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HR Info
Postpartum Mood Disorders
By Carol Ann Friedman, RN, IBCLC, and Program Director of Mothers at
Work®
Giving birth is generally a joyful event. So new mothers may be surprised
if they begin to experience feelings of sadness, anxiety, fear and confusion in the days
and weeks after childbirth. In fact, many new mothers experience some form of postpartum
mood disorder after birth. These feelings are caused by a combination of factors: hormonal
changes, exhaustion from labor and delivery, the emotional ups and downs associated with
a major life change (such as birth) and taking on a new role (such as motherhood). For the
majority of women, these feelings usually go away within a few days. But when these symptoms
do not go away, a woman may have postpartum depression (PPD).
Postpartum mood disorders are currently divided into three categories, although
these classifications often times blend at the margins:
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1) |
The mildest end of the spectrum is the “baby blues.” Because
this condition occurs after 40% to 85% of deliveries, practitioners and patients often
view it as a “normal” phenomenon. Nonetheless, new mothers and their families may be
concerned by irritability, anxiety, confusion, crying spells, mood swings, and disturbances
in sleep and appetite. These symptoms usually peak between postpartum days three and
five, and typically resolve on their own 24 to 72 hours after that. Treatment for the
“baby blues” is generally supportive care and reassurance for a mother who has undergone
a significant change in her life.
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2) |
At the other end of the spectrum is the truly devastating disorder,
postpartum psychosis. It's rare in comparison to the other forms of postpartum mood
disorders, occurring only in about 0.1% to 0.2% of deliveries. Symptoms generally are
present within the first four weeks postpartum but can manifest up to three months after
delivery. A second, smaller, peak may occur between 18 to 24 months. Patients suffering
from postpartum psychosis are severely impaired, suffering from hallucinations and delusions
that frequently focus on the infant dying or being divine or demonic. These hallucinations
often command the patient to hurt herself or others, placing these mothers at the highest
risk. Treatment is generally long-term hospitalization in a psychiatric facility, where
the patient can be treated with medication and psychotherapy.
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Between these two extremes is postpartum depression, which is
increasingly recognized as a unique and serious complication of childbirth. It can occur
in 10% to 15% of all deliveries and 26% to 32% of all adolescent deliveries. The majority
of patients suffer from this illness for more than six months and, if untreated, 25%
of patients are still depressed a year later. More than 60% of patients have an onset
of PPD symptoms within the first six weeks postpartum, though they are often unrecognized
and undiagnosed. This is, in part, because of the social stigma attached to the condition.
A mother with PPD may feel ashamed or guilty and may downplay her struggle. She may
also fear that friends, relative and close family members will compare her to highly
publicized cases of postpartum psychosis that have led to infanticide or suicide. This
can make her feel even more isolated—as she may see other mothers who seem happy
and in control of their lives. These mothers need emotional support and praise for the
good care they are giving to their babies. |
The keys to successful treatment of PPD are early detection and intervention;
medication might be necessary. However, because mothers may be reluctant to seek treatment
or are not aware of the severity of their depression, detection by family members and evaluation
by primary health care providers are integral to properly diagnosing and treating this illness.
Getting Help
If you suspect you may be suffering from a postpartum mood disorder, consult
your physician or OB/Gyn. In addition, consider the following tips:
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Get household help. Stop putting
pressure on yourself to do everything. Do as much as you can and leave the rest. Ask
for help with the household duties and night feedings. A few continuous nights of good
sleep can really do wonders in lifting mothers out of depression.
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Talk with your health care providers about medical treatment.
Do not be concerned about telling them how you feel. Not all providers know how to tell
if you have PPD. If necessary, do not be embarrassed to ask for a referral to a mental
health professional that specializes in treating PPD.
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Get some physical exercise every day.
Physical activity may help take the edge off feelings of depression. Take walks with
the baby.
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Eat nutritious meals and snacks.
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Sleep when your baby sleeps.
Forget about the housework, your rest is more important!
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Get together with other new mothers who have babies around
the same age. Research proves that interaction with other
moms helps combat depression.
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Call trusted friends for moral support.
Spend time alone with your husband or partner.
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Believe that you will feel better again. |
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