Patient Education

Postpartum Depression

Usually, having a baby is an exciting, wonderful journey for most women. The excitement of a new addition to the family and the long awaited months of birth can be a very joyous, fulfilling time. However, not all new mothers may experience these happy feelings. Sometimes new mothers experience many feelings of sadness, anxiety, or resentment after the birth of their child. In mild forms, it is often called having the "baby blues", and is normal to experience for a short period of time. However, not all cases of the "baby blues" go away after a week. When feelings worsen and become more severe or are persistent, this becomes a condition called postpartum depression. It is a medical condition, and requires medical attention and treatment. This page goes over the basics of postpartum depression, with information about what it is to treatment options.

WHAT ARE "BABY BLUES"?

Although the time right after the birth of a baby is stereotyped as being a very happy, perfect time, this is not usually the case for some new mothers. Sometimes, women feel upset after giving birth. They can feel lonely, upset, and even weak. Oftentimes these negative feelings come as a surprise for women, because they are not how they expected they would feel after birth. These feelings oftentimes are confusing as to what is making them so unhappy.

The truth is, the large majority of new mothers experience these feelings, which are consequently dubbed the "baby blues". Around 70-80% of new mothers get the baby blues, which includes symptoms such as:

  • Having trouble sleeping or eating
  • Difficulty with making choices
  • Crying spells for no reason
  • Fear of caring for the baby
  • Feeling anger, anxiety, or resentment
  • Being upset with the new baby, their other children, or their partner

Usually, these symptoms are short-lived, and usually come and go during the first few days to a week after childbirth. They usually do not merit treatment, as they go away by themselves.

WHAT IS POSTPARTUM DEPRESSION, AND HOW IS IT DIFFERENT THAN "BABY BLUES"?

Postpartum depression is much more than just baby blues. It is a condition where a new mother feels seriously depressed, anxious, or desperate. Women with postpartum depression oftentimes have difficulty performing tasks or making decisions. Postpartum depression develops usually within the first 1-3 weeks after birth, although it may occur any time after new birth. Postpartum can depend on the mother’s age or previous amount of children she has had. A woman has just as much chance of developing postpartum depression after her fifth child as she would with her first child. However, it is more likely that a woman will develop postpartum depression if she has had it before, or if she has other psychiatric disorders or recently stressful life situations. Postpartum depression is very serious condition, and needs medical treatment as well as counseling for the new mother. If left untreated, it can worsen greatly.

Sometimes, women will develop an even more condition called postpartum psychosis. It is very rare, and usually occurs in patients who have preexisting mental disorders such as schizophrenia or bipolar disorder. A woman with postpartum psychosis will experience many different symptoms, usually including manic episodes, trouble forming sentences, delusions, verbal hallucinations, violence, and swift mood changes from severe depression to complete ecstasy.

WHY DOES POSTPARTUM DEPRESSION HAPPEN?

There are several factors that can cause postpartum depression when combined all together. Usually, these factors are biological and emotional combined, but they are different for every woman. A woman’s life experiences as well as her bodily changes can trigger postpartum depression, but sometimes it just happens. The different aspects that influence postpartum depression include:

Bodily Changes:  There are many different changes that occur in a woman’s body during pregnancy. However, just as many of these changes occur right after birth in order to return the woman’s body back to its pre-pregnancy state. These changes are caused by the hormone levels of both estrogen and progesterone, which elevate during pregnancy. However, after birth, these levels fall very suddenly after birth. This can inevitably cause some depression in the same way that hormones drop before menstruation that can cause mood swings. The thyroid gland also produces hormones that decrease after birth. This can cause nervousness, sleep problems, mood swings, and tension. Oftentimes, this happens when women do not get enough sleep in the hospital. After birth, a woman’s body craves sleep, and fatigue can cause emotional anger.

Emotional Aspects:  There are many different emotional aspects that can affect a woman’s mood after birth. Some of these include:

  • Early Birth of the Baby: Sometimes, babies that are born early can have many problems that may have arisen from being premature. Sometimes, they will have to stay in the hospital for long periods of time. This is so that they can stay alive and be healthy. The mother may not be able to hold their baby as they want to. This can cause feelings of sadness and guilt, because the mother may feel alone or upset about leaving the baby behind. Babies born with defects also can cause serious postpartum depression, because a woman may feel guilty because she believes she did something "wrong" during the pregnancy and caused this to happen. 
  • Past Life Situations: Sad or traumatic events that may have happened in the woman’s past may contribute to postpartum depression. If a woman has a poor relationship with her mother or has recently lost her, she may feel unfit to raise a baby. Being abused as a child can also cause strong emotions of fear and insecurity in a new mother, especially if she worries that she will end up being violent like her parents.
  • Feelings of Loss: Sometimes, women experience feelings of loss after having the baby. She may feel that she has lost her freedom and will need to spend her life only with the new baby. She may also feel that she has lost an old identity and must take on a new one, as a mother. She also may feel loss of her sexual attractiveness and libido since she is a new mother or because of the changes in her body from the pregnancy.

Lifestyle Factors:  A woman may feel extremely depressed if she does not have support from family, friends, or their partner. It is important for new mothers to have support and help from someone close during this new phase in life. If a woman lives alone or away from family and friends, she may feel alone and hopeless. Also, if a new mother is unable to breastfeed, she may feel guilty and like they cannot feed their baby. However, formula nourishes babies just as well as breast milk.

Common Motherhood Myths:  There are many convoluted myths that circulate around about what a mother should be like and how motherhood will feel. Women who are introduced to these stereotypes may feel depressed if they feel that they do not live up to them, or don’t experience any of the presupposed emotions. These myths include:        

  • "Motherhood is Instinctive": Many women are led to believe by the media and stereotypes from books and movies that they should know exactly how to care for their new baby the second that it is born. The truth is, mothers need to learn motherhood just as anything else. This takes time, patience, and mistakes are made. This may not come naturally and immediately. Parenting books, watching caregivers, and befriending other mothers are oftentimes the best ways to learn. New mothers also believe that they should feel a certain way for their baby and immediately become very maternal. However, it sometimes takes days or weeks to bond with your baby. 
  • "The Perfect Baby": Some new mothers are surprised or disappointed with their newborn baby because it is not what they expected. Sometimes, newborns will look different than the baby that a mother may have imagined they will be. Also, some mothers are surprised to find that their baby is very difficult to comfort or are very fussy and hard to care for. Many women hear that babies should be quiet and cry only sometimes, but this is definitely not the case.
  • "The Perfect Mother": Stereotypes have taught women that they need to be the "perfect mother", and that there is a certain standard to which all women should meet. Some mothers worry that they will not meet up to this standard, and they will be failures of parents. However, this certainly is not true. There are many different ways to raise a new child, and having a perfect balance between work, household chores, and a baby, is not always possible.                                       

WHAT SHOULD I DO IF I AM FEELING SAD AFTER BIRTH?

If you are experiencing upset emotions after the birth of your new baby, there are several things that you can do to help to take care of yourself.  These include:

  • Asking for help from family or friends to help watch the baby, or any other children you may have
  • Getting plenty of rest, especially napping when the baby naps
  • Taking special care to continue being social with others, exercising, and taking care of yourself hygiene-wise (showering, getting dressed cleanly)
  • Talking to your family and friends about your feelings

However, if these negative feelings do not improve or don’t go away after a week, call your doctor. Worsening "baby blues" can be a symptom of severe postpartum depression. If you do not call your doctor and get help, they may get even worse and become debilitating to your life. If you are diagnosed with postpartum depression, the good news is that you can be treated. You may need to see a specialist who can help you with counseling about your feelings. He or she may also prescribe certain medications for you called antidepressants. They are safe and effective in helping your depression improve. If you are still have a feeling hopelessness, there are support groups with women just like you with postpartum depression. These groups get together and talk about their feelings as well as ways to cope and offering support. In order to feel better, it is important to remember to take care of yourself. Showering, getting dressed nicely, and getting out of the house can make a big difference in how you feel.

IN CONCLUSION

Although there are many ideas that new motherhood is supposed to be "joyous" and perfect, this is not always the case. Many women experience sadness, nervousness, or anger, as well as feeling like a failure, after having their baby, which is normal. However, if these feelings do not go away or they worsen, it is important to call your doctor, because you may have postpartum depression. Talk to your doctor about beginning treatment so you can feel better again.