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Postpartum Depression

Donald Aulds, M.D.

Postpartum depression, often referred to as the “baby blues,” is triggered by the hormonal changes that occur in a woman after giving birth and the emotional upheaval of suddenly having another person dependent on her. Studies have reported that approximately 80 percent of all new mothers have some degree of “baby blues” and may feel upset, alone or afraid. On top of that, many mothers feel guilty for having these feelings. Based on the severity, these emotional changes can be divided into three categories:

  • “Baby blues” usually last only a few days to a couple of weeks and can include sadness, mood swings, irritability, anxiety, crying, trouble sleeping and decreased ability to concentrate. This is not considered an illness because it is usually so mild and short-lasting that medications are not needed to control the symptoms. These symptoms usually do not interfere with the mother’s ability to take care of the baby or her family.
  • Postpartum depression may start with baby blues and intensify over time. The symptoms of postpartum depression are more severe, last longer and may lead to the mother’s inability to care for her infant and family. Symptoms include loss of appetite, intense anger, overwhelming tiredness, feelings of shame or inadequacy, difficulty bonding with the baby, loss of interest in sex, withdrawal from family, and thoughts of suicide or harming the baby. If a person has had a history of major depression, major stress or premenstrual dysphoric disorder, she may be at higher risk for developing postpartum depression.
  • Postpartum psychosis is the most severe form of postpartum disorder. It is a rare form that usually develops within the first two weeks after delivery. The symptoms are even more severe and can include hallucinations, delusions, disorientation, confusion, paranoia, and attempts of suicide or harm to the baby. This form requires immediate therapy. It can be associated with individuals who have previously been diagnosed with severe depression, bipolar disorders or severe psychosis prior to pregnancy. This disorder has a higher risk of developing after a birth of future children.

There is no single cause of postpartum depression. Physical changes within 48 hours after the delivery may include a drop in estrogen, progesterone, cortisol and thyroid levels. This sudden change can cause fatigue, sluggishness and depressed feelings. Once the baby is born, the changes in sleep patterns may contribute to the feelings of being overwhelmed and fatigued. After the delivery, the woman may feel that she is less attractive and may struggle with her own sense of being and identity. Lifestyle changes can also contribute to the risk of depression including financial changes because of not being able to work and bring in her salary, difficulty breast-feeding, or lack of support from the spouse.

Are there risk factors that may be identified as a risk for postpartum depression?
The risks factors that have been identified include postpartum depression after the birth of a previous child, a history of depression previously, marital conflict, stress during the previous year such as illness, pregnancy complications and job loss, having a weak support system, and unplanned or unwanted pregnancy.

What therapies are available for postpartum depression?
Women should discuss all options with their physicians, but some suggestions for dealing with depression include:

  • Rest as much as possible. Try to sleep when the baby is sleeping.
  • Eat healthy foods. Try to eat a balanced diet with plenty of fruits, vegetables and grains. Avoid alcohol as this may increase the symptoms of depression.
  • Don’t place extra pressure on yourself. You don’t have to be “Super Mom.” take care of your baby and yourself and leave the rest. You do not have to have the perfect household. Those things can wait.
  • Take some time for yourself. Leave the house, go visit a friend or do an errand. Schedule some time alone with your partner.
  • Take medication if prescribed by your physician. Antidepressant medications have been used to control the symptoms of postpartum depression. It is important to know that any medication you take will pass through the breast milk to your baby. Most antidepressant medications can be used with minimal risk of side effects on the baby.
  • Try acupuncture. Recent studies have shown that acupuncture can promote relaxation and may help the woman sleep better. Acupuncture may help some regain their energy and thereby improve the depression symptoms.
  • Get a message. Message therapy helps relax tight muscles and allows women to sleep better. Studies suggest that some women feel less depressed after a message.
  • Increase intake of omega-3 fatty acids. Recent studies have shown that omeg-3 fatty acids may decrease the depression symptoms by acting directly on chemicals in the brain.
  • Get creative. Drama, music and art may provide a relaxed environment, channel stress, and encourage a new sense of productivity and identity.

If you feel depressed after giving birth, don’t be afraid or embarrassed to seek help. Talk to a counselor, friend, family member or a physician. If the symptoms do not fade after a couple of weeks or if the symptoms interfere with the ability to care for the baby, seek immediate professional help.

More about Dr. Aulds

Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.

Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.

Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.