Did things change after you became pregnant? Are things different than you expected as a new mother? For many mothers, the experience of pregnancy and childbirth is often followed by sadness, fear, anxiety, and difficulty making decisions. Many women have difficulty finding the energy to care for themselves, their infants, and their families. Some even have feelings about harming themselves and their children. If this sounds like you or someone you know, there are two important things you should know.
You are not alone.
Help is near.
This article will begin to explain the possible causes for your feelings—and more importantly— how to find the help you need.
Hormones as Triggers
There are a number of reasons why you may get depressed. As a woman, your body undergoes many hormonal changes during and after pregnancy. When a woman is pregnant, her body produces the female hormones estrogen and progesterone in much greater amounts. But in the first 24 hours after childbirth, these hormone levels drop rapidly back down to their non‐pregnant levels. These hormone changes may lead to depression in a similar way that menstrual hormone changes can trigger these symptoms.
In some women, another possible cause of these symptoms following pregnancy is a drop in thyroid hormones, which are produced by the thyroid gland (located in the neck). These hormones help regulate the way your body uses energy. Low thyroid levels can cause depressed or irritated moods, problems with sleep and concentration, and weight gain.
Combine these changes in your body with the dramatic changes in your life — the normal feelings of being overwhelmed with new responsibilities, pressures to be a "great" mom, a sense of loss regarding the life you had before — and you have a recipe for the baby blues.
Some women are more at risk for depression during and after pregnancy:
- A personal history of depression or another mental illness
- A family history of depression or another mental illness
- A lack of support from family and friends
- Anxiety or negative feelings about the pregnancy
- Problems with a previous pregnancy or birth
- Marriage or money problems
- Stressful life events
- Young age
- Substance abuse
- Women who are depressed during pregnancy have a greater risk of depression after giving birth.
Types of Depression During & After Pregnancy
Depression during and after pregnancy is typically divided into three categories: (1) the baby blues (2) postpartum depression and (3) postpartum psychosis. These disorders exist along a continuum, where the baby blues is the mildest and postpartum psychosis the most severe. In all cases, help is available.
The Baby Blues
Many women have the baby blues in the days after childbirth. For most women, the baby blues is temporary — it's usually gone within a few days or a week after childbirth.
If you have the baby blues, you may:
- Have mood swings
- Feel sad, anxious, or overwhelmed
- Have crying spells
- Lose your appetite
- Have trouble sleeping
The symptoms aren't usually severe, and there are fairly simple and effective ways to handle them:
- Get plenty of sleep. Take naps when your baby does.
- Take the pressure off yourself. You can't do everything by yourself — who can? Do what you can, and leave the rest for later or for others to take care of.
- Avoid spending too much time alone.
- Get help and support from your spouse or partner, family members, and friends.
- Join a support group for new mothers.
- Get plenty of exercise.
The symptoms of postpartum depression last longer and are more severe. Postpartum depression occurs in about 1 in 8 women and can begin anytime within the first year after giving birth. New mothers who find themselves overwhelmed, frustrated, anxious, persistently teary, or depressed should not suffer in silence or shame. Instead, they should talk with their doctors right away and get the support — and in some cases, the treatment — they need.
Symptoms of postpartum depression can range from mild to severe. They can include the same symptoms of the baby blues, but can also include:
- Sleeping too much
- Trouble concentrating or remembering things
- Trouble making decisions
- Loss of interest in caring for yourself ﴾for example, dressing, bathing, fixing hair﴿
- Not feeling up to doing everyday tasks
- Showing too much ﴾or not enough﴿ concern for the baby
- Loss of pleasure or interest in things you used to enjoy ﴾including sex﴿
For mothers with postpartum depression, there are effective treatments. Most often, treatment will include some combination of antidepressant medication and talk therapy. Antidepressants may pose health risks for breastfeeding babies or pregnant women, so it is important to discuss this carefully with your doctor before taking antidepressants.
The same tips for getting through "the baby blues" can also be very helpful in getting through postpartum depression. Whatever steps you and your doctor decide are best, it’s important that you stick to your treatment plan for depression.
A very small number of women (1 or 2 in 1,000 women) suffer a rare and severe form of depression called postpartum psychosis. Women who have been diagnosed with bipolar disorder or a condition called schizoaffective disorder are at higher risk for getting postpartum psychosis.
The symptoms of postpartum psychosis typically begin during the first 6 weeks after delivery and may include:
- Extreme confusion
- Cannot sleep ﴾even when exhausted﴿
- Refusing to eat
- Distrusting other people
- Seeing things or hearing voices that are not there
- Thoughts of hurting yourself, your baby, or others
Postpartum psychosis is temporary and treatable with professional help, but it is an emergency and requires immediate help.
Talk to a Health Care Professional
Screening for depression during and after pregnancy should be a routine part of your health care. Health care professionals—such as your doctor, your baby’s doctor, a nurse, or other health care provider—are familiar with the types of depression new and expectant mothers face. They know ways to help, and can explain your options to you. They are ready to listen to you and can put you on the road to recovery.
Any woman may become depressed during pregnancy or after having a baby. It doesn't mean you are a bad or "not together" mom. You and your baby don't have to suffer. There is help available.
All children deserve the chance to have a healthy mom. And all moms deserve the chance to enjoy their life and their children. If you are feeling depressed during pregnancy or after having a baby, don't suffer alone. Please tell a loved one and call your doctor right away.