The birth of a newborn infant is often a time of great joy, excitement, anxiety and celebration but, in some cases, the birth for the new mother is associated with a serious condition called postpartum depression. If this depression is not diagnosed and treated appropriately it can lead to serious complications for mother and newborn.
Postpartum depression
The vast majority of new mothers experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery, and may last for up to two weeks. A few new mothers experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis may also develop after childbirth.
Postpartum depression is a common problem. It is not the same as “baby blues”, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners as well.
Postpartum depression is not a character flaw or a weakness. Sometimes it is simply a complication of giving birth. Prompt diagnosis and treatment can help tremendously in mothers coping with postpartum depression. Untreated, postpartum depression may last for many months or longer.
What causes postpartum depression?
We are not sure what causes postpartum depression, but physical and emotional issues may play a role.
• Physical changes. After childbirth, a dramatic drop in hormones (oestrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed.
• Emotional issues. When you are sleep deprived and overwhelmed, you may have trouble handling even minor problems. You may be anxious about your ability to care for a newborn. You may feel less attractive, struggle with your sense of identity, or feel that you have lost control over your life. Any of these issues can contribute to postpartum depression.
What are some signs and symptoms of postpartum depression?
Many women feel a bit down, tearful or anxious in the first week after giving birth. This is often called the “baby blues” and is so common that it is considered normal. The “baby blues” do not last for more than 2 weeks after giving birth.
If your symptoms last longer, or start later, you could have postnatal depression.
Postnatal depression can start any time in the first year after giving birth.
Signs that you or someone you know might be depressed include:
• a persistent feeling of sadness and low mood
• lack of enjoyment and loss of interest in the wider world
• lack of energy and feeling tired all the time
• trouble sleeping at night and feeling sleepy during the day
• difficulty bonding with your baby
• withdrawing from contact with other people
• problems concentrating and making decisions
• frightening thoughts – for example, about hurting your baby
Many women do not realise they have postnatal depression because it can develop gradually. It is important to call your doctor as soon as possible if are having the signs and symptoms of postpartum depression.
If you have suicidal thoughts
If at any point you have thoughts of harming yourself, or your baby, immediately seek help from your partner or loved ones in taking care of your baby – and call 911, or your local emergency assistance number, to get help. Also consider these options if you are having suicidal thoughts:
• Seek help from your primary care provider or other healthcare professionals.
• Call a mental health professional.
• Reach out to a close friend or loved one.
• Contact a minister, spiritual leader or someone else in your faith in your community.
Treatments for postnatal depression
Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available. Treatment and recovery time vary, depending on the severity of the depression and individual needs. If you have an underlying illness, your doctor may treat that. Your doctor may also refer you to a mental health professional. Postpartum depression is often treated with psychotherapy, medication or both.
With appropriate treatment, postpartum depression symptoms usually improve. In some cases, postpartum depression can continue, becoming chronic depression. It is important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse.
Prevention
If you have a history of depression — especially postpartum depression — tell your obstetrician if you are planning on becoming pregnant, or as soon as you find out you are pregnant.
Conclusion
Postpartum depression occurs in women soon after giving birth – and it is very common, affecting approximately one in every ten women giving birth. Symptoms include sadness and hopelessness. Counselling and antidepressants are treatment options. Relatives and friends of new mothers, and fathers, should be aware of the symptoms of postpartum depression – and give the necessary support when needed. They should also encourage the individual in question to get professional help.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
