Having a baby can be one of the biggest and happiest events in a woman’s life. While life with a new baby can be thrilling and rewarding, it can also be hard and stressful at times. Many physical and emotional changes can happen to a woman when she is pregnant and after she gives birth. These changes can leave new mothers feeling sad, anxious, afraid, or confused. For many women, these feelings (called the baby blues) go away quickly. But when these feelings do not go away or get worse, a woman may have postpartum depression. This is a serious condition that requires quick treatment from a health care provider.

What is postpartum depression?

Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby. PPD can be treated with medication and counseling. Talk with your health care provider right away if you think you have PPD.

Types of PPD:

  • The baby blues happen in many women in the days right after childbirth. A new mother can have sudden mood swings, such as feeling very happy and then feeling very sad. She may cry for no reason and can feel impatient, irritable, restless, anxious, lonely, and sad. The baby blues may last only a few hours or as long as 1 to 2 weeks after delivery. The baby blues do not always require treatment from a health care provider. Often, joining a support group of new moms or talking with other moms helps.
  • Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. A woman can have feelings similar to the baby blues – sadness, despair, anxiety, irritability – but she feels them much more strongly than she would with the baby blues. PPD often keeps a woman from doing the things she needs to do every day. When a woman’s ability to function is affected, this is a sure sign that she needs to see her health care provider right away. If a woman does not get treatment for PPD, symptoms can get worse and last for as long as 1 year. While PPD is a serious condition, it can be treated with medication and counseling.
  • Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first 3 months after childbirth. Women can lose touch with reality, often having auditory hallucinations (hearing things that aren’t actually happening, like a person talking) and delusions (seeing things differently from what they are). Visual hallucinations (seeing things that aren’t there) are less common. Other symptoms include insomnia (not being able to sleep), feeling agitated (unsettled) and angry, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else.

What are the symptoms?

The symptoms are very similar to those seen in ‘ordinary’ depression.

  • Feeling ‘low’, ‘miserable’ and tearful for no apparent reason. These feelings persist for most of the time, though they may be worse at certain times of day, particularly the morning.
  • Being unable to enjoy yourself. This may be particularly prominent in new mothers who feel that they are not enjoying having a new baby in the way they expected to.
  • Irritability is common. This may be with other children, the new baby and particularly with the partner.
  • Sleep disturbance is part of looking after a new baby. However there may be additional problems of finding it hard to go to sleep even though you are tired, or waking early in the morning.
  • Given that looking after a young baby means having less sleep than usual, it is no surprise that mothers often feel they have no energy. This can be even worse in mothers with PPD.
  • Appetite is sometimes affected, with mothers not being interested in food. This can be a particular problem since new mothers need all the energy they can get to look after their babies.
  • Anxiety frequently occurs in PPD. This may take many forms. It may be feeling tense and ‘on edge’ all the time. Normal concerns and anxieties that any mother feels for a new baby may become overwhelming. In addition mothers may experience ‘panic attacks’ which are episodes lasting several minutes when they feel as if something catastrophic is about to happen – such as collapsing, having a heart attack or stroke. These are extremely frightening but they get better on their own.
  • Depression is often accompanied by feelings of being ‘worthless’ and ‘hopeless’. These feelings are common in PPD. All mothers are faced with new and sometimes difficult problems with a new baby. However, mothers with PPD feel all the more ‘not able to cope’ and unable to see a way through their difficulties.
  • When people are depressed, they sometimes feel that there is no way out of their problems and that they, and their family, would be better off dead. Thoughts of suicide are therefore not uncommon. If you feel this way, it is important that you talk to somebody about how you feel, since there are ways out of your difficulties other than suicide. You should also be aware that your child would be at increased risk of developing mental health problems of their own if you do commit suicide. If you fear that somebody you know feels suicidal, take this seriously and try to talk to them about it. Talking about suicide does NOT increase the risk of the person committing suicide. Strongly advise the person to visit their doctor.

Treatment

Treatments for PPD are largely the same as for clinical depression in general. If the cause of PPD can be identified, treatment should be aimed at the root cause of the problem.
Women need to be taken seriously when symptoms occur. [That is, she must take her symptoms seriously enough to tell her significant other, or a close friend, or her medical practitioner. Also, they must take her symptoms seriously as well.] Generally a combination of psychotherapy and medication can reduce symptoms. The ideal treatment plan includes:

  • Medical evaluation to rule out physiological problems
  • Psychiatric evaluation
  • Psychotherapy
  • Possible medication
  • Support group
  • Home visit
  • Healthy diet
  • Consistent/ healthy sleep patterns

It is critical that women being treated for postpartum depression prolong the treatment even after symptoms subside, because if treatment is ceased prematurely, symptoms can reoccur.

What if I don’t want treatment?

Most women will get better without any treatment after a period of weeks, months or sometimes longer. However, this can mean a lot of suffering. PND can spoil the experience of new motherhood, and strain your relationship with your baby and partner. So the shorter it lasts, the better. It’s important to get help as soon as possible, to relieve the depression, to support your relationship with your baby, and to help your baby’s development in the long run. You should be told about all the likely benefits and risks of treatment so you can make the best choice for you.

Prevention

Early identification and intervention improves long term prognoses for most women. Some success with preemptive treatment has been found as well. A major part of prevention is being informed about the risk factors, and the medical community can play a key role in identifying and treating postpartum depression. Women should be screened by their physician to determine their risk for acquiring postpartum depression. Also, proper exercise and nutrition appears to play a role in preventing postpartum, and general, depression.

Sources: Wikipedia, Netdoctor

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