DEPRESSION - Postpartum Depression and the Baby Blues

Postpartum Depression and the Baby Blues

Symptoms, Treatment, and Support for New Moms

Having a baby is stressful—no matter how much you've looked forward to it or how much you love your child. The baby blues are perfectly normal, but if your symptoms don’t go away after a few weeks or get worse, you may have postpartum depression. Postpartum depression can interfere with your ability to take care of your child, so it’s important to get help right away. With treatment and support, you can get back on the road to happy motherhood.

The baby blues

You’ve just had a baby. You expected to be basking in new mom bliss. You expected to be celebrating the arrival of your little one with your friends and family. But instead of celebrating, you feel like crying. You were prepared for joy and excitement, not exhaustion, anxiety, and weepiness.

You may not have been expecting it, but mild depression and mood swings are common in new mothers—so common, in fact, that it has its own name: the baby blues.

The vast majority of new mothers experience at least some symptoms of the baby blues, including moodiness, sadness, difficulty sleeping, irritability, appetite changes, concentration problems. Symptoms of the baby blues typically show up within a few days of giving birth and last from several days to a couple of weeks.

The baby blues are a normal part of new motherhood—probably caused by the hormonal changes that occur following birth. If you have them, there is no cause for undue worry. You’ll feel better once your hormones level out. Aside from the support of your loved ones and plenty of rest, no treatment is necessary.

Signs and symptoms of postpartum depression

Unlike the baby blues, postpartum depression is a more serious problem—one that you shouldn’t ignore. However, it’s not always easy to distinguish between the two.

In the beginning, postpartum depression can look like the normal baby blues. In fact, postpartum depression and the baby blues share many symptoms, including mood swings, crying jags, sadness, insomnia, and irritability. The difference is that with postpartum depression, the symptoms are more severe (such as suicidal thoughts or an inability to care for your newborn) and longer lasting.

Signs and Symptoms of Postpartum Depression

Lack of interest in your baby Negative feelings towards your baby Worrying about hurting your baby Lack of concern for yourself Loss of pleasure

Lack of energy and motivation Feelings of worthlessness and guilt Changes in appetite or weight Sleeping more or less than usual Recurrent thoughts of death or suicide

Postpartum depression usually sets in soon after childbirth and develops gradually over a period of several months. But postpartum depression can also come on suddenly, and in some women, the first signs don’t appear until months after they’ve given birth.

Signs and symptoms of postpartum psychosis

Postpartum psychosis is a rare, but extremely serious disorder that can develop after childbirth. It is characterized by loss of contact with reality. Postpartum psychosis should be considered a medical emergency. Because of the high risk for suicide or infanticide, hospitalization is usually required to keep the mother and the baby safe.

Postpartum psychosis develops suddenly, usually within the first two weeks after delivery, and sometimes within 48 hours. Symptoms include:

Hallucinations (seeing things that aren’t real or hearing voices) Delusions (paranoid and irrational beliefs) Extreme agitation and anxiety Suicidal thoughts or actions Confusion and disorientation

Rapid mood swings Bizarre behavior Inability or refusal to eat or sleep Thoughts of harming or killing your baby

Postpartum depression causes and risk factors

The exact reasons why some new mothers develop postpartum depression and others don’t are unknown. But a number of interrelated causes and risk factors are believed to contribute to the problem.

Causes of postpartum depression

• Hormonal changes. After childbirth, women experience a big drop in estrogen and progesterone hormone levels. Thyroid levels can also drop, which leads to fatigue and depression. These rapid hormonal changes—along with the changes in blood pressure, immune system functioning, and metabolism that new mothers experience—may trigger postpartum depression.
• Physical changes. Giving birth brings numerous physical and emotional changes. You may be dealing with physical pain from the delivery or the difficulty of losing the baby weight, leaving your insecure about your physical and sexual attractiveness.
• Stress. The stress of caring for a newborn can also take a toll. New mothers are often sleep deprived. In addition, you may feel overwhelmed and anxious about your ability to properly care for your baby. These adjustments can be particularly difficult if you’re a first time mom who must get used to an entirely new identity.

Risk factors for postpartum depression

Some women are more likely than others to develop postpartum depression. The following factors put you at an increased risk:

• a previous history of depression
• a history of severe PMS or premenstrual dysphoric disorder
• medical complications for you or your baby
• relationship difficulties
• lack of support from family or friends

How postpartum depression affects the baby

Postpartum depression can interfere with your ability to function, including your ability to take care of yourself and your child. If you have postpartum depression, it doesn’t mean that you’re a bad mother. However, when you’re consumed with symptoms of depression such as fatigue, irritability, apathy, and tearfulness, it is difficult—if not impossible—to properly look after your newborn’s needs. Your baby will be affected if the depression is left untreated.

The Impact of Postpartum Depression on Children
Behavioral problems	Children of depressed mothers are more likely to develop behavioral problems down the line, including sleep problems, temper tantrums, aggression, and hyperactivity.
Delays in cognitive development	Development is often delayed in babies and children who have depressed mothers. They may learn to walk and talk later than other children. They may also have many other learning difficulties, including problems with school.
Social problems	Children of depressed mothers have difficulty establishing secure relationships. They may find it hard to make friends in school. They may be socially withdrawn, or they may act out in destructive ways.
Emotional problems	Studies have show that children of depressed mothers have lower self-esteem, are more anxious and fearful, are more passive, and are less independent.
Depression	The risk of developing major depression early in life is particularly high for the children of mothers with postpartum depression.

If you’re suffering from postpartum depression, there is no reason to feel guilty or ashamed. The symptoms of postpartum depression are outside your control, and they don’t make you a bad person or a bad parent. However, the choice to get treatment is in your control. Considering the impact depression has on both you and your child, it’s important to seek help right away.

Postpartum depression and attachment

Depressed mothers can be loving and attentive at times, but at other times they may react negatively or they may not respond at all. This inconsistency disrupts the bonding process between mother and child. This emotional bonding process, known as attachment, is the most important task of infancy.Research has shown that depressed mothers interact less with their babies. Women with postpartum depression are less likely to breastfeed, play with, and read to their children. They may also be inconsistent in the way they care for their newborns.

A secure attachment is formed when the mother responds warmly and consistently to her baby’s physical and emotional needs. When the baby cries, the mother quickly soothes him or her. If the baby laughs or smiles, the mother responds in kind. In essence, the mother and child are in synch. They recognize and respond to each other’s signals.

But a depressed mother is less likely to pick up on and respond to her baby’s cues. This sets the stage for an insecure attachment. A child who is insecurely attached is at risk for multiple developmental difficulties and delays, including behavioral, emotional, and social problems.

Comforting a Crying Baby

It’s common to feel frustration, anxiety, and even anger when faced with a crying baby—especially if your baby wails for hours on end and won’t calm down. Equally frustrating is a baby who seems indifferent, who won’t cuddle or make eye contact with you. In these situations, you need to find ways to get your own stress into balance. When you’re calm and centered, you’ll be better able to figure out what’s going on with your child and soothe his or her cries.

Read: When Baby Won’t Stop Crying

Self-help for postpartum depression

The best thing you can do if you have postpartum depression is to take care of yourself. The more you care for your mental and physical well-being, the better you’ll feel.

Simple lifestyle changes can go a long way towards helping you feel like yourself again.

• Don’t skimp on sleep. A full 8 hours may seem like an unattainable luxury when you’re dealing with a newborn, but poor sleep makes depression worse. Do what you can to get plenty of rest—from enlisting the help of your husband or family members to catching naps when you can. 
• Set aside quality time for yourself to relax and take a break from your mom duties. Find small ways to pamper yourself, like taking a bubble bath, savoring a hot cup of tea, or lighting scented candles.
• Make meals a priority. When you’re depressed, nutrition often suffers. What you eat has an impact on mood, as well as the quality of your breast milk, so do your best to establish healthy eating habits.
• Get out in the sunshine. Sunlight lifts your mood, so try to get at least 10 to 15 minutes of sun per day.
• Ease back into exercise. Studies show that exercise may be just as effective as medication when it comes to treating depression, so the sooner you get back up and moving, the better. No need to overdo it. A 30-minute walk each day will work wonders.

Lean on others for help and support

• Make your relationships a priority. When you’re feeling depressed and vulnerable, it’s more important than ever to stay connected to family and friends—even if you’d rather be alone. Isolating yourself will only make your situation feel even bleaker, so make your adult relationships a priority. Let your loved ones know what you need and how you’d like to be supported.
• Don’t keep your feelings to yourself. In addition to the practical help your friends and family can provide, they can also serve as a much-needed emotional outlet. Share what you’re experiencing—the good, the bad, and the ugly—with at least one other person. It doesn’t matter who you talk to, so long as that person is willing to listen without judgment and offer reassurance and support.
• Join a group for new moms. Even if you have supportive friends, you may want to consider seeking out other women who are dealing with the same transition into motherhood. It’s very reassuring to hear that other mothers share your worries, insecurities, and feelings. Good places to meet new moms include support groups for new parents or organizations such as Mommy and Me. Ask your pediatrician for other resources in your neighborhood.

Coping tips for postpartum depression

• Find people who can help you with child care, housework, and errands so you can get some much needed rest.
• Make time for yourself every day, even if it’s only for 15 minutes. Do something relaxing or that makes you feel good about yourself.
• Keep a daily diary of your emotions and thoughts. This is a good way to let everything out and to keep track of your progress as you begin to feel better.
• Give yourself credit for the things you’re able to accomplish, even if you only get one thing done in a day. If you aren’t able to get anything done, don’t be hard on yourself.
• Give yourself permission to feel overwhelmed.
• Remember that no one expects you to be supermom.
• Be honest about how much you can do and ask others for help.

Source: American Academy of Family Physicians

Professional treatment for postpartum depression

If, despite the self-help and the support of your family, you’re still struggling with postpartum depression, you may want to consider seeking professional treatment. Postpartum depression responds to the same types of treatment as regular depression. Therapy, medication, and support groups can all be helpful.

• Individual therapy or marriage counseling – Therapy can be very effective in the treatment of postpartum depression. A good therapist can help you successfully deal with the adjustments of motherhood. If you are experiencing martial difficulties or are feeling unsupported at home, marriage counseling can be very beneficial.
• Hormone therapy – Estrogen replacement therapy sometimes helps with postpartum depression. Estrogen is often used in combination with an antidepressant. There are risks that go along with hormone therapy, so be sure to talk to your doctor about what is best—and safest—for you.
• Antidepressants – For severe cases of postpartum depression where you’re unable to care for herself or her baby, antidepressants may be an option. However, medication use should be accompanied by therapy, as well as close monitoring by a physician.

Taking antidepressants while breastfeeding

If you’re considering the use of antidepressants, it’s important to know that your medication can be passed to your baby through your breast milk. Research suggests that in the case of tricyclic antidepressants and SSRIs, the levels of medication that reach the baby through breastfeeding are either low or undetectable. However, there have been rare reports of adverse reactions in nursing infants. Furthermore, the long-term effects of exposure—even to trace amounts of the medication—are unknown. 

Helping someone with postpartum depression

If your loved one is experiencing postpartum depression, the best thing you can do is to offer support. Give her a break from her childcare duties, provide a listening ear, and be patient and understanding.
You also need to take care of yourself. Dealing with the needs of a new baby is hard for fathers as well as mothers. And if your significant other is depressed, you are dealing with two major stressors.

How to help your wife or partner

• Encourage her to talk about her feelings. Listen to her without judging her or offering solutions. Instead of trying to fix things, simply be there for her to lean on.
• Offer help around the house. Chip in with the housework and childcare responsibilities. Don’t wait for her to ask!
• Make sure she takes time for herself. Rest and relaxation are important. Encourage her to take breaks, hire a babysitter, or schedule some date nights.
• Be patient if she’s not ready for sex. Depression affects sex drive, so it may be awhile before she’s in the mood. Offer her physical affection, but don’t push is she’s not up for sex.
• Go for a walk with her. Getting exercise can make a big dent in depression, but it’s hard to get motivated when you’re feeling low. Help her by making walks a daily ritual for the two of you.