Postpartum depression can occur at any time after childbirth, but it most commonly starts 1-3 weeks after delivery. Women with postpartum depression have such strong feelings of sadness, anxiety, or despair that they have trouble coping with their daily tasks. Women with postpartum depression need treatment with counseling and sometimes medication. Without treatment, postpartum depression may become worse or may last longer.
About 2-3 days after birth, many new mothers begin to feel depressed, anxious, and upset. For no clear reason, they may feel angry with the new baby, their partners, or their other children. These feelings are called postpartum blues or "baby blues." Other common signs and symptoms including the following:
A new mother having any of the following signs or symptoms should take steps right away to get help:
A few new mothers will develop a more severe mental illness called postpartum psychosis. However, this condition is very rare. Women are more at risk if they have had manic depression (bipolar disorder) or schizophrenia or if family members have had these diseases.
Postpartum depression is likely to result from body, mind, and lifestyle factors combined. No two women have the same biologic makeup or life experiences. These differences may be why some women have postpartum depression and others do not. It also may help explain why a woman can cope with the demands of everyday life but find the stress of a new baby hard to handle.
The postpartum period is a time of great changes in the body. These changes can affect a woman's mood and behavior for days or weeks.
Levels of the hormones estrogen and progesterone decrease sharply in the hours after childbirth. This change may trigger depression in the same way that much smaller changes in hormone levels can trigger mood swings and tension before menstrual periods. Hormone levels produced by the thyroid gland also may decrease sharply after birth. If these levels are too low, the new mother may have depression-like symptoms, such as mood swings, nervousness, fatigue, trouble sleeping, and tension.
Many women feel very tired after giving birth. It can take weeks for a woman to regain her normal strength. Some women have their babies by cesarean delivery. Because this is major surgery, it will take them longer to feel strong again.
Also, new mothers seldom get the rest they need. In the hospital, sleep is disturbed by visitors, hospital routine, and the baby's feedings. At home, the baby's feedings and care must be done around the clock, along with household tasks. Fatigue and lack of sleep can go on for months. They can be a major reason for depression.
Feelings of doubt about the pregnancy are common The pregnancy may not have been planned. Even when a pregnancy is planned, 40 weeks may not be enough time for a couple to adjust to the extra effort of caring for a baby.
Feelings of loss after having a baby also are common. Loss can take many forms:
Having a baby who must stay in the hospital after birth can cause sadness and guilt. A woman may feel guilty that she did something wrong during pregnancy. Sadness about coming home without the baby is very common.
Mixed feelings sometimes arise from a woman's past. She may have lost her own mother early or had a poor relationship with her. This might cause her to be unsure about her feelings toward her new baby. She may fear that caring for the child will lead to pain, disappointment, or loss.
A major factor in postpartum depression is lack of support from others. The steady support of a new mother's partner, other family members, or friends is a comfort during pregnancy and after the birth. If a woman lives alone or far away from her family, support may be lacking.
Breastfeeding problems can make a new mother feel depressed. New mothers need not feel guilty if they cannot breastfeed or if they decide to stop. The baby can be well nourished with formula. Your partner or other supportive person can help with some of the feedings, giving you more time for yourself or for rest.
If you are feeling depressed after the birth of your child, there are some things you can do to take care of yourself and your baby:
Blues that do not go away after about a week or feelings that get worse may be signs of a more severe depression. Tell your health care provider if you are afraid you might neglect or hurt your baby.
Your health care provider may refer you to experts in treating depression. These experts will give emotional support, help you sort through your feelings, and help you make changes in your life. You also may be given antidepressants. These drugs generally are considered safe to use during breastfeeding.
Hotlines and support groups are available for women with postpartum depression. Talk to your health care provider about finding help in your area.
Antidepressants: Medications used to treat depression.
Cesarean Delivery: Delivery of a baby through an incision made in the mother's abdomen and uterus.
Estrogen: A female hormone produced in the ovaries.
Postpartum Blues: Feelings of sadness, fear, anger, or anxiety occurring about 3 days after childbirth and usually fading after 1 week (sometimes called "baby blues").
Postpartum Depression: Intense feelings of sadness, anxiety, or despair after childbirth that interfere with a new mother's ability to function and do not go away after a few weeks.
Progesterone: A female hormone that is produced in the ovaries and prepares the lining of the uterus during the second half of the menstrual cycle to nourish a fertilized egg.
Patient Education - Patient Education / FAQ's