Postpartum Depression

Overview

Are mood changes common after childbirth?

Yes. After having a baby, many women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can’t sleep well even when the baby is asleep. These symptoms usually start about 3 to 4 days after delivery and may last several days.

If you’re a new mother and have any of these symptoms, you have what are called the baby blues. The baby blues are considered a normal part of early motherhood and usually go away within 10 days after delivery.

What is postpartum depression?

Some womens have more severe symptoms of the baby blues or symptoms that last longer than a few days. This is called postpartum depression. Postpartum depression is an illness, like diabetes or heart disease.

Symptoms

What are the symptoms of postpartum depression?

The symptoms of postpartum depression affect your quality of life and include:

Although many women get depressed right after childbirth, some women don’t begin to feel depressed until several weeks or months later. Depression that occurs within 6 months of childbirth may be postpartum depression.

In rare cases, a woman may develop postpartum psychosis. This is a very serious disease and includes all the symptoms of postpartum depression and thoughts of hurting yourself or hurting the baby. If you have thoughts of hurting yourself or your baby, get help immediately.

  • Feeling sad or down often

  • Frequent crying or tearfulness

  • Feeling restless, irritable or anxious

  • Loss of interest or pleasure in life

  • Loss of appetite

  • Less energy and motivation to do things

  • Difficulty sleeping, including trouble falling asleep, trouble staying asleep or sleeping more than usual

  • Feeling worthless, hopeless or guilty

  • Unexplained weight loss or gain

  • Feeling like life isn’t worth living

  • Showing little interest in your baby

How long does postpartum depression last?

It varies for each woman. Some women feel better within a few weeks, but others feel depressed or "not themselves" for many months. Women who have more severe symptoms of depression or who have had depression in the past may take longer to get well. Just remember that help is available and that you can get better.

Causes & Risk Factors

Why do women get postpartum depression?

The exact cause isn’t known. Hormone levels change during pregnancy and right after childbirth. Those hormone changes may produce chemical changes in the brain that play a part in causing depression.

Feeling depressed doesn’t mean that you are a bad person, that you did something wrong or that you brought this on yourself.

Who gets postpartum depression?

Postpartum depression is more likely if you have had any of the following:

  • Previous postpartum depression

  • Depression not related to pregnancy

  • Severe premenstrual syndrome (PMS)

  • A difficult or very stressful marriage or relationship

  • Few family members or friends to talk to or depend on

  • Stressful life events during pregnancy or after childbirth (such as as severe illness during pregnancy, premature birth or a difficult delivery)

Treatment

What kinds of treatments help with postpartum depression?

Postpartum depression is treated much like any other depression. Support, counseling ("talk therapy") and medicines can all help. Talk with your doctor about what treatment is best for you.

If I’m breastfeeding, can I take an antidepressant?

If you take an antidepressant medicine, it will go into your breast milk. Talk to your doctor about the risks of taking an antidepressant while breastfeeding. Your doctor can decide which medicine you can use while nursing your baby.

What can I do to help myself?

If you have given birth recently and are feeling sad, blue, anxious, irritable, tired or have any of the other symptoms of postpartum depression, remember that many other women have had the same experience. You’re not "losing your mind" or "going crazy" and you shouldn’t feel that you just have to suffer through. Here are some things you can do that other mothers with postpartum depression have found helpful:

  • Find someone to talk to and tell that person about your feelings.

  • Get in touch with people who can help you with child care, household chores and errands. This social support network will help you find time for yourself so you can rest.

  • Find time to do something for yourself, even if it’s only 15 minutes a day. Try reading, exercising (walking is great for your health and is easy to do), taking a bath or meditating.

  • Keep a diary. Every day, write down your emotions and feelings. This is a way to let out your thoughts and frustrations. Once you begin to feel better, you can go back and reread your diary. This will help you see how much better you are.

  • Even if you can only get one thing done on any given day, remember that this is a step in the right direction. There may be days when you can’t get anything done, but try not to get angry with yourself when this happens.

  • It’s okay to feel overwhelmed. Childbirth brings many changes and parenting is challenging. When you’re not feeling like yourself, these changes can seem like too much to cope with.

  • You’re not expected to be a "supermom." Be honest about how much you can do, and ask other people to help you when you need it.

  • Find a support group in your area. They can put you in touch with people near you who have experience with postpartum depression.

  • Talk with your doctor about how you feel. He or she may offer counseling and/or medicines that can help.

Other Organizations

Questions to Ask Your Doctor

  • I thought I’d feel differently after giving birth. Are my feelings normal?

  • Do my symptoms indicate postpartum depression?

  • What treatment option do you recommend for me? Do I need medicine?

  • I’m breastfeeding. Is this treatment safe for the baby?

  • How long before I can expect relief from my symptoms?

  • What can I do at home to help relieve my symptoms?

  • What should I do if my symptoms don’t get better, or if I feel like I might hurt myself or my baby?

  • If I have another baby, what are my chances of having postpartum depression again?

Citations

  • Postpartum Major Depression: Detection and Treatment by C. Neill Epperson, M.D.( 04/15/99, http://www.aafp.org/afp/990415ap/2247.html)