Postpartum Depression: Symptoms, Diagnosis and Treatment

Post pregnancy can be a tough time for some women.

What Is Postpartum Depression (PPD)?

New Mothers Can Suffer

This is a mood disorder that affects some women after pregnancy and childbirth. A woman who has just given birth may feel anxiety, deep sadness, and exhaustion afterwards. Symptoms can be so severe that they interfere with a mom's ability to carry out daily activities and care for themselves, their babies, and others.

A Real Mental Health Condition

Postpartum depression is more than just the baby blues. It is not possible to just "snap out of" it. Postnatal depression is a real mental health condition that requires proper diagnosis and treatment. The feelings of sadness and depressive symptoms a mother has postpartum cannot be talked away. This is a physical illness that responds to medical intervention. Baby blues is less severe and resolves more quickly than PPD.

Depression takes a toll on mental health.

Depression Takes a Toll

It Lasts More Than a Few Weeks

A woman's hormones change after childbirth. It's an adjustment to have a new member of the family. Insomnia contributes to stress. Some depression and sadness after giving birth are normal, but if they persist for more than a few weeks, PPD may be present. The levels of two hormones, estrogen and progesterone, drop very quickly after a new mom gives birth. This change triggers mood swings. Treatment with antidepressants and therapy can help a mother feel better.

Lack of sleep contributes to the condition.

It's Hard to Sleep

Lack of Rest Contributes to the Condition

A new mother who has postnatal depression may have difficulty sleeping, either sleeping too much or too little. She may have trouble falling asleep. She may want to sleep when the infant does, but may not be able to. Frequent nighttime feedings also make it difficult to get sufficient rest. It's important for a new mother to take naps during the day when the infant is sleeping to make up for nighttime sleep deficits. She will feel better if she rests whenever she can.

You may eat too much or too little with depression.

Appetite Changes

Depression and Appetite

Depressive episodes may cause a new mother to eat too much or too little. Some may lose their appetite completely. Pregnancy and childbirth can deplete the body of nutrients. Breastfeeding also increases a woman's nutritional requirements. It is critical that a mom get adequate nutrition throughout pregnancy and after giving birth to support her body, especially if she is breastfeeding. The body requires a lot of support during the postpartum period.

Anxiety is a common symptom.

Anxiety and Irritability

Hormones and Mood

After giving birth, hormone levels drop and anxiety may result. A mom who has depression in the postpartum period may feel anxious, restless, scared, and irritable. Her mind may race and she can worry excessively. Some women worry specifically about the health and safety of their baby. You may feel completely overwhelmed by having to take care of a new baby. Anxiety is a common symptom of PPD. Treatment is available so new mothers do not have to suffer, and they are able to take care of their child.

Mood swings may happen after pregnancy.

Mood Swings

Ups and Downs May Occur

A woman who has postnatal depression may be laughing one minute and crying the next. Some mood changes are normal after giving birth, but if they persist weeks or months later, it may be a symptom of postpartum depression. Falling hormone levels after giving birth may trigger mood swings in some new mothers. Medication, specifically antidepressants, can treat mood swings and minimize symptoms.

PPD is more than just the baby blues.

Is It Baby Blues or Depression?

How to Tell the Difference

Having a baby is a life-changing event that affects a mother physically, mentally, and emotionally. It's normal to have some depression and mood swings in the first couple of weeks after giving birth. Crying spells and feelings of anxiety or sadness are also normal during this time. If, however, these symptoms persist or get worse over time, it may mean a new mom has PPD.

Seek immediate help if you're considering suicide.

When to Get Help

Reach Out

Women who have postpartum depression may suffer severe symptoms that require immediate intervention. If symptoms get worse or a mother has difficulty caring for herself or for her baby, it's time to seek help. If symptoms last more than 2 weeks, it's time to see a health care provider. If anyone has thoughts of harming themselves or others, including their child, call the national suicide hotline at 1-800-273- TALK.

Rule out thyroid disorders and other health problems.

Could It be Thyroid Trouble?

Depression vs. Thyroid Disorders

Many symptoms associated with depression -- weight gain, fatigue, constipation, dry skin, and forgetfulness -- are also symptoms of an underactive thyroid gland. A new mom who is experiencing these symptoms may ask the doctor to run a blood test to check thyroid hormone levels. Thyroid medication can bring these levels back into an acceptable range. If thyroid hormones are in range, but a new mother is experiencing symptoms, she may have PPD.

Changing hormone levels trigger difficulty coping.

Postpartum Depression Causes

A Combination of Factors

Postpartum depression is likely caused by a variety of factors. The drop in estrogen and progesterone levels after a woman gives birth is one factor. This triggers chemical changes that contribute to mood swings. Lack of rest and the stress of taking care of a newborn also contribute to exhaustion, which can increase the risk of depression. A combination of physical and emotional factors affect the risk of developing postpartum depression. Having a prior history of depression is also a risk factor for mood problems during the postpartum period.

Postpartum psychosis may be associated with delusions.

Postpartum Psychosis

It Is Serious

Postpartum psychosis is a severe mental illness that some women experience, particularly those who have a personal or family history of schizophrenia or bipolar disorder. A mother may exhibit serious symptoms including severe restlessness, irritability, erratic behavior, delusional thinking, confusion, or rapidly changing moods. A woman with this illness is a potential risk to herself and her child so it is important to seek immediate medical evaluation and treatment. Hospitalization or inpatient treatment in a clinic may be required for these severe disorders.

See your doctor for a health evaluation.

PPD Diagnosis

Seek Help If You Need It

Many women are embarrassed if they experience feelings of sadness or an inability to cope after having a child. Some moms may not want to admit that they are struggling or having bad thoughts about themselves or their babies. There is no reason to feel ashamed for having postpartum blues or full-blown PPD. A woman who suspects she may have postpartum depression should see her health care provider for an evaluation. The doctor can tell the difference between postpartum blues and PPD.

Psychotherapy can be helpful after a pregnancy.

Postpartum Depression Therapy

A Good Therapist Can Help

A doctor may recommend that a woman with postpartum depression seek therapy from a knowledgeable therapist. Qualified practitioners include counselors, psychiatrists, social workers, and psychologists. Two kinds of therapy have been found to be very effective in treating postpartum depression. Interpersonal therapy (IPT) helps people gain a deeper understanding of their relationships and helps them work through problem areas. Cognitive behavioral therapy (CBT) involves examining and changing negative thoughts and behaviors. The doctor or therapist may also suggest a referral for a support group. Psychiatric intervention can be very helpful to combat negative thoughts and feelings associated with PPD.

SSRIs and other antidepressants can help.

Postpartum Depression Treatment

Medication Can Help

Antidepressants are commonly prescribed for women suffering from postpartum depression. These medications are effective but they may not be appropriate for every woman who has postpartum depression. Antidepressants may be associated with side effects or interact with other medications a woman is taking. They may also take a few weeks to or longer to be effective. Never start, stop, or change the dose of any medication, especially an antidepressant, without consulting with a doctor first. Stopping an antidepressant abruptly may be associated with withdrawal and other serious side effects. A doctor may order electroconvulsive therapy for severe cases of PPD that do not respond to medication.

SSRIs and other meds end up in breast milk.

Breastfeeding and Antidepressants

Medication in Breast Milk

Antidepressants may be passed to a baby via the mother's breast milk. The levels of many drugs passed in this way are safe, but make sure to let the doctor know if you are breastfeeding. Postpartum depression is dangerous for mothers and babies, so it's important to treat it. Follow the doctor's recommendations regarding safe, effective treatment for both mother and child.

Untreated PPD affects mom and child.

Dangers of Untreated Postpartum Depression

Potential Complications

Untreated, postpartum depression can continue for months to years. It can be incredibly disruptive to a mother's health and her ability to bond with her baby and care for herself and her family. Postpartum depression affects both mother and child, including their ability to eat and sleep. Behavior is affected as well.

Walking helps you feel better.

How to Help Yourself

Tips to Feel Better

It's difficult to live with a depressive disorder, especially in the postpartum period. Ask for help from family and friends when you need it. Network with other moms to share your feelings and struggles. You are truly not alone. Ask family and friends to watch the baby to get some much needed time to yourself. Hire a babysitter if you have to. Get as much rest as you can. Try to sleep when the baby sleeps and take naps during the day to make up for lack of rest at night.

Stay hydrated to feel better.

Count on Diet and Exercise

Step Up Your Lifestyle

Eating right and exercising can go a long way to help alleviate depression during the postpartum period. Reach for fresh produce, lean meats, complex carbs, and plenty of water to provide your body with essential nutrients. Join a mom's group and go on walks together. Spending time with friends and out in the sunshine can help improve mood. Eating right and exercising helps alleviate depression, reduces your risk of conditions like diabetes, and boosts overall health. Getting back in shape after having a baby can be a boon to your self-esteem.

Family and friends can support your health.

Family Can Help

Reach Out for Support

Family and friends of a postpartum mom can be sources of great support. They may be the first to notice that she is struggling with sad feelings or suffering from postpartum depression. If she is neglecting her baby or her mental health is suffering, family and friends can encourage her to seek psychiatric help. They can help by caring for the baby or helping out with tasks around the house. Family and friends can offer emotional support, too.

You can regain your health and smile again.

PPD Prognosis

It Will Get Better

One of the main feelings people experience when they have depression is the fear that things will never get better. Pregnancy and childbirth are some of the most life-changing stressors a female can go through. Most people are overwhelmed by the experience. Just know you can get better. Proper treatment, medication, and support groups can help you feel better.

Sources:

IMAGES PROVIDED BY:

  1. iStock
  2. A.T.White/Riser
  3. Annie Engel/Cultura
  4. Peter Dazeley/Riser
  5. Terry Vine/Blend Images
  6. Steven Brisson Photography
  7. Robert Lang Photography/Flickr
  8. Jerome Tisne/Photographer's Choice
  9. Southern Illinois University/Photo Researchers
  10. Visuals Unlimited, Inc./Dr. Arthur Siegelman
  11. Pasieka/SPL
  12. Michele Constantini/PhotoAlto
  13. Steve Pomberg/WebMD
  14. Steve Pomberg/WebMD
  15. Ed Fox/Aurora
  16. Walter B. McKenzie/The Image Bank
  17. Amy Frazier/Flickr
  18. Zia Soleil/Iconica
  19. KidStock/Blend Images
  20. Moodboard/Cultura

REFERENCES:

  • American Academy of Family Physicians: “Depression During and After Pregnancy: When It’s More Than the Baby Blues."
  • American Congress of Obstetricians and Gynecologists.
  • American Psychiatric Association.
  • American Thyroid Association.
  • American Psychological Association.
  • International Journal of Women’s Health: “Treatment of Postpartum Depression: Clinical, Psychological and Pharmacological Options”
  • KidsHealth.org.
  • Massachusetts General Hospital Center for Women's Mental Health.
  • Medscape: "Safety of Newer Antidepressants in Pregnancy."
  • National Institutes of Mental Health: “Postpartum Depression Facts."
  • WomensHealth.gov.
WebMD does not provide medical advice, diagnosis or treatment. See additional information