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In the Spotlight

November 30, 1999

Postpartum Depression: More than Just the "Blues"

By Michael Woo-Ming M.D., MPH
Personal MD.com
Medical Contributor

 

Its your first baby and the whole family is excited. The first grandchild in both families and everyone wants to visit all at once. Yet, you are exhausted, but thats OK, everyone realizes a new baby leads to a lot of sleepless nights.

However, the exhaustion lingers, and you find yourself increasingly anxious and moody. It is now a few weeks since the baby was born. You are feeling more and more depressed. You are becoming more disinterested in the baby. You are beginning to withdraw emotionally from the rest of your family and feel isolated.

The above scenario is a classic example of postpartum depression, a type of depression, which could lead to serious problems if left untreated. About 80% of new mothers develop the postpartum blues, a very common condition that occurs soon after the baby is born. It usually doesnt last more than a week, and the symptoms are very mild.

The postpartum blues will usually get better with rest (if you can find it!) and adequate nutrition. However, if sadness and depression continues for weeks to months after birth, postpartum depression may occur, and these people generally need professional help. Interestingly, second-time moms are usually more at risk than first-time moms.

What Happens?

There are various theories as to why postpartum depression occurs and it is probably the result of a multitude of causes. The stress of the birth itself can takes it toll, as well as the new responsibility of having to care for another human being. Financial stresses can also be a burden.

Some women envision the perfect pregnancy, and are disappointed with anything less. Hormonal changes occur during pregnancy and the birthing process, resulting in mood swings and other emotional changes. Anxiety and feelings of guilt can settle in.

The sooner it is recognized, the sooner you can do something about it. It is a treatable condition, and doctors can prescribe medications to aid in the symptoms.

Some women who develop postpartum depression can develop a rare condition known as postpartum psychosis. These women are usually severely depressed and apathetic, which can lead to them developing into suicidal thoughts. Hospitalization to prevent them from harming themselves may be necessary. They may also try to harm the baby, due to their confusion and paranoia.

Whos At Risk?

  • Previous history of postpartum depression in other pregnancies
  • Lack of social support from spouse or family
  • History of anxiety, depression or other mood disorders.

What Can You Do?

Early recognition of postpartum depression is essential. Feelings of despair, irritability, and unrealistic expectations that go from weeks to months need to be investigated. Discuss your feelings with your doctor, who can initiate treatment, and may know support groups in your area. Family and friends should be involved as well.

Symptoms of Depression

If you experience five or more of the following symptoms for more than two weeks, or if they interfere with your family life or work, see your doctor:

  • Persistent sad, anxious, or empty mood
  • Loss of interest or pleasure in activities, including sex
  • Restlessness, irritability, or excessive crying
  • Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism
  • Sleeping too much or too little, early-morning awakening
  • Appetite and/or weight loss, or overeating and weight gain
  • Decreased energy, fatigue, feeling slowed down
  • Thoughts of death or suicide, or suicide attempts
  • Difficulty concentrating, remembering, or making decisions
  • Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

If you are a new mother, it is important to look for help with the baby and family. Do what ever you can to relieve stress and fatigue. Get family members to come over to help with meals or household errands. Make sure to devote time to regular exercise and eating properly.

Even a ten-minute walk can help. Dont be overly concerned with an excessively tidy house; this is the time to take care of the baby and yourself. Most communities have organizations devoted to helping new mothers. Do yourself a favor and check your local telephone book or call your local hospital. Remember, youre not alone!

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