Idaho CareLine: In Idaho, Dial 2-1-1 or 800-926-2588 (En Español) Postpartum Depression "Baby Blues" vs. Postpartum Depression After having a baby, most women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite, or find that they can't sleep well even when the baby is asleep. These symptoms usually start about 3 to 4 days after delivery and may last several days. These symptoms are commonly referred to as the "baby blues" and are considered a normal part of early motherhood and usually go away within 10 days after delivery. However, when women have more severe symptoms or symptoms that last longer it is called "postpartum depression.” Postpartum depression is an illness, like diabetes or heart disease. It can be treated with therapy, support networks, and medicines such as antidepressants. By Laura Nittolo, RN, BSN, Young Children and Family Programs Postpartum depression is a disorder that affects women after giving birth to a child. It occurs in about 10 to 20 percent of women depending on the assessment criteria used1. Postpartum depression is a clinical term referring to a major depressive episode that is associated with childbirth2. Postpartum depression can be confused with maternity blues if the individual is not aware of the difference between the two. "Maternity blues" or "baby blues" affect 50 to 80 percent of all mothers in the early postpartum period3. (See box at right.) Maternity blues are not considered a postpartum disorder, but a normal response to hormonal fluctuations. Symptoms include: Tearfulness; Irritability; Loss of appetite; Trouble sleeping; and Mood swings. Although for most women the blues are short-lived, evidence suggests that women who experience them have an increased risk for postpartum depression later in the postpartum period, especially if the blues symptoms were severe2. Symptoms Although Hippocrates acknowledged postpartum illnesses inthe year 4 B.C., it never has been described as a distinct diagnosis in the Diagnosis and Statistical Manual of Mental Disorders1. Postpartum depression may begin anywhere from 24 hours to several months after delivery. Some of the symptoms that frequently are evaluated are: Loss of interest or pleasure in life; Loss of appetite; Less energy and motivation to do things; A hard time falling asleep or staying asleep; Sleeping more than usual; Increased crying and tearfulness; Feeling worthless, hopeless, or overly guilty; Feeling restless; Irritability, anxiety; Unexplained weight loss or gain; Feeling like life isn’t worth living; Thoughts about hurting yourself; and Worrying about hurting your baby (American, 2002). Most postpartum depressions resolve spontaneously within about six months, but studies show that about 25 percent of affected mothers are still depressed at the child’s first birthday (Gregorie, 1996). If you ever have thoughts of harming your baby or yourself, call your health care provider immediately! Although the origins of postpartum disorders are complex, research suggests that biological factors contribute significantly to the onset of these illnesses. Following birth, the levels of progesterone and estrogen drop suddenly in a woman’s body3. It may well be that maternity blues are related to withdrawal of progesterone following delivery. Normal hormonal changes that take place after childbirth trigger alterations in brain chemistry, fostering depression. The shifts may cause an imbalance and are known to affect mood, and may be the cause of postpartum depression. Predictors Associated with Postpartum Depression Up to 70 percent of women with postpartum illness have no previous psychiatric history. The following are some predictors associated with postpartum depression: Single mothers; Women with unplanned pregnancies; Women who have poor relationships with their own mothers; Depression during pregnancy; Unrealistic expectations of motherhood; Delivery of a premature infant; and A temperamentally difficult baby. Treatment There are a number of reasons why there may be an association between postpartum depression and adverse child development. (Murray, 1996). An area of postpartum depression that has been studied at some length is ways to treat the illness without harming the infant. Treatment consists of validation, reassurance, assistance with self and baby care, and observation for worsening symptoms3. Only some of the drugs effective in the treatment of postpartum depression are safe for breastfeeding infants. Antidepressant medication generally is recommended for at least one year to avoid relapse3. Counseling or drug therapy may be used alone or in combination. For mild to moderate postpartum depression, the decision may be left for the patient to make (O’Hara, 2001). During lactation, many women understandably choose a non-drug form of treatment to avoid exposing their infant to psychotropic drugs. Ask for help This can be difficult, but the sooner you ask for help, the sooner you will start feeling better. Call your health care provider and ask about counseling, support groups, other treatment options. Talk with your family or friends. Let others know you need help or have worries. Take care of yourself now so you can better care for your baby and build a loving bond.
(En Español)
Postpartum Depression
"Baby Blues" vs. Postpartum Depression
After having a baby, most women have mood swings. One minute they feel happy, the next minute they start to cry.
They may feel a little depressed, have a hard time concentrating, lose their appetite, or find that they can't sleep well even when the baby is asleep.
These symptoms usually start about 3 to 4 days after delivery and may last several days. These symptoms are commonly referred to as the "baby blues" and are considered a normal part of early motherhood and usually go away within 10 days after delivery.
However, when women have more severe symptoms or symptoms that last longer it is called "postpartum depression.”
Postpartum depression is an illness, like diabetes or heart disease. It can be treated with therapy, support networks, and medicines such as antidepressants.
By Laura Nittolo, RN, BSN, Young Children and Family Programs
Postpartum depression is a clinical term referring to a major depressive episode that is associated with childbirth2. Postpartum depression can be confused with maternity blues if the individual is not aware of the difference between the two.
"Maternity blues" or "baby blues" affect 50 to 80 percent of all mothers in the early postpartum period3. (See box at right.) Maternity blues are not considered a postpartum disorder, but a normal response to hormonal fluctuations.
Symptoms include:
Although for most women the blues are short-lived, evidence suggests that women who experience them have an increased risk for postpartum depression later in the postpartum period, especially if the blues symptoms were severe2. Symptoms
Although Hippocrates acknowledged postpartum illnesses inthe year 4 B.C., it never has been described as a distinct diagnosis in the Diagnosis and Statistical Manual of Mental Disorders1.
Postpartum depression may begin anywhere from 24 hours to several months after delivery. Some of the symptoms that frequently are evaluated are:
Most postpartum depressions resolve spontaneously within about six months, but studies show that about 25 percent of affected mothers are still depressed at the child’s first birthday (Gregorie, 1996).
Although the origins of postpartum disorders are complex, research suggests that biological factors contribute significantly to the onset of these illnesses.
Following birth, the levels of progesterone and estrogen drop suddenly in a woman’s body3. It may well be that maternity blues are related to withdrawal of progesterone following delivery. Normal hormonal changes that take place after childbirth trigger alterations in brain chemistry, fostering depression. The shifts may cause an imbalance and are known to affect mood, and may be the cause of postpartum depression.
Predictors Associated with Postpartum Depression
Up to 70 percent of women with postpartum illness have no previous psychiatric history.
The following are some predictors associated with postpartum depression:
Treatment
There are a number of reasons why there may be an association between postpartum depression and adverse child development. (Murray, 1996).
An area of postpartum depression that has been studied at some length is ways to treat the illness without harming the infant. Treatment consists of validation, reassurance, assistance with self and baby care, and observation for worsening symptoms3.
Only some of the drugs effective in the treatment of postpartum depression are safe for breastfeeding infants. Antidepressant medication generally is recommended for at least one year to avoid relapse3.
Counseling or drug therapy may be used alone or in combination. For mild to moderate postpartum depression, the decision may be left for the patient to make (O’Hara, 2001).
During lactation, many women understandably choose a non-drug form of treatment to avoid exposing their infant to psychotropic drugs.
Ask for help
This can be difficult, but the sooner you ask for help, the sooner you will start feeling better. Call your health care provider and ask about counseling, support groups, other treatment options. Talk with your family or friends. Let others know you need help or have worries. Take care of yourself now so you can better care for your baby and build a loving bond.
Excerpt of an article by Melanie Person, Young Children and Family Programs, Gritman Medical Center, Moscow, Idaho. Footnote references: Harris, 19961; Epperson, 19992; Mills, 19983.
Additional Articles/Resources
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Idaho Hospital Based Support Groups
American Academy of Family Physicians
"Baby Blues" The National Women's Health Information Center