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http://www.psychiatry.org/postpartum-depression

WOMEN & POST-PARTUM DEPRESSION

Having a baby is supposed to be a joyous time in your life, but for women suffering with depression it can become very distressful and difficult.  An estimated 13 percent of new mothers experience depression after childbirth (postpartum depression).  Depression is a treatable medical illness involving feelings of extreme sadness, indifference, and anxiety.

Postpartum depression is different from the “baby blues.” Up to 70 percent of all new mothers experience the “baby blues,” a short-lasting condition that doesn’t impair functioning and doesn’t require medical attention.  Symptoms of this emotional letdown may include crying for no reason, irritability, restlessness, and anxiety. Postpartum depression is different from the baby blues in that it involves more debilitating effects that may continue for months.

Symptoms of postpartum depression include:

• Sluggishness, fatigue
• Feeling sadness, hopeless, helpless, or worthless
• Difficulty sleeping/sleeping too much
• Changes in appetite
• Difficulty concentrating/confusion
• Crying for “no reason”
• Lack of interest in the baby
• Fear of harming the baby or oneself

A woman experiencing depression usually has several of these symptoms and the symptoms and their severity may alternate.  These symptoms may cause new mothers to feel isolated, guilty, or ashamed. Getting treatment is important for both the mother and the child. You should contact your doctor if you are experiencing several of these symptoms for more than two weeks; you have thoughts of suicide or thoughts of harming your child; depressed feelings are getting worse; or you are having trouble with daily tasks and taking care of your baby. Depression is a medical illness -- not a sign of weakness or poor parenting, and it can be treated.

Who Is At Risk?

While any women may experience symptoms of depression, women are at increased risk of depression during or after pregnancy if they have previously experienced (or have a family history of) depression or other mood disorders, if they are experiencing particularly stressful life events, or if they don’t have support of family and friends. Research suggests that rapid changes in hormone and thyroid levels after delivery have a strong effect on moods and may contribute to postpartum depression. 

Treatment

Women need to be taken seriously when these symptoms occur. Depression can be treated with medication, psychotherapy, or both.  A medical evaluation can rule out physical problems, such as thyroid changes. The support of family, friends, and support groups can be helpful. It is important that women being treated for postpartum depression continue with treatment even after they feel better, because if they stop the treatment prematurely, symptoms can recur.

Other Postpartum Conditions

Postpartum Anxiety
Some women do not feel depressed, but have intense anxiety or irrational fears after giving birth. Their symptoms may include rapid heart rate, a sense of impending doom, and dizziness.  There is also another subset of women that experience obsessive-compulsive disorder, a type of anxiety involving persistent, recurring thoughts, impulses, or images. Some research has shown that postpartum anxiety affects more new mothers than postpartum depression.

Posttraumatic Stress Disorder after Childbirth
Women can develop posttraumatic stress disorder (PTSD) following a traumatic birth.  PTSD often involves reliving the experience through flashbacks or nightmares, having difficulty sleeping, and feeling detached or estranged.  

Postpartum Psychosis
Postpartum psychosis is an extremely rare but serious condition—it occurs in only one or two out of every 1,000 deliveries. The symptoms of postpartum psychosis are exaggerated and may include insomnia, excessive energy, agitation, hallucinations, and extreme paranoia or suspiciousness.  Symptoms of postpartum psychosis are a serious medical emergency and require immediate attention.