Postpartum Depression

It’s a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners, although this is less common.

The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.

Many new moms experience the “postpartum baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery, and may last for up to two weeks.

But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.
Postpartum depression isn’t a character flaw or a weakness. Sometimes it’s simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and enjoy your baby.

Symptoms of Postpartum Depression

Some of the more common symptoms a woman may experience include:

  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Feeling moody, irritable, or restless
  • Oversleeping, or being unable to sleep even when her baby is asleep
  • Having trouble concentrating, remembering details, and making decisions
  • Experiencing anger or rage
  • Losing interest in activities that are usually enjoyable
  • Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle pain
  • Eating too little or too much
  • Withdrawing from or avoiding friends and family
  • Having trouble bonding or forming an emotional attachment with her baby
  • Persistently doubting her ability to care for her baby
  • Thinking about harming herself or her baby.

What causes PND?

Many possible causes for PND have been suggested. There is probably no single reason, but a number of different stresses may add up to cause it.
You are more likely to have PND if you:
have had mental health problems, including depression before
have had depression or anxiety during pregnancy
do not have support from family or friends
have had a recent stressful event – e.g. death of someone close to you, relationship ending, losing a job.
There may be a physical cause for your depression, such as an underactive thyroid. This can be easily treated.
PND can start for no obvious reason, without any of these causes. Also having these problems does not mean that you will definitely have PND.

Can postnatal depression be prevented?

We don’t know enough about PND to prevent it in the first place. The following suggestions seem sensible and may help to keep you well.

Don’t try to be ‘superwoman’. Try to do less and make sure that you don’t get over-tired.
Do make friends with other women who are pregnant or have just had a baby. It may be more difficult to make new friends if you get PND.

Do find someone you can talk to. If you don’t have a close friend you can turn to, try the National Childbirth Trust or The Pandas Foundation. Their local groups are very supportive both before and after childbirth.
Do go to antenatal classes. If you have a partner, take them with you. If not take a friend or relative.
Don’t stop antidepressant medication during pregnancy without advice. Around 7 in 10 women who stop antidepressants in pregnancy relapse if they stop the medication.  You need to discuss the risks and benefits of continuing treatment in pregnancy and breastfeeding.

Do keep in touch with your GP and your health visitor if you have had depression before. Any signs of depression in pregnancy or PND can be recognised early.

Do make sure that you have treatment for depression in pregnancy. This may be a talking therapy or medication.
Do accept offers of help from friends and family.

What to Do

Getting proper rest, nutrition, and support are quite important — since being exhausted or sleep deprived or feeling stressed can reinforce and fuel feelings of sadness and depression.

To cope with baby blues, new moms should try to 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.
REFERENCES:
www.nimh.nih.gov
www.rcpsych.ac.uk