POST PARTUM DEPRESSION
About 70%-80% of women have what is known as the “baby blues” after childbirth. About 2-3 days after birth they begin to feel depressed, anxious and upset. For no clear reason they may feel angry with the new baby, their partner, or other children. These feelings may come and go in the first few days after childbirth.
In fact, about 10% of new mothers have a greater problem called postpartum depression. Postpartum depression last longer and is more intense. It often requires counseling and treatment. Postpartum depression (PPD) can occur after any birth, not just the first. Women with PPD have such strong feelings of sadness, anxiety or despair that they have trouble coping with their tasks. Without treatment, PPD may worsen or last longer. Postpartum depression is more likely to develop in women who lack the support of a partner or who have had:
- Postpartum depression before
- A psychiatric illness
- Recent stress
Postpartum depression (PPD) affects women of all ages, economic status, and racial/ethnic backgrounds. Any woman who is pregnant, had a baby within the past few months, miscarried, or recently weaned a child from breastfeeding can also develop PPD. Research has shown that women who have had problems with depression may be more at risk for PPD than women who have not had a history of depression. Postpartum Depression is likely to result from body, mind and lifestyle factors combined. No two women have the same life experiences or biologic makeup. This may be an explanation for why some women have PPD and others don’t. 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 hormones, primarily estrogen and progesterone, drop 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. Emotional factors affect a woman’s self-esteem and the way she deals with the stress and challenges of motherhood. This is thought to add to postpartum depression. Additionally, stressful changes in home and work routines may be caused if the baby was born early.
It is not yet known for sure what causes postpartum depression. Hormonal changes in a woman’s body very well may trigger its symptoms. We do know that during pregnancy the amount of two female hormones, estrogen and progesterone, increase greatly in a woman’s body. In the first 24 hours after childbirth, the amount of these hormones rapidly drops and keeps dropping to the amount they were before the woman became pregnant.
A major factor in postpartum depression may be lack of support from others. The steady support of a new mother’s partner is thought to be a comfort during pregnancy and particularly after the birth. Breastfeeding problems can make a new mother feel depressed. If they cannot breastfeed or if they decide to stop, new mothers often feel an unnecessary sense of guilt or disappointment. Thyroid levels may also drop sharply after giving birth. (The thyroid is a small gland in the neck that helps to regulate how the body uses and stores energy from foods eaten). Low thyroid levels cause symptoms that can feel like depression: mood swings fatigue, agitation, insomnia and anxiety. A simple thyroid test can tell if this condition is causing a woman’s PPD. If so, thyroid medication can be prescribed by a health care provider.
Other things that are believed to contribute to PPD are:
- Not enough rest often keeps a new mother from regaining her full strength for weeks. This is particularly so if she has had a C-section delivery
- A sense of being overwhelmed with a new, or another, baby to take care of
- Stress from changes in work and home routines. The concept of thinking they have to be “super mom” or perfect
- Feelings of loss – loss of identity (who you are, or were, before having the baby), loss of control, loss of a slim figure, and feeling less attractive
- Having less control over time and less free time
- Having less time to spend with the baby’s father
Women who have an idea of the “perfect mother” are more likely to feel let down and depressed when faced with the needs of day-to-day mothering. Four myths about being a mother are common:
Myth #1: Being a Good Mother is Natural
First-time mothers often believe that they should just know how to care for a newborn. New mothers need to learn mothering skills just as they learn any other life skill.
Myth #2: My Baby Will Be Perfect
When the baby arrives, it may not match the baby of their dreams. Babies have distinct personalities right from birth. A new mother may find it hard to adjust to the baby.
Myth #3: I Will Be a Perfect Mom
For some women, being perfect is a never-ending goal. A mother may think she is not living up to the ideal. She may feel that she is a failure.
Myth #4: We Will Be The Perfect Family
It comes as a shock to many just how different things become when a new family member is added. The perfect family has a strong, happy father, a beautiful, satisfied wife, and a darling baby who coos and gurgles at the appropriate times, and all other members of the family are just as delighted by the new arrival as the parents. But reality can be much different. The adults are facing new challenges, finding that they do not live up to new expectations and possibly living with less than the optimal amount of sleep. The new baby may have colic, a temper, a mind of it’s own, and/or it’s own internal time clock – not at all what the new parents were anticipating! The other children may feel like an intruder has arrived to steal the limelight. Each family is different, which goes to prove that there is no one “perfect” family.
It is important to know that PPD is treatable and that it will go away in time. The type of treatment will depend on how severe the PPD is. It can be treated with medication (antidepressants) and psychotherapy. Women with PPD are often advised to attend a support group to talk with other women who are going through the same thing. If a woman is breastfeeding, she needs to talk with her health care provider about taking antidepressants. Some of these drugs affect breast milk and should not be used.
The good news is that if you have PPD, there are things you can do to take care of yourself.
- Talk to friends and relatives about how you’re feeling. You might be surprised to learn that they, too, have experienced PPD.
- Contact an Internet source for support such as www.ivillage.com or http://www.postpartum.net/ or http://www.ppdsupportpage.com/
- Talk to your doctor about possible medical treatment. Be aggressive about discussing your concerns; tell it like it really is. Not all health care providers to recognize PPD if they haven’t been told the whole story. If necessary, ask for a referral to a mental health professional that specializes in treating depression.
- Try to nap when the baby naps.
- Find a trustworthy babysitter and make a point to spend time alone with your husband.
- Join a local support group with other mothers, so you can learn how they coped and get their recommendations for health care providers.
- Do not spend a lot of time alone – get out/leave the house/invite someone over.
- Don’t put pressure on yourself to do everything. Do what you can and leave the rest! Ask for help!
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