POSTPARTUM DEPRESSION--DEFINITION, SYMPTOMS AND TREATMENT

Christy Bergemann, BA, LCCE

If you have symptoms of depression--during pregnancy or after the baby is born

contact www.postpartumva.org or call 703-243-2904

Most women develop the "baby blues" after giving birth. Some women develop depression during or after the baby is born. The baby blues is normal and should clear up in 2-3 weeks.

If it doesn't, or if mom gets over the baby blues and then becomes depressed anytime during the first 12 months postpartum, this is postpartum depression (PPD).

"Baby Blues"

• Symptoms usually begin 3-4 days after delivery, worsen by days 5-7, and tend to go away by the end of the second week, the third week at the latest.
• Most new moms experience them
• Doesn't affect only 1^st time mothers

Postpartum Depression

If mom is not over the "baby blues" after 2-3 weeks, she and her partner and support system should be alert for POSTPARTUM DEPRESSION (PPD)

• 10-20% of all postpartum women develop PPD; not just first-time moms
• Onset can be as early as 2 weeks postpartum and as late as 1 year postpartum
• Can last 3-14 months
• More likely to develop it if a woman has had clinical depression when not pregnant
• Caused by changes in brain chemistry
• NOT a "personality flaw"
• ACKNOWLEDGING THE PROBLEM IS ONE OF THE DIFFICULTIES WITH PPD--WOMEN FREQUENTLY DON'T GET HELP IF:
• Mom may feel guilty or be told that she "should get over it" or "has no right to be sad, she's got a beautiful baby"
• Mom may feel depression is normal after the birth of a baby
• Mom may feel too tired to get help
• PHYSICIANS AND FAMILY MEMBERS MAY FEEL THE SYMPTOMS ARE CAUSED BY THE STRESS OF CARING FOR A NEWBORN AND THEREFORE THE ILLNESS MAY BE DISMISSED AND NOT DIAGNOSED.
• MOM NEEDS TO BE URGED TO GET HELP

Postpartum Depression Symptoms

• Feel sad, hopeless, anxious, overwhelmed, panicky, regret having the baby,
• May have trouble sleeping, even when the baby sleeps
• Feel the family would be better off without her
• Afraid to leave the house or to be alone
• Isolates self from friends or family
• Unexplained anger or irritability
• Fear of harming self or the baby
• Trouble coping with daily tasks
• Difficulty concentrating or making simple decisions
• Feel "out of control"
• Feel guilty for feeling this way
• Losing interest or pleasure in activities one used to enjoy
• Fatigue, feeling restless or slowed down--especially very slowed down (voice, movements)
• Agitated, frantic, sense of guilt or worthlessness, loss of self-esteem
• Appetite changes
• Recurring thoughts of death or suicide, anxiety about the baby's health
• Multiple visits to her doctor for vague complaints--women with PPD have 3 times as many postpartum medical visits as unaffected women

Postpartum psychosis

• Occurs in 0.1-0.2% of women who develop PPD
• Occurs from 2 days to 1 month postpartum
• May want to harm self (Mom has terrible feelings of guilt and she feels she needs punishment)or harm baby (feels something is wrong with the baby)
• Woman needs hospitalization

Cultural/racial differences--in presentation of symptoms:

• African-American women--more prone to experience variations in daytime symptoms
• Caucasions--more prone to panic, obsessional thoughts--for example, mom needs to check the baby 20 times in a few minutes to make certain she okay
• Latinas--more prone to physical symptoms

Treatment

• Psychological/psychiatric counseling and possibly medication for mild cases
• Psychological/psychiatric counseling and medication needed for more severe cases
• Hospitalization in a psychiatric facility may be needed

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