Post-Partum Depression

October 3, 2020

3 min read

Having a baby sets off a cascade of powerful emotions that can be positive or negative. For some women, intense sadness, fear, or anxiety can occur. They may have mood swings, cry, feel insecure, and have difficulty sleeping. These emotions, referred to as “baby blues,” usually start within a few days after delivery. Typically, the baby blues settle after a couple of weeks; but, in some cases, a more severe and long-lived form of depression can develop. This is called postpartum depression.

Symptoms

The symptoms of postpartum depression vary for each person. In some cases, the depression can be mild and difficult for others to notice. Symptoms can begin during or after pregnancy, sometimes starting many months after birth.

Extreme fatigue
Major changes in sleeping patterns (inability to sleep or sleeping too much)
Excessive crying
Depressed mood
Severe mood swings or irritability
Loss of appetite
Less interest in activities that were previously enjoyed
Feelings of hopeless, guilt, or inadequacy as a mother.
Inability to bond with the baby
Severe panic or anxiety
Thoughts of self-harm or harming the baby

Postpartum psychosis

Rarely, a woman may develop and extreme form of depression called postpartum psychosis. This condition usually develops within a week of the birth, and the symptoms are severe and obvious:

Confusion
Obsessive thoughts
Hallucinations or delusional behavior
Disturbed sleep
Excessive energy
Paranoid thoughts
Agitated behavior
Attempts to self-harm self or harm the baby

These behaviors can be life-threatening for the mother and baby, so immediate medical treatment is needed.

Causes

Postpartum depression can be caused by multiple factors.

Fatigue: A combination of natural hormonal changes (e.g., thyroid hormone decreases), the physical demands of recovering from childbirth, and lack of sleep while caring for a newborn all contribute to excessive tiredness.
Emotions: Women may react differently to the transition to motherhood. Sadness, insecurity, anger, and guilt can all affect the new mother’s self-esteem and ability to manage stress.
Hormonal changes: Immediately after childbirth, the levels of the female hormones, estrogen and progesterone, decline rapidly. These abrupt shifts can trigger mood swings.
History of depression or mental disorder: Women who have experienced depression or mental disorders (e.g., bipolar disorder) at any time in their life are at a higher risk for developing postpartum depression.
Other life events: Stressful life events can make it more difficult to manage the emotions and stress that are a normal part being a mother. Examples include family illness, moving to a new town, the death of a friend or family member, or financial hardship.
Lack of support: Women who do not have a support network available to help them manage the emotions and physical demands of new motherhood are more likely to feel overwhelmed.
Having multiples: the demands of having multiples can cause increased stress and fatigue.
Baby with special needs: All mothers worry about their babies, but mothers of children with special needs (e.g., mental or physical disabilities) face increased stress.

Diagnosis

Postpartum depression is common, so mothers who suspect they may have this condition should not be embarrassed to share their symptoms with their doctor. As part of their evaluation, the doctor may have the woman fill out a questionnaire or answer questions. If a woman has some symptoms, they may ask questions to better understand the severity and how long they have been having them. If they are diagnosed with postpartum depression, blood tests may be ordered to rule out obvious causes of the symptoms (e.g., an underactive thyroid gland), which can help inform treatment options.

Treatment

Postpartum depression symptoms can be successfully treated. The treatment and recovery time depend on the severity of the depression and individual causes. If an underlying illness or hormonal imbalance is contributing to the depression, medication may be prescribed to address them.

Mental health professionals may also be involved in treatment. Psychotherapy (counseling) can help the woman better understand and manage her feelings. This therapy can be done alone or with other members of the family. Medications, such as antidepressants, can also be used. Three to four weeks of medication may be needed to start feeling relief.

Postpartum Depression in Fathers

Postpartum depression can also occur in fathers. The symptoms are similar to those experienced by women. Like motherhood, becoming a new father causes a surge of emotions and life changes that can trigger depression. Both mothers and fathers who may be experiences postpartum depression should seek medical help.