Having a baby is a joyous time, but many women are surprised at how weak, sad, angry, afraid or anxious they feel after giving birth. Most new mothers have these feelings of the baby blues a few days after childbirth. For no clear reason they may cry, have trouble sleeping, eating and question how they can care for the baby. These feelings will come and go. Often times go away in a few hours or weeks without treatment.

For some women the problem is more serious, it lasts longer and is more intense. These women suffer from postpartum depression. Postpartum depression can occur at any time after birth but is more common one to three weeks following delivery.

Women with postpartum depression need treatment with counseling and sometimes medication. It tends to occur in women who lack emotional support or have had:

• Postpartum depression before
• A psychiatric illness
• Recent streak, such as losing a love one, family illness or moving to a new city.

It can also occur in women without any of these risk factors.

Signs and Symptoms of Postpartum Depression

• The baby blues do not fade after about a week, or get worse
• Strong feeling of anger and depression come one to two months after childbirth
• Feelings of sadness, doubt, guilty or helplessness increase each week and get in the way of normal functions
• A woman is not able to care for herself or the baby
• Trouble doing tasks at home or on the job
• Change in appetite
• Things that used to bring her pleasure no longer do
• Concern and worry about the baby is too intense or just lacks interest in the baby
• Anxiety or panic attacks occur
• Fears of harming the baby. These feelings are almost never acted on but can be scary
• Thoughts of self-harm or suicide

A new mother with these signs or symptoms should seek help right away.

Reasons for Postpartum Depression

Postpartum depression is likely a result from body, mind and lifestyle factors combined.

Body changes The postpartum period is time of many changes in a women’s body that can affect her mood or behavior. In the hours following childbirth the levels of the hormones estrogen and progesterone decrease sharply and may trigger depression. Some women are more bothered by these changes than others.

After birth many women are very tired, it can take weeks for a woman to regain her normal strength. New mothers seldom get the rest they need and this can be a major reason for depression.

Emotional Aspects There are many factors that affect a women’s self-esteem and the way she handles stress adding to the postpartum depression. Many women have feelings of loss after the birth of a baby that can lead to depression. The loss can come in many forms including:

• Loss of freedom
• Loss of an old identity
• Loss of the pre-pregnancy shape

Lifestyle Factors One of the biggest factors in postpartum depression is a lack of support. She needs the steady support of her partner, family and friends to provide comfort and help support some of the household chores and share in child care. If a woman, lives away from her family or is alone she may be lacking support.

The Role of Myth Many women have an idea of the “perfect mother” and are likely to feel let down when faced with the day-to day needs of mothering. Here are the thee most common myths about being a mother:

Myth 1 Motherhood is Instinctive

Many women believe they should just know how to take care of a newborn. The truth is new mothers need to learn how to be a mother just like you would learn any other new skill. It takes time and patience’s.

Myth 2 The Perfect Baby

Babies are born with distinct personalities right from birth. Some are easier to care for than others. They may not be easy to comfort and fussy and women can find it hard to adjust to the new baby.

Myth 3 The Perfect Mother

No mother is perfect

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Perinatal depression is a mood disorder that can occur either for the first time in pregnancy or within the first 12 months of giving birth.  Many people have heard of postpartum depression which is when depression occurs after delivery but some women can develop depression during the pregnancy.

It is a very common condition with 1 in 8 women being affected.  Risk factors for pregnancy or postpartum mood disorders include:

• A history of postpartum depression
• A history of mood disorder outside of pregnancy
• Preterm delivery or sick infant
• Unstable living situation
• Lack of family support
• Domestic violence
• Substance use
• Difficulties breast-feeding

Postpartum depression must be distinguished from the "baby blues" which is a very common and short-lived feeling of sadness and moods being up and down the first few weeks after giving birth.  This is more common and affects the majority of women but symptoms are usually mild and go away on their own within a few weeks.  It is thought that mood disorders are triggered by hormonal changes combined with sleep deprivation and the stress of caring for an infant.  There may also be a family history of mood disorders suggesting a genetic component.

Not all women experience postpartum depression and postpartum anxiety is nearly as common.  There is some overlap with these 2 conditions. Symptoms of either of these mood disorders include excessive fatigue, tearfulness, thoughts of self-harm, or harming the infant.  Other women may not eat or have a difficult time sleeping even though they are exhausted.  Many women also feel like they are "just not myself" or may have a partner or family member comment that they are concerned.   It is important to listen to the people who know you the best and care about you.  If they are expressing concerns try to listen and seek help from one of your providers.  It is important to make sure you express any questions or concerns with your provider as having any mood disorders not only affects you but also affects your relationship with your infant, other children, partner and other family members. 

It is important that you get help for postpartum depression so that it is not become something more severe such as postpartum psychosis which is a very serious condition where women may have hallucinations or even thoughts about harming her baby.  This is rare but we want to make sure it does not happen.

Treatment for postpartum depression and mood disorders does not always mean that medication as needed.  Sometimes your provider can recommend counseling, a trial of hormones or other medications.  It is important to know that you are not alone.  Please reach out and talk to someone.  We are here to help!