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Postpartum Depression

Is this your symptom?

Feeling depressed or anxious much of the time during the period up to one year after having a baby(postpartum)
Not taking good care of yourself or your baby
Do not feel a bond with the baby

Risk Factors for Postpartum Depression:

History of mental health problems
Mental health problems during pregnancy
Unplanned pregnancy
Recent major life events (death of a loved one, divorce, job loss)
Substance use or abuse (drugs, tobacco, alcohol)
Low birth weight, still birth or sudden infant death syndrome
Depression in the father of the child, poor relationship with partner or parental stress after the birth
Difficulty getting pregnant
Thyroid problems

Causes and Conditions that Impact Mental Health After Birth

Postpartum Psychosis (serious) is a rare but serious form of mental illness that puts the mother and baby at risk. The mother may have symptoms which range from low mood to losing touch with reality. She may think of harming herself or her baby. Seek help right away if these symptoms occur.
Depression. The cause is unknown. Some people are more likely to develop depression than others. It may be inherited. It may also be triggered by life events. Women are more likely to develop depression than men. The risks are higher after childbirth and at the time of the menopause.
Anxiety is a feeling of being tense or fearful. There may be physical symptoms such as dry mouth, nausea, sweating, shaking or palpitations (thumping heartbeat). In severe cases there may be chest pain and rapid breathing. Anxiety is normal in stressful situations. It is abnormal if it lasts after the stressful situation has gone away or if it happens without stress. Treatment involves self-help, trying to understand the reason for the anxiety and/or depression, talking therapies and meds, if needed.
Adjustment Reaction. This is like anxiety but it grows over a period of days or weeks in reaction to something that has happened (like a divorce). It may include depression. Treatment involves self-help, trying to understand the reason for the anxiety and/or depression, talking therapies and meds, if needed.
Phobia is a strong fear or dread of something that is out of proportion with the reality of the threat. Coming into contact with the situation/threat, or in some cases just thinking of the threat, can bring on symptoms of severe anxiety. Examples include agoraphobia (fear of going outside), arachnophobia (fear of spiders), fear of flying and many others. Behavioral therapies can have great success. Meds may also be used.
Social Anxiety Disorder (social phobia). This is a type of phobia in which you become very worried about what people think of you. It limits your ability to interact with other people in social situations.
Panic Attacks and Panic Disorder. A panic attack is the sudden onset of symptoms of severe anxiety and panic for no apparent reason. This can be overwhelming with all the symptoms of severe anxiety and in addition pins and needles and spasm of the hands and feet muscles due to over-breathing (hyperventilation). The person may look ill and appear white around their mouth. They rarely pass out and the attack often passes off after about 10 minutes. It can be difficult to tell whether the symptoms are due to panic or a heart condition. If in doubt Call 911. Panic disorder is diagnosed if you have repeated panic attacks at variable intervals.
Depression from Health Problems. A number of physical conditions can cause low mood and may be mistaken for depression. It is important to rule out physical conditions as treatment of the underlying condition may be needed. These include:
- Underactive thyroid (a gland in the neck which produces thyroxine). Low levels can make you feel low, weepy and tired
- Underactive pituitary gland (a gland in the brain which makes various hormones). Low levels affect sex drive and fertility as well as causing weight gain and low mood.
- A head injury, even if it happened many years ago
- Polymyalgia Rheumatica (an inflammatory condition) causing joint pain and stiffness as well as depression.
- Early dementia may present as depression
Seasonal Affective Disorder. Some people get depression in the winter months only. The cause is thought to be due to lack of sunlight. Symptoms include trouble waking up. The symptoms become worse as the hours of daylight become shorter. The most severe symptoms tend to occur between November and January. Treatment includes getting as much natural sunlight as you can and/or light therapy from a lightbox with a bright light. The usual therapies for depression may also help.

When to Call for Postpartum Depression

When to Call for Postpartum Depression
Call 911 Now You have tried to kill yourself or feel like you will try within the next few minutes You have attempted to harm your baby or are neglecting your baby You are thinking about harming or abandoning your baby You have hurt yourself, taken an overdose of medicine or swallowed a poison You think you have a life-threatening emergency Call Doctor or Seek Care Now You feel life is not worth living and feel guilty, worthless or helpless (or call 988, the Suicide and Crisis Lifeline) Your wife or partner is behaving oddly, such as: neglecting the baby doing strange things seeing or hearing things that are not there You had a still born baby or a baby who died within the past 12 months You are afraid to be left alone with your baby You have a history of bipolar disorder and feel your mood is changing You think you need to be seen, and the problem is urgent (or call 988)	Contact Doctor Within 24 Hours You are not able to take care of yourself or your baby (not eating and drinking normally, drinking too much alcohol, not bathing/showering) You have a constant feeling of anxiety, fear, worry and/or panic You are crying all the time You think you need to be seen, but the problem is not urgent Contact Doctor During Office Hours Trouble sleeping You feel cranky, easily upset or restless Trouble focusing or feel tired all the time Mild low mood symptoms happen once in a while; does not affect normal activities Baby Blues (mild depression), but no thoughts of harming yourself or your baby You have other questions or concerns

Call 911 Now

You have tried to kill yourself or feel like you will try within the next few minutes
You have attempted to harm your baby or are neglecting your baby
You are thinking about harming or abandoning your baby
You have hurt yourself, taken an overdose of medicine or swallowed a poison
You think you have a life-threatening emergency

Call Doctor or Seek Care Now

You feel life is not worth living and feel guilty, worthless or helpless (or call 988, the Suicide and Crisis Lifeline)
Your wife or partner is behaving oddly, such as:
- neglecting the baby
- doing strange things
- seeing or hearing things that are not there
You had a still born baby or a baby who died within the past 12 months
You are afraid to be left alone with your baby
You have a history of bipolar disorder and feel your mood is changing
You think you need to be seen, and the problem is urgent (or call 988)

Contact Doctor Within 24 Hours

You are not able to take care of yourself or your baby (not eating and drinking normally, drinking too much alcohol, not bathing/showering)
You have a constant feeling of anxiety, fear, worry and/or panic
You are crying all the time
You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Trouble sleeping
You feel cranky, easily upset or restless
Trouble focusing or feel tired all the time
Mild low mood symptoms happen once in a while; does not affect normal activities
Baby Blues (mild depression), but no thoughts of harming yourself or your baby
You have other questions or concerns

Care Advice

General Advice

What You Should Know about Postpartum Depression:

Postpartum depression can arise as a new problem after pregnancy or the mother may have had depression before.
About 1 in 10 mothers have postpartum depression.
It is important to recognize the symptoms. The well-being and safety of two people are at risk, the mother and the baby.
Treatment with meds and therapy can help. With the right treatment, most women make a full recovery.
Here is some care advice that should help.

Types of Low Mood after Having a Baby

Baby Blues. Symptoms include feeling tired and emotional in the first week after childbirth, feeling exhausted, not sleeping, feeling anxious about the baby.
Postpartum Depression often develops within the first 4 weeks after childbirth. It can start months or even up to a year later. Symptoms last longer than Baby Blues.
Postpartum Psychosis is a rare, but serious form of mental illness that puts the mother and baby at risk. The mother's symptoms may range from low mood to losing touch with reality. She may have abnormal thoughts, strange ideas and thoughts of harming herself or the baby.
Postpartum depression is a real illness with real symptoms. It is not a sign of weakness or something you can address by 'pulling yourself together.' Left untreated, it can affect the bond between the mother and her child long term.

Recognize When You are Anxious or Depressed

Postpartum Depression has the same symptoms as depression in women who have not had a baby. They include:

Feeling sad or anxious often, or almost all of the time
Feeling irritable, are easily frustrated or restless
You don't want to do things that used to be fun
Trouble sleeping (falling asleep or waking very early) or still feel tired even after sleeping well
Not taking care of yourself
You don't want to do anything or can't concentrate
Change in appetite; eating more or less than is normal for you
Feeling guilty, worthless or helpless
Feeling that people would be better off without you (including the baby)
Loss of sex drive
Feeling aches or pains that do not get better with treatment
Thoughts about suicide or harming yourself, the baby, or both of you

Maintain a Healthy Lifestyle:

There are things you can do to feel better. These include:

Exercise can help depression. It is one of the best ways you can help yourself if you have mild depression.
Eat a healthy diet; reduce weight if needed
Quit smoking and limit alcohol
Get plenty of sleep
Tackle changes one at a time
Seek help from your doctor or support groups

Talking Therapies

For mild depression it may help to talk to a family member or close friend about how you feel. Get their support with any changes you want to make to help you feel better. They may have noticed things you have not.
You could reach out to someone in your faith group, such as a minister or spiritual leader.
Self-help groups are often available locally or online. Sharing your feelings with others can be helpful. Be sure to contact you doctor if you are not getting better or are getting worse.
Self-help books may offer helpful ideas.
You can also talk to your doctor about therapy or counselling. Therapy can help you understand your illness and how to make lifestyle changes which will help you feel better. It can also help you identify what bothers you, how to overcome it and how to take control.

Manage Your Stress:

Stress is one of the main causes of anxiety and depression.
Take note of what kind of things in your life cause you to be stressed.
Reduce stress by changing your expectations. We often set our expectations of ourselves very high. Quiet your inner critic.
Be realistic about what you can achieve. Learn to say, "No."
Set priorities and focus on what you can control (not what you can't control).
Plan time and activities that will allow you to relax.
Ask for help if you need it. It may be that a friend or colleague can help. Your doctor will also be able to advise you where else you can get help.

Medicines:

If you think any meds you are taking (or drugs or alcohol) are the cause of your depression, contact your doctor for advice.
If your doctor prescribes antidepressants, ask exactly how you should take them. Follow the advice carefully.
Be patient. It may take up to 4 weeks for the medicine to take effect and for your doctor to get the dose just right for you.
Side effects, if any, often reduce or go away all together as your body adjusts to the medicine.
Don't stop taking the medicine, even if you feel better. Stopping suddenly can cause symptoms to get worse. Talk to your doctor about the best way to reduce and then stop it.

What to Expect:

Most mild depression goes away within a few weeks.
Treatment can include lifestyle changes, self-help, talking therapies and medication.
Treatment will depend on whether you have mild, moderate or severe depression.
If you have severe depression, you may need help from mental health services and long-term medicines.

Call Your Doctor If:

You feel like harming yourself or your baby
Sadness or depression lasts more than 2 weeks
You want a referral to a counselor or psychiatrist
You think you need to be seen
You think your depression is getting worse

Resources

Hotlines: Local and National Mental Health Hotlines or Crisis Lines (US numbers):

Hotlines (Crisis Lines) are available 24/7. They provide counselors who can help you now.
Suicide and Crisis LifeLine: 988. Available 24/7.
Child Abuse Hotline: 1-800-422-4453.
Substance Abuse Hotline: 1-800-662-4357. This is a 24/7 substance use and mental health referral line. They can give you local treatment choices and numbers for support groups.
National Poison Control Number: 1-800-222-1222.

Helplines: Local and National Mental Health Helplines (US numbers):

Helplines are not crisis lines. They provide services Monday through Friday during regular hours.
Call your local or state mental health resource first, if you have the number. If not, call a national helpline for assistance.
Postpartum Depression Helpline: 1-800-944-4773.
National Alliance on Mental Health (NAMI) Helpline: 1-800-950-6264. This is an information and referral source for finding local mental health programs.

Remember! Contact your doctor if you or your child develop any "Contact Your Doctor" symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

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