Whether you're becoming a mom for the first time or the
fourth, the days and weeks immediately following your baby's
birth can be as overwhelming as they are joyful and exciting.
Many women experience major mood shifts after childbirth,
ranging from brief, mild baby blues to longer-lasting, deeper
clinical depression, which is known as postpartum depression.
Feelings of sadness and depression are more common after
childbirth than many people may realize. It's important for new
mothers - and those who love them - to understand the symptoms of
postpartum depression and to reach out to family, friends, and
medical professionals for help.
With the proper support and treatment, mothers who are
experiencing any degree of postpartum depression can go on to be
healthy, happy parents.
Baby Blues
Up to 80% of women experience something called the
baby blues
, feelings of sadness and emotional surges that begin in the first
days after childbirth. With the baby blues, a woman might feel
happy one minute and tearful or overwhelmed the next. She might
feel sad, blue, irritable, discouraged, unhappy, tired, or moody.
Baby blues usually last only a few days - but can linger as long as
a week or two.
Why It Happens
These emotional surges are believed to be a natural effect of
the hormone shifts that occur with pregnancy and childbirth. Levels
of estrogen and progesterone that have increased during pregnancy
drop suddenly after delivery, and this can affect mood. These
female hormones return to their pre-pregnancy levels within a week
or so. As hormone levels normalize again, baby blues usually
resolve on their own without medical treatment.
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.
Postpartum Depression
For some women, the feelings of sadness or exhaustion run deeper
and last longer than baby blues. About 10% of new mothers
experience
postpartum depression
, which is a true clinical depression triggered by childbirth.
Postpartum depression usually begins 2 to 3 weeks after giving
birth, but can start any time during the first few days, weeks, or
months post-delivery.
A woman with postpartum depression may feel sad, tearful,
despairing, discouraged, hopeless, worthless, or alone. She also
may:
- have trouble concentrating or completing routine tasks
- lose her appetite or not feel interested in food
- feel indifferent to her baby or not feel attached or
bonded
- feel overwhelmed by her situation and feel that there is no
hope of things getting better
- feel like she is just going through the motions of her day
without being able to feel happy, interested, pleased, or joyful
about anything
Feelings and thoughts like these are painful for a woman to
experience - especially during a time that is idealized as being
full of happiness. Many women are reluctant to tell someone when
they feel this way. But postpartum depression is a medical
condition that requires attention and treatment.
Why It Happens
Postpartum depression can affect any woman - but some may be
more at risk for developing it. Women who have battled depression
at another time in their lives or have one or more relatives who
have had depression might have a genetic tendency to develop
postpartum depression.
Most postpartum depression is thought to be related to
fluctuating hormone levels that affect mood and energy. Levels of
estrogen and progesterone that have increased during pregnancy drop
suddenly after delivery. In some cases a woman's thyroid
hormone may decrease, too.
These rapid hormone shifts affect the brain's mood chemistry
in a way that can lead to sadness, low mood, and depression that
lingers. Stress hormones may have an added effect on mood. Some
women may experience this more than others.
When to Call the Doctor
If feelings of sadness or depression are strong, if they linger
throughout most of the day for days in a row, or if they last
longer that a week or two, talk to your doctor. A new mother who
feels like giving up, who feels that life is not worth living, or
who has suicidal thoughts or feelings needs to tell her doctor
right away.
Postpartum depression can last for several months or even longer
if it goes untreated. With proper treatment, a woman can feel like
herself again. Treatment may include talk therapy, medication, or
both. In addition, proper diet, exercise, rest, and social support
can be very helpful. Some women find yoga to be beneficial. Some
research suggests that expressing thoughts and emotions through
certain writing techniques can help relieve symptoms of
depression.
It may take several weeks for a woman to begin to feel better
once she is being treated for depression, though some women begin
to feel better sooner. Ask your doctor about how soon to expect
improvements and ways to take care of yourself in the meantime.
Postpartum Psychosis
A more serious and rare condition is
postpartum psychosis
. It affects about 1 in 1,000 women who give birth and occurs
within the first month after labor and delivery. It may include
hallucinations, such as hearing voices or seeing things, or
feelings of paranoia.
With postpartum psychosis, a woman can have irrational ideas
about her baby - such as that the baby is possessed or that she has
to hurt herself or her child. This condition can be extremely
serious and disabling, and new mothers who are experiencing these
symptoms need medical attention right away.
Why It Happens
Women who have other psychiatric illnesses, such as bipolar
disorder or schizoaffective disorder, may be at greater risk of
developing postpartum psychosis.
When to Call the Doctor
Postpartum psychosis requires immediate medical attention and,
often, a brief hospitalization. If you or someone you know is
experiencing symptoms, don't delay getting medical
attention.
Understanding the Changes After Childbirth
New mothers experience many layers of change in the days and
weeks immediately following labor and delivery. In addition to
the sudden drop in estrogen and progesterone - which can affect
mood - there are other huge physical, emotional, and domestic
changes that can affect how a new mom feels.
Physical Changes
Pregnancy brings many physical changes, and labor and
delivery are physically intense and challenging. It takes time for
the body to
recover
, and a new mother might feel exhausted, emotionally drained, or
uncomfortable after delivery.
Personal and Emotional Changes
A woman's role and responsibilities may change quite a bit
when she becomes a new mother. It can take time to adjust - even if
she felt prepared for the change. Some women may feel isolated,
worried, or scared.
Some new mothers face added stresses related to difficult
circumstances or lack of support. Enduring a tough relationship, a
precarious financial situation, or some other major life event
at the same time - like a move or a job loss - can add stress.
Pregnancy-related stress - such as difficulty conceiving or
complications during pregnancy or labor - can add to a new
mom's feeling of being depleted. Sometimes (but not
always) these stresses can pave the way for depression.
Changes in Routines and
Responsibilities
A newborn brings special demands on a mother's time,
attention, and energy. For first-time mothers, there can be lots to
learn about meeting the baby's most basic needs, like sleeping,
feeding, bathing, and soothing. There are lots of new routines to
establish.
The baby's sleeping, waking, and feeding schedules can make
it hard for a new mom to get the sleep and rest required to help
handle all these new stresses and responsibilities. And without a
good night's sleep, even small things can seem
overwhelming.
Getting Help and Helping Yourself
Tell your doctor if you're having trouble with postpartum
moods, thoughts, or feelings. Let someone else you trust know, too.
This might be your partner, a friend, or a family member. This is a
time to reach out and accept help and support from people close to
you.
In addition to getting treatment for postpartum depression,
small things you do can make it easier to get through a difficult
time. You might find it helpful to:
-
Take time for yourself.
Schedule a babysitter for a regular time. This way you'll be
sure to get time for yourself and know that it's coming.
-
Focus on little things to look forward to during the
day.
This might be a hot shower, relaxing bath, walk around the block,
or visit with a friend.
-
Read something uplifting.
Since depression may make it difficult to concentrate, choose
something light and positive that can be read a bit at a
time.
-
Indulge in other simple pleasures.
Page through a magazine, listen to music you enjoy, sip a cup of
tea.
-
Be with others.
Create opportunities to spend time with other adults, like family
and friends, who can provide some comfort and good company.
-
Ask for help.
Don't shy away from asking for emotional support or help with
caring for the baby or tackling household chores.
-
Accept help.
Accepting help doesn't make you helpless - by reaching
out you help yourself and your baby.
-
Rest.
Give your child a quiet place to sleep, and try to rest when the
baby does.
-
Get moving.
A daily walk can help lift mood. (Check with your doctor before
starting any new exercise program.)
-
Be patient.
Know that it may take time to feel better and take one day at a
time.
-
Be optimistic.
Try to think of small things you're grateful for.
-
Join a support group.
Ask your doctor or women's center about resources in your
community.
Helping Someone With Postpartum Depression
If you're concerned that your partner or someone else you
know is experiencing postpartum depression, it's important to
encourage her to talk to her doctor and to a mental health
professional. Sometimes a woman is reluctant to seek help or may
not recognize her own symptoms right away.
Consider giving the new mom some information on postpartum
depression, and offer to read through it together. You might offer
to make an appointment for her and go with her if she wants.
Once she's receiving the care she needs, support, love, and
friendship are good medicine, too. Here are a few things that you
can continue do for her:
- Check in with her regularly to see how she's doing.
- Listen when she wants to talk.
- Go for a walk with her (every day if possible!).
- Make her a nutritious meal (regularly!).
- Give her some breaks from housework and child care
responsibilities.
- Let her take a nap or a relaxing bath while you care for her
baby.
- Be patient, be kind.
- Believe in her - and remind her of her true qualities and
strengths.
Brighter Days Ahead
Like all forms of depression, postpartum depression creates a
cloud of negative feelings and thoughts over a woman's view of
herself, those around her, her situation, and the future. Under the
cloud of depression, a woman might see herself as helpless or
worthless. She might view her situation as overwhelming or
hopeless. Things might seem disappointing, uninteresting, or
without meaning. Keep in mind that the bleak negative perspective
is part of depression.
With the right treatment and support, the cloud can be lifted.
This can free a woman to feel like herself again, to regain her
perspective and sense of her own strength, her energy, her joy, and
her hope. With those things in place, it's easier to work with
changes, to see solutions to life's challenges, and to enjoy
life's pleasures again.
Reviewed by:
D'Arcy Lyness, PhD
Date reviewed: May 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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