Postpartum Blues

DEFINITION

Depression beginning after delivery up to 6 weeks following childbirth.

SIGNS & SYMPTOMS

  • Feelings of sadness, hopelessness or gloom.
  • Appetite and weight loss.
  • Sleep disturbances or frightening dreams.
  • Loss of energy; easy fatigueability.
  • 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 if it is not the first child. For the family the chapter is closed after rejoicing but for the mother a new era of added chores and responsibility has begun where even the husband does not share the woes!

Inadequate rest usually accompanies these physical and emotional stresses 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.

APPROPRIATE HEALTH CARE

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

DIAGNOSTIC MEASURES

  • Observation of symptoms, by self or spouse.
  • History and examination by a doctor.

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 hospitalization may be necessary. Medication, counseling and support from others usually cure even severe depression in 3 to 6 months.

TREATMENT

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.
  • If possible, 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 center 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. Resume sexual relations within 3 to 4 weeks after delivery. Ask your doctor for specific instructions.

DIET

No special diet.

CONTACT YOUR DOCTOR IMMEDIATELY, 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!