Postpartum Depression

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General Information

DEFINITION - Depression beginning up to 6 weeks following childbirth.

BODY PARTS INVOLVED - Brain.

SEX OR AGE MOST AFFECTED - Females of childbearing age.

SIGNS & SYMPTOMS

• Feelings of sadness, hopelessness or gloom.
• Appetite and weight loss.
• Sleep disturbances or frightening dreams.
• Loss of energy; fatigue.
• Slow speech and thought.
• Frequent headaches and other physical discomfort.
• Confusion about one's ability to improve life.

CAUSES - It's common for mothers to experience some degree of depression during the first weeks after birth. Pregnancy and birth are accompanied by sudden hormonal changes that affect emotions. Additionally, the 24-hour responsibility for a newborn infant represents a major psychological and lifestyle adjustment for most mothers - even after the first child. These physical and emotional stresses are usually accompanied by inadequate rest until the baby's routine stabilizes, so fatigue and depression are not unusual.

RISK INCREASES WITH

• Stress.
• Lack of sleep.
• Poor nutrition.
• Lack of support from one's partner, family or friends.
• Pre-existing neurosis or psychosis.

HOW TO PREVENT - Cannot be prevented, but can be minimized with rest, an adequate diet and a strong emotional support system.

What To Expect

DIAGNOSTIC MEASURES

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Psychotherapy or counseling, if depression persists.
• Hospitalization (severe cases only).

POSSIBLE COMPLICATIONS

• Lack of bonding between mother and infant, which is harmful to both.
• Serious depression that may be accompanied by aggressive feelings toward the baby, a loss of pride in appearance and home, loss of appetite or compulsive eating, withdrawal from others or suicidal tendencies.

PROBABLE OUTCOME - With support from friends and family, mild postpartum depression usually disappears quickly. If depression becomes severe, a mother may not be able to care for herself and the baby, and rarely, hospitalization may be necessary. Medication, counseling and support from others usually cure even severe depression in 3 to 6 months.

How To Treat

GENERAL MEASURES

• Don't feel guilty if you have mixed feelings about motherhood. Adjustment and bonding take time.
• Schedule frequent outings, such as walks and short visits with friends or family. These help prevent feelings of isolation.
• Have your baby sleep in a separate room. You will sleep more restfully.
• Ask for daytime help from family or friends who will shop for you or care for the baby while you rest.
• If you feel depressed, share your feelings with your partner or a friend who is a good listener. Talking with other mothers can help you keep problems in perspective.
• If depression becomes severe and hospitalization is necessary, choose a facility close enough to home so you can continue a close relationship with your baby.

MEDICATION - Your doctor may prescribe antidepressant drugs. These are often effective when used for 3 to 4 weeks. Any medication use must be carefully considered if you are breast-feeding.

ACTIVITY - No restrictions. Resume your normal activities as soon as possible.

DIET - No special diet.

Call Your Doctor If

• You have postpartum depression and additional life changes occur, such as divorce, career change or moving.
• Postpartum depression does not improve in 4 to 6 weeks.
• You seriously consider suicide. This is an emergency!

From the Complete Guide to Symptoms, Illness & Surgery by H. Winter Griffith, M.D. © 1995 The Putnam Berkley Group, Inc.; electronic rights by Medical Data Exchange.