Postpartum depression

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Overview

The birth of a baby can bring a range of emotions, from joy to anxiety. Many new moms experience postpartum “baby blues,” characterized by mood swings, anxiety, and crying spells, lasting up to two weeks after childbirth. However, some new moms develop a more severe and long-lasting form of depression called postpartum depression, which may begin during pregnancy and continue after childbirth.

Postpartum depression is not a character flaw but a complication of giving birth. Prompt treatment can help manage symptoms and facilitate bonding with the baby.

Symptoms

Postpartum depression symptoms can vary in intensity and include:

Baby blues symptoms:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping

Postpartum depression symptoms:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with the baby
  • Withdrawing from family and friends
  • Loss of appetite or overeating
  • Insomnia or sleeping too much
  • Overwhelming tiredness
  • Loss of interest and pleasure in activities
  • Intense irritability and anger
  • Feelings of worthlessness, shame, or guilt
  • Reduced ability to think clearly or make decisions
  • Restlessness
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or the baby
  • Recurring thoughts of death or suicide

Postpartum psychosis symptoms:

  • Feeling confused and lost
  • Having obsessive thoughts about the baby
  • Hallucinations and delusions
  • Sleep problems
  • Excessive energy and agitation
  • Paranoia
  • Attempts to harm yourself or the baby

Postpartum depression in the other parent:

New fathers can also experience postpartum depression, exhibiting symptoms similar to those in mothers.

When to See a Doctor

If you experience any symptoms of baby blues or postpartum depression, call your healthcare provider promptly. Seek immediate help if symptoms include thoughts of harming yourself or the baby.

Causes

The causes of postpartum depression may include genetics, physical changes, and emotional issues:

  • Genetics: A family history of postpartum depression increases the risk.
  • Physical changes: Hormonal shifts after childbirth, such as a drop in estrogen and progesterone, may contribute to depression.
  • Emotional issues: Sleep deprivation, feeling overwhelmed, and other stressors can contribute to postpartum depression.

Risk Factors

Risk factors for postpartum depression include a history of depression or bipolar disorder, family history of mood disorders, stressful events, health problems in the baby, relationship issues, weak support system, financial problems, and unplanned pregnancy.

Complications

Untreated postpartum depression can affect mother-child bonding, family relationships, and child development. It may lead to ongoing depressive disorder and increase the risk of future depression episodes.

Prevention

If you have a history of depression, inform your healthcare provider when planning a pregnancy. Screening and early treatment during pregnancy and after childbirth can help manage postpartum depression. Most antidepressants are safe to take while breastfeeding.

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Diagnosis

Your healthcare provider will talk with you about your feelings, thoughts, and mental health to determine if you have postpartum baby blues or a more severe form of depression. It’s common, so don’t be embarrassed to share your symptoms and work with your provider to create a treatment plan.

An evaluation may include a depression screening and other tests to rule out other causes for your symptoms.

Treatment

Treatment and recovery time vary depending on the severity of depression and individual needs. Postpartum depression can be treated with psychotherapy (talk therapy), medication, or both.

Baby blues:

The baby blues usually fade on their own within a few days to 1 to 2 weeks. In the meantime, you can:

  • Get as much rest as you can.
  • Accept help from family and friends.
  • Connect with other new moms.
  • Create time to take care of yourself.
  • Avoid alcohol and recreational drugs.
  • Seek help from a lactation consultant if you’re having breastfeeding problems.

Postpartum depression:

Treatment for postpartum depression may include:

  • Psychotherapy: Talk through concerns with a mental health professional to cope with feelings, solve problems, and respond positively to situations. Family or relationship therapy may also help.
  • Antidepressants: Medication may be recommended, and most are safe during breastfeeding.
  • Other medicines: Additional medicines may be used to address specific symptoms, such as severe anxiety or insomnia.

Brexanolone is a drug approved for postpartum depression, but it requires a stay in a healthcare facility for monitoring.

Research continues on an oral medicine with fewer side effects for postpartum depression.

Postpartum psychosis:

Postpartum psychosis requires immediate treatment, usually in the hospital. Treatment may include medications and electroconvulsive therapy (ECT) for severe cases.

A hospital stay during treatment can challenge breastfeeding, but support for lactation can be arranged.

Lifestyle and Home Remedies

In addition to professional treatment, you can do the following:

  • Make healthy lifestyle choices, including physical activity, rest, and healthy eating.
  • Set realistic expectations and prioritize tasks.
  • Make time for yourself and seek support from loved ones.
  • Avoid isolation and talk about your feelings with others.
  • Ask for help with caregiving and parenting skills.

Coping and Support

Postpartum depression is a common medical condition that needs treatment. Talk with your healthcare provider and consider joining support groups for new moms or those with postpartum depression.

Preparing for Your Appointment

Before your appointment, make a list of symptoms, medical issues, medications, and questions to ask your provider. Don’t hesitate to seek help and ask for support.

Your provider may ask about your symptoms, ability to care for the baby, sleep, energy level, appetite, anxiety levels, support system, major stressors, and previous medical or mental health conditions.

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