Depression Mind & Body

Depression After Childbirth

A car chase and death in Washington, D.C., focus attention on postpartum depression

The death of Miriam Carey, the 34-year-old woman who last week led police on a car chase from the White House to Capitol Hill before being shot and killed, has placed a spotlight on postpartum depression. According to Carey’s mom, Carey had been diagnosed with the mood disorder shortly after giving birth to her daughter a year ago. (Carey’s daughter, in the car at the time of the chase, was unharmed.)
What Is Postpartum Depression?
Pregnant women usually expect the days and weeks following the birth of their child to be a happy time. Most people have heard about the chance of “baby blues,” so a few days of unsettled mood and overwhelming feelings might not come as a big surprise. In fact, most new moms experience baby blues. Experts say this is normal and is a realistic response to a new mom’s new circumstances. But if the low mood does not go away, you might be developing depression. Clinical depression after childbirth is much the same as depression at any other time of life, except for one major difference: Depressed new mothers often feel very guilty about the way they are feeling. They worry about how hard it is to care for their baby when they are feeling so badly themselves.
Having a new baby to care for is hard work, and many women just do not have as much emotional support and practical help as they need. Depression, fatigue and worry on top of all that is a tough combination. And although you should not feel guilty about being depressed, being depressed over time can interfere with your relationship with your new baby. It is important to pay attention to deep unhappiness and moodiness after birth, and get more support.
The first step is recognizing that there is a problem—without being judgmental. If you are depressed, sometimes you do not realize when it has become so bad that you need help. One of the features of depression is that it can be hard to know when you are in it, and when the moods have stopped being “normal.” Or you might feel so bad that you cannot reach out for the help you need. So it might be your doctor or midwife, your partner or a friend, or other family member who will need to understand what is happening, and help you get more support so you can start enjoying your life with your new baby.
How to Tell If a New Mother Is Developing Depression
There are many terms for mood swings and turbulent feelings after giving birth, like baby blues, postnatal depression and postpartum depression. Postnatal and postpartum mean “after the birth.” Perinatal means “around birth,” and it includes pregnancy.
Postnatal blues might last for a few days after giving birth. Then it is usually over, although it could take up to two weeks for the woman’s emotions to settle down completely. Crying, mood swings and irritability are all common. This could happen to as many as half of all women who have just given birth. Support and understanding are usually enough to help you through.
Postnatal depression is different, although it can include all the emotions that someone who is having baby blues has as well. About 15 percent of women will get depressed in the first three months after giving birth. Half of these women will have mild or moderate depression, and around 7 percent will have major depression.
Depression is actually more likely to happen during pregnancy than after giving birth, and many women who have depression after the birth already had an episode of depression while they were pregnant.
These are the signs of postnatal depression:
Deep sadness and crying
Not enjoying things that usually give you pleasure
Insomnia and changes in appetite
Poor concentration
Low self-esteem
Thoughts of harming yourself or your baby
An online screening test used by medical professionals also can help you assess your situation.
What Causes Postpartum Depression?
There is no single cause. Rather, depression likely results from a combination of factors:
Depression is a mental illness that tends to run in families. Women with a family history of depression are more likely to have depression.
Changes in brain chemistry or structure are believed to play a big role in depression.
Stressful life events (the death of a loved one, caring for an aging family member, abuse and poverty) can trigger depression.
Hormonal factors unique to women may contribute to depression in some women. We know that hormones directly affect the brain chemistry that controls emotions and mood. We also know that women are at greater risk of depression at certain times in their lives, such as puberty, during and after pregnancy, and during perimenopause. Some women also have depressive symptoms right before their period.
Levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps regulate how your body uses and stores energy from food. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can tell if this condition is causing your symptoms. If so, your doctor can prescribe thyroid medicine.
Other factors may play a role in postpartum depression. You may feel:
Tired after delivery
Tired from a lack of sleep or broken sleep
Overwhelmed with a new baby
Doubts about your ability to be a good mother
Stress from changes in work and home routines
An unrealistic need to be a perfect mom
Loss of who you were before having the baby
Less attractive
A lack of free time
What Should You Do If You Experience Symptoms of Postpartum Depression?
Call your doctor if:
Your baby blues don’t go away after two weeks
Symptoms of depression get more and more intense
Symptoms of depression begin any time after delivery, even many months later
It is hard for you to perform tasks at work or at home
You cannot care for yourself or your baby
You have thoughts of harming yourself or your baby
Your doctor can ask you questions to test for depression. Your doctor can also refer you to a mental health professional who specializes in treating depression.
Some women don’t tell anyone about their symptoms. They feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They worry they will be viewed as unfit parents.
Any woman may become depressed during pregnancy or after having a baby. It doesn’t mean you are a bad mom. You and your baby don’t have to suffer. There is help.
Here other helpful tips:
Rest as much as you can. Sleep when the baby is sleeping.
Don’t try to do too much or try to be perfect.
Ask your partner, family and friends for help.
Make time to go out, visit friends, or spend time alone with your partner.
Discuss your feelings with your partner, family and friends.
Talk with other mothers so you can learn from their experiences.
Join a support group. Ask your doctor about groups in your area.
Don’t make any major life changes during pregnancy or right after giving birth. Major changes can cause unneeded stress. Sometimes big changes can’t be avoided. When that happens, try to arrange support and help in your new situation ahead of time.
What Is Postpartum Psychosis and How Is It Treated?
Postpartum psychosis is a separate, very severe form of mental illness that can appear after a woman gives birth. Symptoms include delusions, hallucinations and disorganized thinking. This illness, which affects one in 1,000 women who give birth, requires immediate intensive medical intervention. It’s important to note that postpartum psychosis is rare. A 2012 study found 34 cases in this country of new mothers with postpartum psychosis who killed their children between 1969 and 2010.

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