Postpartum Depression: The Baby Blues

Childbirth is a major event in the life of a family. Even if you feel well prepared for parenthood, you can expect to have a broad range of emotions. Some of your reactions and emotions may surprise you, especially if they seem negative. These negative feelings may run from mild blues to severe depression.

Why Does This Happen?

Many normal hormonal changes take place in your body after you give birth. These changes can affect your mood stability, and are believed to be one of the main causes of the “baby blues,” the weepy, sad, feelings many women experience following the birth of a baby. In some women, this hormonal change can lead to a more severe form of baby blues called postpartum depression. While 80 percent of all new mothers experience the baby blues, about 10 percent have postpartum depression. An even smaller number, less than 1 percent, have postpartum psychosis.

Who is at risk?

The normal emotional upheaval of childbirth is enough to put all women at some risk. But, genetics and personal history may increase the risk of developing postpartum depression.

Some factors that may put you at increased risk are:

• Current depression
• Depression at some other time in your life
• Relationship difficulties
• No support network of family, friends, etc.
• A baby who is especially demanding
• A difficult pregnancy or birth
• Blood relatives who have had postpartum depression

What are the symptoms of “baby blues”?

The mildest and most common reaction for new mothers, symptoms usually start on the second or third day after the birth and last around 10 days.

Common symptoms are:

• Anxiety
• Crying spells
• Fear of being alone
• Feeling overwhelmed
• Lack of confidence in mothering ability
• Loneliness
• Mood swings

What are the symptoms of postpartum depression?

Postpartum depression has many of the same symptoms as the baby blues but it is more severe, and there are additional symptoms. Postpartum depression may start as early as the second or third day after birth or may take several weeks and even up to a year to develop.

Common symptoms are:

• Dislike or fear of touching the baby
• Extreme nervousness
• Feelings of hopelessness or emptiness
• Frightening thoughts about the baby
• Inability to sleep even when the baby sleeps
• Irritability
• Loss of appetite
• No energy

What are the symptoms of postpartum psychosis?

In rare instances, symptoms of postpartum depression may become severe. These symptoms may appear as early as the first 48-72 hours after birth or within the first two weeks after delivery.

In addition to the symptoms listed for postpartum depression, other symptoms may also happen. These include:

• Disorganized behavior
• Hallucinations
• Irrational false beliefs (delusions)
• Inability to sleep
• Withdrawal from family members

In extreme cases, these symptoms will contain:

• Suicidal thoughts
• Thoughts of harming the baby

Treatment

While “baby blues” generally go away on their own, postpartum depression may require some help and postpartum psychosis definitely requires help. These symptoms are treatable–the earlier you get help the easier they are to treat, and the quicker you will feel like yourself again. Not seeing your doctor soon after these feelings start may cause them to become more serious.

Here are other actions you can take to help yourself:

• Give yourself a break; these feelings are not your fault.
• Allow negative feelings to be expressed.
• Avoid any major decisions until you are feeling better.
• Develop a support system from what is available to you, such as a mother’s group, exercise class, neighbors, friends, or family members.
• Find a workable structure for your day.
• Recognize positive feelings when they happen.
• Keep expectations of yourself, family, and friends realistic.
• Nurture yourself with good food, rest, fluids, and mild exercise.
• Remember your sense of humor.

When self-help isn’t enough

If things seem to be getting worse despite your efforts, don’t wait to get help. Get help right away from your doctor. You may need a physical checkup, medication or psychotherapy with a professional who is trained to help you with postpartum depression. Many new mothers put off calling the doctor because they feel guilty, or don’t want to be seen as “crazy.” Your obstetrician has seen many other women in the same situation and will help you to feel better.

When to seek immediate help

You need to call your doctor immediately if you experience any of these symptoms:

• You sleep all day.
• You cry for long periods of time.
• You fear you may harm yourself or your baby.
• You have unreasonable fears or hallucinations.
• You do not feel able to care for your baby or other children’s basic needs.

Who to call? Where to go?

• Your obstetrician
• The nearest hospital emergency room
• The Phone (Crisis Line) 924-3900

How Fathers and Other Caregivers Can Help

Just as new mothers go through emotional upheaval after the birth of a child, the rest of the family does, too. Add to this a depressed new mother and everyone feels stressed! There are ways to speed up the recovery process, however.

Here is how you can help:

• If you witness troublesome physical or emotional changes in the new mother, talk to a health care provider.
• Learn everything you can about postpartum depression.
• Do not leave the new mother alone until you are told by a health care professional that it is all right to do so.
• Provide emotional support.
• Take care of the baby so that the new mother can get some sleep.
• Be sure that nutritious food is available.
• Get help with household chores.
• Take care of your own needs, too.