Is It Postpartum Depression or the “Baby Blues”?

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Giving birth is one of the most joyous experiences of a woman's life. Everybody says so. Family, friends, books, magazine articles. Everything she knows has prepared her for the elation that will accompany the arrival of her baby.

And yet, within days of giving birth, most women find themselves teary, sad, anxious, and fatigued. The “baby blues” affect as many as 80 percent of new mothers and its typically mild symptoms dissipate within a few days or a week with adjustment to new motherhood and with support from a partner, family, and friends.

But about 15 percent of women suffer from postpartum depression, a more serious condition that starts later—generally weeks or even months after delivery—and is more severe, interfering with a woman's ability to care for herself and her family. Postpartum depression does not resolve on its own; it requires treatment by a medical professional and can have serious consequences if untreated. New mothers and their families must be alert to the symptoms and seek treatment when needed.

What are the symptoms of postpartum depression?

Caring for a new baby is hard work. It's normal to feel tired and anxious in the first days and weeks. The symptoms of postpartum depression are more intense and longer-lasting. They include:

• Overwhelming feelings of sadness, hopelessness, irritability.
• Feeling incapable of caring for the baby.
• Finding it difficult to bond with the baby.
• Sleeping too much or too little, even when the baby is asleep
• Loss of pleasure in previously pleasurable activities; withdrawing from family and friends.
• Thoughts of self-harm or harming the baby.
• History of severe PMDD (Premenstrual dysphoric disorder with substantial mood swings in the week before menses).
• A prior history of post-partum depression, with prior pregnancies.

Only a medical professional can accurately diagnose postpartum depression but if these symptoms are severe and persistent for more than two weeks, help should be sought immediately.

What causes postpartum depression? Are some women more at risk?

It is generally thought that the dramatic changes in hormone levels during and after pregnancy may be responsible for changes in mood and that some women might be more sensitive to these hormonal fluctuations. Genes may also play a role but the precise cause isn't known. There are, however, several known factors that predispose a woman to postpartum depression, most notably a similar episode with a previous pregnancy. Others include:

• Personal or family history of depressive illness.
• Stressful personal or family events around the time of the pregnancy and delivery; mixed feelings about the pregnancy.
• Medical complications such as premature delivery or having a baby with medical problems.
• Problems with alcohol or drug abuse.
• Lack of strong support from partner, family, friends.

How is postpartum depression treated?

There are several effective modes of treatment for postpartum depression and almost all women are able to overcome the condition and function well and happily as mothers. One-on-one counseling with a mental health professional may be based on cognitive behavioral therapy (CBT), which helps people change negative thoughts and behaviors and which has been particularly effective in treating postpartum depression. Medication is often used along with counseling. Antidepressant medications that act on the brain chemicals responsible for mood regulation are generally considered safe for breastfeeding mothers but women should discuss with their doctors the benefits and risks of medication for both mother and child.

While being treated professionally for postpartum depression, women must accept help from supportive family and friends—help caring for the baby, help caring for the home, help caring for herself. She should get plenty of rest, take time for herself or be with friends, consider joining a support group, and talk about her feelings to her partner and other mothers whose experiences can be helpful.

Untreated postpartum depression can have serious consequences for the mother's relationship with her baby and for the child's development in the years to come. Women must avoid the vicious circle in which depression makes her feel like a bad mother, and feeling like a bad mother makes her depression worse. Most important, she must acknowledge her feelings to herself and to others. Seeking help is not a sign of weakness; it is a sign of strength. Postpartum depression can be overcome so women can enjoy the rewards of motherhood.