The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression.
Many new moms experience the baby blues after childbirth, which commonly include mood swings and crying spells and fade quickly. But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme form of postpartum depression known as postpartum psychosis develops after childbirth.
Postpartum depression isn't a character flaw or a weakness. Sometimes postpartum depression is simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms — and enjoy your baby.
Signs and symptoms of depression after childbirth vary depending on the type of depression.
Baby blues symptoms
Postpartum depression symptoms
Untreated, postpartum depression may last for a year or more.
When to see a doctor
Getting early treatment for postpartum depression can speed your recovery.
If you suspect that you're developing postpartum psychosis, seek medical attention immediately. Don't wait and hope for improvement. Postpartum psychosis may lead to life-threatening thoughts or behaviors.
There's no single cause for postpartum depression. Physical, emotional and lifestyle factors may all play a role.
In addition, some women may be genetically more vulnerable than others to postpartum depression. However, it's not clear whether hereditary factors that increase a woman's risk of postpartum depression are different from those that increase her risk of depression overall.
Postpartum depression can develop after the birth of any child, not just the first. The risk increases if:
The risk of postpartum psychosis is higher for women who have bipolar disorder.
Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. Children of mothers who have untreated postpartum depression are more likely to have behavioral problems, such as sleeping and eating difficulties, temper tantrums and hyperactivity. Delays in language development are more common as well.
Untreated postpartum depression can last up to a year or longer. Sometimes untreated postpartum depression becomes a chronic depressive disorder. Even when treated, postpartum depression increases a woman's risk of future episodes of major depression.
Preparing for your appointment
If you have signs and symptoms common to postpartum depression, call your doctor. Don't let shame or anxiety stop you. Postpartum depression is common and your doctor knows it's not your fault. To protect your health and the health of your baby, the condition needs to be treated as soon as possible.
After your initial appointment, your doctor may refer you to a mental health provider who can create the right treatment plan for you.
Here's some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
Questions to ask a doctor who sees you for possible postpartum depression include:
In addition to the questions that you've prepared in advance, don't hesitate to ask for more information at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
If at any point you have thoughts of harming yourself or your baby, immediately give your baby to your partner or another loved one and call 911 or your local emergency assistance number.
Tests and diagnosis
The Diagnostic and Statistical Manual of Mental Disorders (DSM) considers postpartum depression a subtype of major depression. The DSM is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
According to the DSM, in order for postpartum depression to be diagnosed, signs and symptoms of major depression must develop within four weeks of giving birth.
Signs and symptoms of a major depressive episode include, in part:
To distinguish between a short-term case of the baby blues and a more severe form of depression, your doctor may ask you to complete a depression-screening questionnaire.
In addition, your doctor likely will perform blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms.
Treatments and drugs
Treatment and recovery time vary, depending on the severity of your depression and your individual needs.
With appropriate treatment, postpartum depression usually goes away within a few months. In some cases, postpartum depression lasts up to a year. It's important to continue treatment after you begin to feel better, however. Stopping treatment too early may only lead to a relapse.
When your safety is assured, a combination of medications — such as antidepressants, antipsychotic medications and mood stabilizers — may be used to control your signs and symptoms. Sometimes electroconvulsive therapy (ECT) is recommended as well. During ECT, a small amount of electrical current is applied to your brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when you need immediate results.
Treatment for postpartum psychosis can challenge a mother's ability to breast-feed. Separation from the baby makes breast-feeding difficult, and some medications used to treat postpartum psychosis aren't recommended for women who are breast-feeding. If you're experiencing postpartum psychosis, a team of health care providers will help you work through these challenges.
Lifestyle and home remedies
Postpartum depression isn't generally a condition that you can treat on your own — but you can do some things for yourself that build on your treatment plan. In fact, taking good care of yourself can help speed your recovery.
Remember, the best way to take care of your baby is to take care of yourself.
If you have a history of depression — especially postpartum depression — mention it to your doctor as soon as you find out you're pregnant. Your doctor will monitor you closely for signs and symptoms of depression. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants are recommended — even during pregnancy.
After your baby is born, your doctor may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier postpartum depression is detected, the earlier treatment can begin. If you have a history of postpartum depression, your doctor may recommend antidepressant treatment immediately after delivery.
Coping and support
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. And new dads are already at increased risk of depression, whether or not their partner is affected.
Regardless, there's no question that the already stressful, exhausting period following a baby's birth is even much more difficult when depression is added to the mix. You may begin to resent a partner struggling with depression, especially when you're overworked and under-rested yourself. But remember: Depression is never anyone's fault, and it can't be fixed with a stiff upper lip or a positive attitude. Depression is a medical illness that needs treatment.
If you're having trouble coping with postpartum depression in your family, talk with a therapist. Depression is a treatable condition. The sooner you get help, the sooner you'll be fully equipped to help your partner and enjoy your new baby.
Last Updated: 2010-06-03
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