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Postpartum Depression and the “Baby Blues”
Am Fam Physician. 1999 Apr 15;59(8):2259-2260.See related article postpartum depression.
Are changes in mood common after childbirth?
After having a baby, many women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can't sleep well even when the baby is asleep. These symptoms usually start about three to four days after delivery and may last several days.
If you're a new mother and have any of these symptoms, you have what is called the “baby blues.” “The blues” are considered a normal part of early motherhood and usually go away within 10 days after delivery. However, some women have worse symptoms or symptoms last longer. This is called “postpartum depression.”
What is postpartum depression?
Postpartum depression is an illness, like diabetes or heart disease. It can be treated with therapy, support networks and medicines such as antidepressants. Here are some symptoms of postpartum depression:
Loss of interest or pleasure in life
Loss of appetite
Less energy and motivation to do things
A hard time falling asleep or staying asleep
Sleeping more than usual
Increased crying or tearfulness
Feeling worthless, hopeless or overly guilty
Feeling restless, irritable or anxious
Unexplained weight loss or gain
Feeling like life isn't worth living
Having thoughts about hurting yourself
Worrying about hurting your baby
Although many women get depressed right after childbirth, some women don't feel “down” until several weeks or months later. Depression that occurs within six months of childbirth may be postpartum depression.
Who gets postpartum depression?
Postpartum depression is more likely if you had any of the following:
Previous postpartum depression
Depression not related to pregnancy
Severe premenstrual syndrome (PMS)
A difficult marriage
Few family members or friends to talk to or depend on
Stressful life events during the pregnancy or after the childbirth
Why do women get postpartum depression?
The exact cause isn't known. Hormone levels change during pregnancy and right after childbirth. Those hormone changes may produce chemical changes in the brain that play a part in causing depression.
Feeling depressed doesn't mean that you're a bad person, or that you did something wrong or that you brought this on yourself.
How long does postpartum depression last?
It's hard to say. Some women feel better within a few weeks, but others feel depressed or “not themselves” for many months. Women who have more severe symptoms of depression or who have had depression in the past may take longer to get well. Just remember that help is available and that you can get better.
What kinds of treatments help with postpartum depression?
Postpartum depression is treated much like any other depression. Support, counseling (“talk therapy”) and medicines can help.
If I'm breast-feeding, can I take an antidepressant?
If you take an antidepressant medicine, it will go into your breast milk. Talk to your doctor about the risks of taking an antidepressant while breast-feeding. Your doctor can decide which medicine may be best for you to use while nursing your baby.
What can I do to help myself?
If you have given birth recently and are feeling sad, blue, anxious, irritable, tired or have any of the other symptoms mentioned here, remember that many other women have had the same experience. You're not “losing your mind” or “going crazy” and you shouldn't feel that you just have to suffer. Here are some things you can do that other mothers with postpartum depression have found helpful:
Find someone to talk to—and tell that person about your feelings.
Get in touch with people who can help you with child care, household chores and errands. This social support network will help you find time for yourself so you can rest.
Find time to do something for yourself, even if it's only 15 minutes a day. Try reading, exercising (walking is good for you and easy to do), taking a bath or meditating.
Keep a diary: every day, write down your emotions and feelings as a way of “letting it all out.” Once you begin to feel better, you can go back and reread your diary—this will help you see how much better you are.
Even if you can only get one thing done in any given day, this is a step in the right direction. There may be days when you can't get anything done. Try not to get angry with yourself when this happens.
It's OK to feel overwhelmed. Childbirth brings many changes, and parenting may be a new role. When you're not feeling like yourself, these changes can seem like too much to cope with.
You're not expected to be a “supermom.” Be honest about how much you can do, and ask other people to help you.
Find a support group in your area or contact one of the organizations listed below. They can put you in touch with people near you who have experience with postpartum depression.
Postpartum Depression Resources
The following organizations can help you find a support group:
Postpartum Support International
927 N. Kellogg, Santa Barbara, CA 93111
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1999 by the American Academy of Family Physicians.
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