Postpartum Depression (PPD)

What is postpartum depression?

Postpartum depression is a mental health illness that affects women after giving birth. For some women, it is normal to feel the “baby blues” for a week or two after giving birth. With postpartum depression, feelings of sadness, loneliness, worthlessness, restlessness, and anxiety may last longer than two weeks.

After having a baby, many women have mood swings. One minute they feel happy, and 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 3 to 4 days after delivery and may last several days.

If you’re a new mother and have any of these symptoms, you may have the baby blues. The baby blues are considered a normal part of early motherhood and usually go away within 10 days after delivery.

Symptoms of postpartum depression

The symptoms of postpartum depression affect your quality of life and include:

• Feeling sad or down often
• Frequent crying or tearfulness
• Feeling restless, irritable, or anxious
• Loss of interest or pleasure in life
• Loss of appetite
• Less energy and motivation to do things
• Difficulty sleeping, including trouble falling asleep, trouble staying asleep, or sleeping more than usual
• Feeling worthless, hopeless, or guilty
• Unexplained weight loss or gain
• Feeling like life isn’t worth living
• Showing little interest in your baby
• Not feeling attached to your baby

Most women who develop postpartum depression do so right after childbirth; however, some women don’t begin to feel depressed until several weeks or months later. Depression that occurs within 6 months of childbirth may be postpartum depression.

In rare cases, a woman may develop postpartum psychosis. This is a very serious disease. It often includes many of the symptoms of postpartum depression along with delusions, hallucinations, and paranoia. Additionally postpartum depression may cause the mother to be at risk of hurting herself or her baby

What causes 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. This plays a part in causing depression.

Postpartum depression is more likely to occur if you have had any of the following:

• Previous postpartum depression
• Depression not related to pregnancy
• Severe premenstrual syndrome (PMS)
• A difficult or very stressful marriage or relationship
• Few family members or friends to talk to or depend on
• Stressful life events during pregnancy or after childbirth (such as severe illness during pregnancy, premature birth, or a difficult delivery)

How is postpartum depression diagnosed?

Schedule a visit with your doctor if you suspect you have postpartum depression. Your doctor will talk to you about your symptoms and feelings. He or she will ask you how long you have been feeling depressed. Your doctor may ask you to complete a questionnaire about your depression or order a blood test to check your hormone levels.

Can postpartum depression be prevented or avoided?

Postpartum depression cannot be prevented or avoided. However, if you have a history of depression or postpartum depression after giving birth to other children, you can prepare. Preparation might include keeping your mind and body healthy. Eat healthy during your pregnancy, exercise, and learn stress reduction strategies. Once your baby is born, stay away from alcohol and caffeine. Continue to make healthy lifestyle decisions. See your doctor earlier in your pregnancy or sooner after giving birth if you are worried you will have postpartum depression.

Additionally, the American Academy of Family Physicians (AAFP) recommends screening for depression in the general adult population. This includes pregnant and postpartum women. Screening efforts should focus on ensuring accurate diagnosis, effective treatment, and appropriate follow up.

Postpartum depression treatment

Postpartum depression is treated much like any other depression. Support, counseling (talk therapy), and prescription medicines (antidepressants) can help. Talk with your doctor about what treatment is best for you. If you have thoughts of hurting yourself or your baby, get help immediately. Call a suicide hotline, a friend, family member, or 911.

If you are breastfeeding, talk to your doctor about the benefits and risks of taking an antidepressant. Many antidepressant medicines are safe for breastfeeding infants. Your doctor can decide which medicine you can use while nursing your baby.

Most importantly, don’t assume there’s nothing you can do if you are suffering from postpartum depression. Help is available, and you can get better.

Living with postpartum depression

Feeling depressed doesn’t mean that you are a bad person. It doesn’t mean that you did something wrong or that you brought this on yourself. It also does not mean that you don’t love your baby. If you have given birth recently and are feeling sad, blue, anxious, irritable, tired, or have any of the other symptoms of postpartum depression, remember that many other women have had the same experience.

You’re not “losing your mind” or “going crazy.” You shouldn’t feel that you just have to suffer through it. 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 childcare, household chores, and errands. This 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 great for your health and is easy to do), taking a bath, or meditating.
• Keep a daily diary. Write down your emotions and feelings. This is a way to let out your thoughts and frustrations. Once you begin to feel better, you can go back and reread your diary. This will help you see how much better you are.
• Celebrate small achievements. Even if you can only get one thing done on any given day, remember that 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 okay to feel overwhelmed. Childbirth brings many changes and parenting is challenging. When you’re not feeling like yourself, these changes can seem like too much to handle.
• You’re not expected to be a supermom. Be honest about how much you can do. Ask other people to help you when you need it.
• Find a support group in your area. They can put you in touch with people near you who have experience with postpartum depression.
• Talk with your doctor about how you feel. He or she may offer counseling and/or medicines that can help.

Questions to ask your doctor

• Will I have to take antidepressants for life?
• If I take medicine, will I have trouble getting off the medicine when I feel better?
• How will I know if the medicine is making me feel better or if I’m naturally getting better?
• Will I have postpartum depression with every pregnancy?
• Who should I call if I am having thoughts of suicide or of harming my baby?

Resources

American Pregnancy Association: Baby Blues

Centers for Disease Control and Prevention: Depression Among Women

Office on Women’s Health: Postpartum depression