This information was reprinted from information provided by The Office on Women's Health, 8550 Arlington Blvd., Suite 300, Fairfax, VA  22031

The birth of a baby can be one of life's most exciting and joyful events, but it can also be stressful, confusing and sometimes even frightening.  At first, you may feel overwhelmed by the number of new challenges with which you are faced. Remember to go easy on yourself as you make this major life transition.  One question you may be asking yourself is what range of emotions is considered "normal" and when should I seek help?

BABY BLUES

This is a common set of symptoms experienced by many new mothers.  The "baby blues" typically begin a few days following delivery and can last up to two weeks.  Feelings you may experience are sadness (tearfulness), anger, loneliness, low self-esteem and anxiety.  Mood swings are also common in which you may feel very happy one moment and very irritable and sad the next.

POSTPARTUM DEPRESSION

Postpartum Depression (PPD) is a similar, but much more serious condition that affects approximately 10% to 20% of women following delivery.  Symptoms of PPD can range from mild to serious and can occur after the birth of any child (not just the first).  These symptoms frequently disrupt a woman's ability to function, which is an important sign that professional help is needed.  If PPD goes untreated, symptoms can worsen and last for as long as a year.

Symptoms of Postpartum Depression may include:

• feelings of sadness and frequent crying
• restlessness, irritability
• sleep difficulties
• feelings of guilt and worthlessness
• lack of interest in the baby
• loss of interest in pleasurable activities including but not limited to sexual activity
• difficulty concentrating or making decisions
• anxiety, panic attacks (see below)

It is also possible to feel very anxious after having a baby and not have PPD.  Some women develop extreme anxiety or panic disorder.  Symptoms include chest pain/pressure, difficulty breathing and/or rapid breathing, hot flashes or chills, trembling, numbness, fear of losing your mind or going crazy.  Both counseling and medication can be used to treat postpartum anxiety.

WHO IS AT RISK FOR PPD?

Any woman who has had a baby in the past few months, women who have miscarried or terminated a pregnancy or women who have recently weaned a baby from breastfeeding.

Most at risk are women who have:

• a history of depression or PPD
• severe premenstrual syndrowm (PMS)
• a non-supportive partner and/or stress related to family, work or other events

WHAT CAUSES PPD?

The exact cause of PPD is not known for certain; however, there are a number of biological, psychological and environmental factors related to PPD.

Biological:

1. Hormonal changes (estrogen and progesterone levels drop rapidly in the 24 hours following delivery)
2. Thyroid changes (thyroid levels drop sharply after the birth of a baby)

Psychological/Environmental:

1. Fatigue, disrupted sleep
2. Responsibilities for a new family may lead to becoming overwhelmed and questioning one's ability to mother
3. Changes in home and work routine
4. Feelings of loss of identity, loss of control, and perceived loss of physical attractiveness
5. Reduced free time, less time with husband, and possibly more time isolated indoors

POSTPARTUM PSYCHOSIS

This is an uncommon and very serious mental illness that can accompany PPD and is characterized by a loss of touch with reality.  Postpartum Psychosis often happens within the first 3 months following birth.  Symptoms may include:

• hearing or seeing things that aren't there
• insomnia
• irrational statement
• agitation and anger
• bizarre feelings or behavior
• suspiciousness
• extreme confusion

WHAT DOES TREATMENT INVOLVE?

PPD is treated in the same way that other types of depression are treated.  Most important is that PPD is both temporary and treatable.

Common treatments include:

• psychotherapy
• antidepressant medication (mothers who are breastfeeding should alert the doctor as some antidepressants should be avoided)
• support groups

WHAT CAN I DO TO HELP MYSELF FEEL BETTER IF I HAVE PPD?

• Try to rest as much as possible.  Nap when the baby naps.  Eat more frequent small meals (rather than 3 large ones).
• Don't put pressure on yourself to do everything and be everything to everyone.  As for help with the baby and chores.
• Talk to your partner, friends, and family about your feelings.
• Be active and try not to isolate yourself.  Get dressed and leave the house for a short while.
• Talk with other mothers so you can learn from their experiences.
• Join a support group for women with PPD.
• Talk to your health care provider about mental health treatment options.  Be assertive about your concerns.  Not all health care providers recognize the symptoms of PPD.

For more information contact:

Lisha Kievit, Ph.D.
Licensed Clinical Psychologist
Charleston, SC
(843) 766-8620

Additional Resources:

• Mental Health Professionals
• Your Physician
• Local Support Group:  The Ruth Rhoden Craven Foundation, Inc.
  (843) 881-2047
  www.ppdsupport.org
• National Women's Health Information Center
  (800) 994-9662
  www.4woman.gov
• Postpartum Support International
  (805) 967-7636
  www.postpartum.net