parental Stress Line: http://www.parentshelpingparents.org/ phone: 800-632-8188
Online PPD Support group: http://www.ppdsupportpage.com/
Blog: http://postpartumprogress.com/
For Fathers: www.postpartumdads.org/

Local Resources:

Postpartum Support International of Massachusetts
Jewish Family & Children’s Services: 1430 Main Street, Waltham, MA 02451 / Phone: 781-647-JFCS (5327)
Massachusetts General Hospital Center for Women’s Mental Health

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  1. I’m surprised to see nothing in this article about sleep deprivation and its role in postpartum depression. I gave birth to my first child 6 months ago and I did feel depressed at times in the following few months, but it was clearly, directly the result of sleep deprivation due to having to wake up every 1-3 hours to feed a newborn, which is to be expected. Why is this never discussed in articles about postpartum depression? Furthermore, it seems a little silly to talk about the “inability to sleep” as a symptom of depression when discussing new mothers – their sleep is constantly disrupted and thus dysfunctional regardless of whether or not they are depressed, so “inability to sleep” cannot be considered a reliable sign of depression. It seems to me that depression resulting from this kind of extreme sleep deprivation is quite natural and needs to be considered before the proper treatment can be decided upon – it should not be approached in the same way as depression arising in other contexts or stages of life.

    Comment by Melanie on June 14, 2012 at 12:19 pm
  2. This is an excellent point, and sleep deprivation, along with many other stressors of new motherhood, certainly can contribute to the development of postpartum blues or depression. The symptom of insomnia or “inability to sleep” refers to the inability to sleep when there is actually time to sleep, although, as you point out, those periods of time are shortened substantially when caring for a baby. Treatment for postpartum blues can include improving support systems, and ensuring adequate nutrition and sleep for the mother. Increasing sleep time alone is not typically sufficient treatment for postpartum depression, but can certainly help in addition to other treatment options.

    Comment by Harvard Vanguard on June 20, 2012 at 9:08 am

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