What is Postpartum Depression?

You’ve just had a beautiful baby, and you had expected to be filled with joy during this time. Instead, you are overwhelmed by feelings of dread, self-doubt, sadness, and confusion. These feelings could be a sign that you are experiencing postpartum depression. If you suspect you might have postpartum depression, know that there is help available and that you don’t have to go it alone. Seeking help early can help make these negative feelings go away sooner, and help you focus on enjoying this special time with your newborn. Read on to find out what some of the symptoms of postpartum depression are and how this condition differs from the “baby blues.” You'll also learn about treatment that may be recommended to you if you are diagnosed with postpartum depression. Not only that: We provide information on postpartum depression in men, and offer tips on what to do if someone you know has postpartum depression.

What Is Postpartum Depression?

Postpartum depression (PPD) is a medical condition that causes severe and long-lasting negative emotions or thoughts in the months after giving birth. The feelings associated with this condition can be so strong that you may find yourself unable to do normal day-to-day tasks like caring for yourself and your baby. As the name suggests, PPD usually appears during the postpartum period, often between one and three weeks after your baby is born. For some women, it may begin up to a year after giving birth. In some cases, it may start before you give birth, while you are still pregnant. Postpartum depression can occur after any delivery, not necessarily the first one. Keep in mind that feeling overwhelmed, particularly in those first few months, can be totally normal and understandable: You have a new family member, you’re not sleeping much, and you have a lot on your plate. But if your feelings seem to be more severe and long-lasting, it may be that you have postpartum depression. With postpartum depression, the feelings of sadness and emptiness linger, typically lasting longer than two weeks. This condition is not a character flaw or a sign of weakness; instead, it can be considered a complication of childbirth. Postpartum depression can interfere with your day-to-day life and prevent you from enjoying motherhood and bonding with your baby, so getting treatment from your healthcare provider is essential.

How Common Is Postpartum Depression?

It’s more common than you might think. About 10 to 15 percent of women who’ve given birth experience postpartum depression. So if you think you have the symptoms of PPD (described in the next section) or if you’ve recently been diagnosed, know that you are not alone and there is help available.

Signs and Symptoms of PPD

It's important to be aware of the signs and symptoms of postpartum depression. These can include:

• Feelings of hopelessness and despair

• Severe anxiety

• Feeling depressed

• Severe mood swings

• Intense irritability and anger

• Crying a lot

• Difficulty bonding with your baby or not having an interest in your little one

• Fear that you’re not a good mother

• Loss of appetite or eating much more than usual

• Inability to sleep (insomnia) or sleeping too much

• Overwhelming fatigue or loss of energy

• Having trouble focusing

• Finding it hard to handle everyday tasks

• Withdrawing from loved ones

• Reduced interest in activities you used to enjoy

• Feelings of worthlessness, shame, guilt, or inadequacy

• Having panic attacks

• Experiencing aches or pains like headaches or stomach problems

• Thoughts of harming yourself or your baby

• Recurrent thoughts of death or suicide.

Only your healthcare provider can diagnose postpartum depression, and telling your provider about what you're experiencing is essential for getting the help and treatment you need. Contact your healthcare provider right away if

• your symptoms last longer than two weeks

• your symptoms are getting more severe over time

• you’re struggling to get through the day, including caring for yourself and your baby

• you have thoughts of hurting yourself or your baby.

Causes of Postpartum Depression

It’s not known exactly what causes postpartum depression, but it is likely triggered by a combination of physical and emotional factors, which may include:

• Hormonal changes. A sharp drop in the level of the pregnancy hormones estrogen and progesterone after you give birth may contribute by causing mood swings. In addition, levels of other hormones produced by your thyroid gland may also drop, making you feel tired, sluggish, and depressed.

• Sleep deprivation. Recovering from giving birth combined with caring for your newborn can takes its toll on your ability to get adequate rest. This sleep deficit builds up and can lead to physical discomfort as well as exhaustion, which can trigger symptoms of postpartum depression.

• Emotional issues. This is a period of big change in your life. Feeling overwhelmed and anxious, feeling less attractive, struggling with your sense of identity, and feeling as if you’ve lost control of your life may also be contributing factors.

Risk Factors

Postpartum depression can affect any new mom, but having these risk factors may increase the likelihood experiencing this condition:

• A history of depression, either during pregnancy or at other times

• Experiencing premenstrual syndrome (PMS) before your periods

• Having a history of mental health problems

• Having had postpartum depression after a previous pregnancy

• A family history of depression or other mood problems

• Experiencing major stressors recently (even those unrelated to pregnancy)

• Difficult transitions, such as returning to work

• Having twins or multiples

• Giving birth preterm

• Having a baby who has health problems or other special needs

• Having difficulty breastfeeding

• Problems in your relationship with your partner

• A weak support system

• Financial worries

• Having a bipolar disorder.

If you have a history of postpartum depression, tell your healthcare provider as soon as you find out you are pregnant. If you have any of the other risk factors, it may be safest to mention this to your healthcare provider either during your pregnancy or after you give birth. If your healthcare provider suspects you may be at risk, as part of your prenatal care, she may take any of the following steps:

• Monitor you closely for any signs and symptoms of postpartum depression

• Give you a depression-screening questionnaire (such as the Edinburgh Postnatal Depression Scale) during your pregnancy and after delivery

• Suggest you attend support groups, counseling, or other therapies to help you handle any mild depression

• Recommend antidepressants—even during pregnancy

• Recommend psychotherapy immediately after delivery.

The Difference Between Postpartum Depression and “Baby Blues”

Postpartum depression is not the same as the “postpartum blues” or the “baby blues.” The term baby blues or postpartum blues refers to less severe symptoms of sadness and feeling overwhelmed. With this condition, you may experience short bouts of crying and anxiety. You might also have trouble sleeping or lose your appetite. The milder symptoms associated with the blues typically begin a few days after you give birth, and usually go away after a couple of days or weeks without treatment. Although having the baby blues can be difficult, these feelings aren’t so severe that they interfere with being able to care for yourself or your baby the way postpartum depression can. You should know that you’re not alone if you feel down after giving birth—up to 70 to 80 percent of new moms feel this way. You’ve been through a lot and your body is adjusting, and some feelings of sadness and even anger are normal. During this time, what can help is for you to feel reassured and supported by those around you. Some good strategies for coping with the postpartum blues can include:

• Getting as much rest as you can

• Talking to your loved ones about how you’re feeling

• Asking for help

• Exercising (as long as your healthcare provider has given it the OK)

• Joining a support group of other new parents

• Giving yourself a little “me time” each day, including some time spent out of the house.

Postpartum Psychosis

Postpartum depression should also not be confused with a mood disorder called postpartum psychosis, which involves more severe symptoms, such as hallucinations. Postpartum psychosis is very rare (about 4 new moms for every 1,000 births experience it), and it requires emergency medical treatment.

Treatment for Postpartum Depression

Your provider will be able to diagnose postpartum depression based on how you are feeling and the symptoms you have. Your postpartum depression treatment options may include psychotherapy (also known as talk therapy or mental health counseling) and/or medications, such as antidepressants. Antidepressants help with mood regulation by balancing chemicals in the brain. There are many types of antidepressants, and your healthcare provider will be able to prescribe one that's appropriate for you. Keep in mind that it may take up to a month for the medication to start working. With talk therapy, you’ll have the chance to speak to a mental health professional about how you’re feeling and get advice on how to manage your emotions. Sometimes these sessions are one-on-one with a therapist, and sometimes these take place in a group of others going through similar challenges. Although PPD isn’t generally something you can treat on your own, these ideas may help set a solid foundation for your medical treatment plan, and could help speed up recovery:

• Maintain a healthy lifestyle. Be physically active every day, whether it's taking a walk with your baby or some other form of exercise. Try to get as much sleep as you can, and eat healthily.

• Have realistic expectations. You’re adjusting to having a new baby, so don’t put pressure on yourself for everything to be perfect.

• Make time for yourself. Let someone care for your baby while you have some “me time.” Leave the house, and do something relaxing that you enjoy with people you feel comfortable with.

• Connect with others. Feeling isolated can be a problem for some new moms. Talk to your loved ones about how you’re feeling, and speak to other moms about their experiences. There may even be a support group in your local area you can join—check with your healthcare provider or community centre for information on what may be available.

• Share the load. Your loved ones will often be happy to help out. Sometimes all it takes is just to ask! There may be practical things they can do—such as cooking you some meals, or helping with chores—that can take some of the pressure off you.

• Limit upheaval. Having a baby is enough of a change in your life. As much as possible, try to limit additional major life changes at this time, such as moving or changing jobs.

• Follow your healthcare provider’s advice. Don’t stop treatment simply because you “feel better,” as this may lead to a relapse.

Breastfeeding and Antidepressants

Experts say that it’s typically safe for most women to take antidepressants while breastfeeding. However, your healthcare provider will weigh the risks and benefits and make a recommendation based on your personal situation.

How Long Does Postpartum Depression Last?

Postpartum depression needs treatment from your healthcare provider. Your personal situation and healthcare provider’s treatment plan will have a bearing on how soon it will come to an end. For some women, symptoms may peak after a few weeks, but then linger for 3 to 12 months more. Getting treatment early can help reduce the severity of your symptoms and may help resolve the condition more quickly.

What Can Happen if Postpartum Depression Isn’t Treated?

Not getting treatment for postpartum depression can mean that the severe negative feelings last for a long time. Lack of treatment can also affect bonding between you and your baby, and can lead to development problems for your baby.

Can Your Postpartum Depression Affect Your Baby?

Yes, indirectly, it can. Bonding with your baby is important for your baby’s development, and postpartum depression can stand in the way of that. Any stress and anxiety you feel can also affect your infant and his brain development. This is another reason why diagnosis and treatment for postpartum depression is so important.

Can Postpartum Depression Be Prevented?

If you are at risk of postpartum depression, your provider may monitor you for signs of depression during your pregnancy and afterward. In some cases, she may recommend treatment in the form of antidepressants or therapy while you are still pregnant, or right after you give birth, as a way to help reduce the risk. After the birth of your baby, your provider may also recommend you go in for an earlier postnatal checkup to screen for signs of postpartum depression so that it can be detected at the earliest possible time.

Postpartum Depression in Men

If you are the other parent of the newborn, keep in mind that there is such a thing as paternal postpartum depression (or male postpartum depression). Experts suggest it can affect up to 25 percent of new dads in the first year after their baby is born. Experts also believe that same-sex and non-biological parents can also experience the symptoms of depression as they adjust to being a new parent. Coping with the added responsibilities and challenges of being a new parent, trying to bond with your baby, and feeling the pressures of having to provide for your growing family could all contribute to feelings of depression. Symptoms of paternal depression can also include feelings of anger and irritability, withdrawing from loved ones, and feeling sad and overwhelmed. As the other parent, your emotional wellbeing is crucial for your baby’s development and the overall wellbeing of your family. Plus, you deserve to feel happy and healthy for your own sake, too. If your partner is depressed, it can also affect you, as your risk of depression is already higher during this time. If you find yourself feeling depressed, speak to your healthcare provider, and try some of the self-care strategies mentioned above.

How to Support a Loved One Who Has Postpartum Depression

People with PPD may not be able to tell that they’re depressed; they may not know the signs and symptoms. If you suspect a loved one has postpartum depression, help him or her seek medical advice right away. Keep in mind that as a partner, friend, or family member, you can’t “fix” postpartum depression, but you can be there for the new parent. Here are some practical things you can try:

• Encourage seeing a healthcare provider

• Listen to and accept his or her feelings; understand that someone with PPD cannot control negative feelings

• Offer to take care of the baby so he or she can do relaxing things like go for a walk, get a massage, or meet friends guilt-free

• Arrange for a family member, friend, or babysitter to care for the baby for a few hours, so he or she has a chance to get some quality sleep

• Help out by doing basic errands, chores, or day-to-day tasks to take some of the responsibility off his or her plate.

The Bottom Line

Postpartum depression is not your fault. Unfortunately, many women feel guilty or ashamed because they can’t find any reason to explain why they feel so unhappy. Some may even experience having their feelings dismissed or criticized by others. Remember that postpartum depression is a medical condition that requires treatment, and that you don’t need to suffer alone. There is support out there, and once the fog clears, you’ll be able to enjoy this time with your baby.