Postpartum depression

Caring for a newborn baby can feel overwhelming for a mother. New mothers may experience mood swings, anxiety, and trouble sleeping. These may be the symptoms of baby blues that often begin during the first couple of days after childbirth and last for 2 weeks. If symptoms persist and become more severe, they can be signs of persistent postpartum depression or postpartum psychosis, a rare but extreme mood disorder.

Postpartum depression can be treated. It is not a sign of weakness or a personal shortcoming.

What are the symptoms of postpartum depression?

Baby blues

Baby blues can start the first couple of days after your child is born and last for 1-2 weeks. You may experience:

• Anxiety, mood swings
• Feeling overwhelmed and irritated
• Sadness, crying
• Trouble concentrating and falling asleep
• Poor appetite

Postpartum depression

Postpartum depression is more severe and persists longer – up to a year. The symptoms often develop within the first few weeks after delivery; they are:

• Intense mood swings, severe anxiety, or panic attacks
• Feeling worthless and not a good enough mother
• Frequent crying
• Trouble bonding with your newborn
• Feeling hopeless, recurrent thoughts of harming yourself and your baby, death, and suicide
• Loss of or increased appetite
• Insomnia or excessive sleep
• Lassitude, loss of interest or pleasure in things you used to enjoy
• Isolate yourself from family and friends
• Confused, unable to concentrate

Postpartum psychosis

Postpartum psychosis is a rare but severe condition that begins during the first postpartum week. Immediate treatment is essential. If left untreated, it can lead to life-endangering thoughts and behaviors. Symptoms include:

• Obsessive thoughts about your baby
• Attempts to harm yourself or your baby
• Paranoia, confusion, and disorientation
• Hallucinations and delusions
• Sleep disturbances
• Heightened energy and agitation

Paternal postpartum depression

Paternal postpartum depression New fathers, particularly those who are young, have financial problems or a history of troubling relationships, or depression can also develop postpartum depression, affecting child development and family relationships.

When to see a doctor

Consult your doctor as soon as you suspect or have symptoms of postpartum baby blues, depression, or psychosis. Do not delay your appointment, especially when:

• It is challenging to carry out your daily tasks or care for your baby.
• You harbor thoughts of harming yourself or your baby.
• You are not better after 2 weeks.

What causes postpartum depression

There are no clear causes of postpartum depression. Things that may spur postpartum depression development are:

• The precipitous decrease of hormones such as estrogen and progesterone may be responsible for postpartum depression. The sharp drop in thyroid hormone may cause fatigue, sluggishness, and depression.
• Concern about the care of the newborn. You may have difficulty dealing with even minor issues when you don’t get enough rest or sleep. You may feel a loss of control or a sense of self-worth.

Risk factors

• Unwanted or unplanned pregnancy
• History of depression, postpartum depression, or bipolar disorder
• Stressful events such as unemployment, sickness, or pregnancy complications
• Multiple births such as twins or triplets
• Breastfeeding problems
• Financial or marital issues
• Lack of familial support

Complications

• Lack of mother-child bonding may lead to subsequent family problems.
• If left untreated, new mothers may develop future chronic or major depressive disorders.
• New fathers are prone to depression regardless of whether their partner has postpartum depression. If their partner is depressed, the father’s chance of depression is enhanced.
• Newborns of untreated depressed mothers tend to be fussy, have poor sleep and feeding, cry incessantly, and face language development problems.

Prevention

Promptly inform your doctor if you have a history of depression.

• During pregnancy: Your doctor will monitor for signs and symptoms of depression. You may be asked to fill out depression screening questionnaires or recommended to join a support group or undergo therapy.
• After delivery: Your doctor may recommend a screening test to look for signs and symptoms of postpartum depression and prescribe antidepressants or psychotherapy after childbirth.

Diagnosis

Any new mothers can develop postpartum depression. Do not be afraid or shy to share your symptoms with your doctor. Early detection helps lay out a treatment plan to control the symptoms.

Your doctor may ask you to:

• Complete a screening questionnaire
• Have blood tests to check hormone levels that may contribute to your postpartum depression.
• Do other tests to rule out other possible causes.

Treatment

The treatment plan will be tailor-made to suit your needs and the severity of your symptoms. If postpartum depression is caused by known metabolic problems such as underactive thyroid or preexisting conditions, these will be treated first.

Baby blues

Baby blues can improve on its own within a couple of days or weeks. Meanwhile, you should set aside time to rest, when possible; reach out to your family or friends for help and talk to other new moms to know that you are not facing this alone. Do not use alcohol or drugs, which can worsen your symptoms.

Postpartum depression

• Psychotherapy. Talking to a doctor or mental health professional allows you to vent your anxiety and find an effective way to cope with your emotions and situation.
• Antidepressants. Most antidepressants are safe to use during breastfeeding. If you are concerned, discuss the risks and benefits before use with your doctor.

Most patients improve after treatment. Make sure to keep all appointments even if you are better to prevent relapse. If the symptoms do not respond to treatment, they may escalate to chronic depression.

Postpartum psychosis

Postpartum psychosis Immediate hospitalization is necessary if you have postpartum psychosis.

• Medication. Your doctor may prescribe antipsychotic medications, mood stabilizers, and benzodiazepines to keep your symptoms under control. However, some drugs are to be avoided for breastfeeding mothers.
• Electroconvulsive therapy (ECT). If your symptoms are not responsive to medications or other treatments, ECT may be necessary. It is a procedure to pass a small electrical current through your brain, causing changes in brain chemistry that can quickly reverse depressive symptoms.

Lifestyle modification and home remedies

It is important to not only take care of the baby but also look after yourself physically and mentally.

• Set a healthy lifestyle routine. Find time to exercise or do outdoor activities such as walking with your children, eating healthy foods, and having enough rest and sleep.
• Do not try to do everything by yourself. Ask for help from your family and friends. Not blame yourself if you cannot do everything perfectly; do what you can. Get out of the house to have time for respite. Ask your partner or family member to take care of the baby, so you can unwind and do whatever you like.
• Talk or ask for advice from your partner, family, or friends. Do not isolate yourself from others. Talk to other mothers and share your experience with them. You may even learn new techniques like how to calm down a fussy baby.

Preparing for your appointment

• List all the symptoms you have.
• Make a list of the medications or dietary supplements you are taking
• List questions you would like to ask your doctor

Questions you may want to ask your doctor:

• What treatments do you recommend? Are there any side effects?
• When would my symptoms improve?
• How long do I need the treatments?
• Can I continue breastfeeding?
• Do I have a risk of developing more severe mental health problems?
• How can I prevent the condition from recurring?
• Where can I find more information about postpartum depression?

Questions your doctor may ask:

• What symptoms do you have? When did they start?
• What improves or worsens your symptoms?
• Is your ability to care for your baby affected?
• Do you feel bonded to your baby?
• How much rest or sleep do you get?
• What is your energy level? Can you eat as usual?
• Do you have any anxiety, irritation, or loss of temper?
• Have you ever thought of harming your baby or yourself?
• Do you have anyone helping you at home?
• Do you have any other medical conditions or mental health issues?

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