Dealing with Post-Partum Depression

Copyright © 2015, Liz Currin, Ph.D.

What could be more exciting than the birth of a baby?  A new life and new hope for the future, as well as a tangible sign of a couple's love for each other.  The baby showers, the preparation of the nursery, stocking up on clothing, diapers, a stroller, toys, can be very pleasurable moments of anticipation for expecting couples.

Aside from the physical rigors of pregnancy and childbirth, the reality of a new baby is often different from what we anticipated.  Many of us are familiar with the term “baby blues”.  This refers to a  temporary slump in mood and energy after the birth of the baby, which usually improves within a few weeks after delivery.  Approximately 80% of new mothers experience some degree of this.  “Post-partum depression” is the more technical term for this.  But post-partum depression can also refer to a more prolonged and troublesome condition which follows the birth of a baby, and which may require professional attention.

Post-partum depression refers to a cluster of symptoms, including:  sadness, anxiety, and mood swings; tearfulness; oversleeping or insomnia; problems with concentration and memory; lack of interest in activities you previously enjoyed; either decreased appetite or overeating; physical symptoms, such as headache or unexplained pain; and withdrawal from friends and family.  Some particularly troubling symptoms can be difficulty in forming an emotional bond with your baby, lack of confidence in being able to care for your baby, or even thoughts of harming the baby.

Post-partum depression affects up to approximately 15% of new mothers.  PPD (Post-partum Depression) involves more severe symptoms of the “baby blues.”  It may require medical attention and treatment.  Treatment may include psychotherapy or counseling and perhaps antidepressant medication.  Before you start on medication, however, you want to discuss with your doctor whether you should continue breastfeeding and any possible effects on the baby. 

Who is at risk for PPD?  While it can affect any woman, those who are most susceptible are those who have a personal or family history of depression, are experiencing multiple life stressors, those who have had a difficult delivery or a baby with medical complications (for example, breathing difficulties related to prematurity, cerebral palsy, or birth defects).  Other risk factors include ambivalence about the baby (for example, an unplanned pregnancy), lack of social support from family and friends, and drug or alcohol use.

If post-partum depression goes untreated, it can lead to attachment problems, that is, problems developing a healthy emotional relationship with your baby.  It can also contribute to childhood behavioral problems, as well as well as difficulties with routine behaviors, such as eating and sleeping.

In very rare cases, a new mother may develop post-partum psychosis.  This is an extremely serious condition which typically develops around one to three months after the birth of a baby.  It may include both auditory and visual hallucinations (hearing voices or seeing things that are not actually real) or delusions (for example, thinking that the baby is evil).  Post-partum psychosis is an extremely dangerous condition which requires immediate medical attention.  Family and friends of the new mother also need to be vigilant and supportive, helping her to receive the medical attention needed to address this condition and assisting in caring for children who may be at risk due to the mother's condition.  Many of us remember the tragic case of Andrea Yates, the mother of five, who drowned all  her children in 2001.

Whether it's a fairly mild case of the “blues” after the birth of your baby, or a change in mood and energy that feels more serious and is not improving with time, there is help for the new mother.  Don't hesitate to reach out to family and friends and let them know you need their support.  And don't hesitate to contact your doctor to see if medication and other resources can help you in the short run as you adjust to caring for your new baby.