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Ask Dr. Sue
POST-PARTUM DEPRESSION
Dear Dr. Sue,
I had my second child a couple of
months ago. Shortly after my little boy was born I
started feeling very tired, sad, depressed and even
angry. My feelings went away within a couple of weeks,
but they scared me while they were here. Was this
postpartum depression, do you think? What causes that
to happen, and why do some mothers actually go so far as
to hurt their children?
Dear Mom,
Mood disturbances after the birth of a baby come in a
range of severity. The mildest form, known as “the
baby blues,” usually starts in the first few days after
the baby is born. It tends to be milder in degree
than true postpartum depression, and can last up to a
week or two. Actual postpartum depression can
happen just a few days after delivery, or it can be
delayed for months. The feelings can be similar to
those experienced with the baby blues, but they are much
stronger. They are also more likely to get in the
way of normal function. If postpartum depression
is not treated, it can sometimes last up to a year.
The worst of these mood disorders is the rarer condition
of postpartum psychosis. Symptoms usually come on
within 3 months of giving birth. Women with this
disorder lose touch with reality, and may experience
hallucinations (either hearing or seeing things that
aren’t there) and delusions (believing things that
aren’t really true). This condition can pose a
risk to mother and baby both, and therefore must be
treated. Often hospitalization is necessary.
No one really knows what causes postpartum depression,
or why one woman develops it and another doesn’t.
It probably has to do with the interaction of many
different factors, including the mother’s genetic
makeup, the sudden hormonal changes that occur at
childbirth, medical complications of childbirth, lack of
sleep, the baby’s demands, difficulty with
breastfeeding, stress at home or work, lack of support
systems, perfectionism and unrealistic expectations of
herself and/or her new baby, and changes in pre-existing
relationships (including the baby’s father and any
previous children). It is well recognized,
however, that if a woman has true postpartum depression
with one child, her risk of developing it again with her
next baby is somewhere between 50 and 100%!
What are the signs of postpartum
depression?
-
Anger
-
A feeling of guilt or unworthiness
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Frequent crying
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Restlessness
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Sadness
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Fatigue (often combined with
difficulty sleeping)
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Mood swings
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Weight loss and loss of appetite or
weight gain and overeating
-
Feeling uninterested in the baby
-
Loss of interest in previously
enjoyed activities
-
Feeling afraid you might hurt the
baby or yourself
Signs of postpartum anxiety, which is
related to postpartum depression, include a strong
sensation of anxiety or fear, rapid breathing and heart
rate, hot or cold flashes, chest pain, and tremors or
dizziness.
Actual postpartum psychosis causes more severe symptoms,
including extreme anger and agitation, confusion and
disorientation, actual thoughts about harming yourself
or your baby, hallucinations or delusions, paranoia, and
strange thoughts or remarks. Most people suffering
from postpartum psychosis will not be able to recognize
those symptoms in themselves. Someone who loves
them (or a caring neighbor) must recognize the situation
for what it is and take action immediately. Five
percent of women with postpartum psychosis commit
suicide and five percent kill their children. Delay can
be catastrophic.
Simple baby blues only last for 10 to 14 days after
delivery. Any woman who is experiencing even mild
symptoms of depression for longer than that should see
her doctor. (Feel free to mention your feelings to
your pediatrician; he or she can refer you for help).
Your doctor will probably test your thyroid hormone
(inadequate levels of this hormone can cause symptoms of
depression) and discuss your feelings with you to
determine if you are actually depressed. They may
administer a written depression “test” to you, as well.
Postpartum depression can be treated with psychotherapy,
medications (even if you are breastfeeding) and/or
hormone therapy. Postpartum psychosis can also be
treated with medications, including antipsychotic
medicines and mood stabilizers. Other therapies
can also be used.
What can you do for yourself if you have postpartum
depression?
-
Develop a support group. Talk
to other mothers who may be feeling the same
feelings. Join groups of new mothers through
organizations like Parents Place and Mothers of
Preschoolers.
-
Allow others to help you take care of
the baby, the house, and meals. Insist on it,
if necessary. Don’t be a perfectionist.
Let the dishes stay in the sink overnight, if you’re
exhausted and no one else is able to do them.
Forget about the dust bunnies. Don’t, however,
let your home become an absolute mess; your mood
will benefit from some degree of order and
cleanliness.
-
Schedule some time to recharge your
battery. Have the baby’s father be in charge
of the baby while you walk around the block (or the
lake). Go to a movie with a friend.
-
Eat nutritious foods, exercise
regularly, drink plenty of fluids, and nap when the
baby sleeps. It’s hard to feel emotionally healthy
when you feel physically unhealthy as well as
exhausted.
-
Educate yourself about postpartum
depression. The following sources can help.
They can also put you in touch with someone who has
experienced postpartum depression or with a support
group specifically aimed at mothers in your
situation.
 
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