The birth of a newborn is often associated with a variety of emotional feelings for the mother. There is often much excitement, joy, and celebrations, but many newborn mothers often experience depression which is often not adequately addressed by healthcare providers. Prompt treatment can help the mother manage her symptoms and help her bond with her baby. Untreated, postpartum depression may last for many months or longer.
What is postpartum depression?
Many mothers after the birth of their newborn will experience some “baby blues”, 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. Postpartum depression is different. In postpartum depression the symptoms are very severe and debilitating. The depression symptoms could last months or get worse, and have a significant impact on the new mother, her baby and her family.
Postpartum depression is a complication of pregnancy and is not a character flaw or a weakness. Being depressed does not mean you are a bad parent.
What causes postpartum depression?
There is no single cause of postpartum depression, but physical and emotional issues may play a role.
What are some common symptoms of postpartum depression?
Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with a mother’s ability to care for her baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ? during pregnancy ? or later — up to a year after birth.
Postpartum depression signs and symptoms may include the following:
• Depressed mood or severe mood swings
• Excessive crying
• Difficulty bonding with your baby
• Withdrawing from family and friends
• Loss of appetite or eating much more than usual
• Inability to sleep (insomnia) or sleeping too much
• Overwhelming fatigue or loss of energy
• Reduced interest and pleasure in activities you used to enjoy
• Intense irritability and anger
• Fear that you are not a good mother
• Hopelessness
• Feelings of worthlessness, shame, guilt or inadequacy
• Diminished ability to think clearly, concentrate or make decisions
• Restlessness
• Severe anxiety and panic attacks
• Thoughts of harming yourself or your baby
• Recurrent thoughts of death or suicide
People with depression may not recognize or acknowledge that they are depressed. They may not be aware of signs and symptoms of depression. If you suspect that a friend or loved one has postpartum depression, help her seek medical attention immediately. Do not wait and hope for improvement.
Treatment
If you have symptoms suggestive of postpartum depression seek help. Talk to your gynaecologist or midwife. If they cannot help, they will know someone who can.
Fathers and other relatives, if you think the mother has symptoms of postpartum depression encourage her to seek help. Do not let the new mother struggle alone hoping that the problem will go away.
Postnatal depression can be lonely, distressing and frightening – but support and effective treatments are available.
Treatment options include the following:
• self-help – things the mother can try, include: talking to family and friends about her feelings and what they can do to help, making time for herself to do things she enjoy, resting whenever she get the chance, and getting as much sleep as she can at night, exercising regularly, eating a healthy diet.
• psychological therapy – your doctor may be able to recommend a self-help course, or may refer you for a course of therapy such as cognitive behavioural therapy (CBT)
• antidepressants – these may be recommended if your depression is more severe or other treatments have not helped. Your doctor can prescribe a medicine that is safe to take while breastfeeding.
Postpartum depression in new fathers
New fathers can experience postpartum depression, too. They may feel sad or fatigued, be overwhelmed, experience anxiety, or have changes in their usual eating and sleeping patterns ? the same symptoms mothers with postpartum depression experience.
Fathers who are young, have a history of depression, experience relationship problems or are struggling financially are most at risk of postpartum depression. Postpartum depression in fathers ? sometimes called paternal postpartum depression ? can have the same negative effect on partner relationships, and child development, as postpartum depression in mothers can.
If you are a new father, and are experiencing symptoms of depression or anxiety during your partner’s pregnancy, or in the first year after your child’s birth, talk to your healthcare professional. Similar treatments and supports provided to mothers with postpartum depression can be beneficial in treating postpartum depression in fathers.
Complications of postpartum depression
Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.
• For mothers. Untreated postpartum depression can last for months or longer, sometimes becoming a chronic depressive disorder.
• For fathers. Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s father may also increase.
• For children. Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and delays in language development.
Suicidal thoughts
All mothers should not ignore 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. You should seek urgent medical attention either from your doctor or at the accident and emergency unit at the hospital. If you are reluctant to contact a healthcare provider, please reach out to a close friend or loved one, or contact you minister or someone of faith in your community. If you have suicidal thoughts please let someone know and seek help.
Can postnatal depression be prevented?
Although there have been several studies in preventing postnatal depression, there is no evidence that there is anything specific persons can do to prevent the condition developing, apart from maintaining as healthy a lifestyle as they can. If a woman has a history of depression or mental health problems, or if she has a family history of mental health problems after childbirth, she is strongly advised to tell her midwife, gynaecologist or mental health team if she is pregnant or thinking of having a baby. This will enable them to offer her appropriate monitoring and treatment, if necessary.
If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth.
Conclusion
Postpartum depression is a form of clinical depression that can start any time during the first year after childbirth, but symptoms tend to start in the first three weeks after delivery. Symptoms can be very severe, and the mother might feel sad, hopeless, and guilty because she may not feel like she wants to bond with, or care for, her baby. Treatment is available, and most of those women with postpartum depression find that it helps. If you have symptoms suggestive of postpartum depression seek 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-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
