The signs of postpartum depression (also called post natal depression) are often overlooked because new mothers are told that symptoms such as mood swings, sadness, or fatigue are perfectly normal following the birth of a baby. And, it’s true – up to 80% of new mothers experience what is called the “baby blues”. But, sometimes it is more than the “blues”, and the feelings or symptoms will not pass in just a few days, or even a week.
Many women wait longer than necessary to seek help for post natal depression because they think they are just experiencing the baby blues, and believe that if they “wait it out” things will return to normal shortly.
PPD is one of the most under-diagnosed forms of depression – partly because some doctors do not recognize it as an illness, but more often it is due to the fact that many women are reluctant to seek help for fear that others will see them as an unfit or “bad” mother. After all, isn’t the birth of a child supposed to bring joy and excitement? Then, why do they feel tired, sad, or inadequate? They believe that their feelings are wrong, which leads to guilt or anger and makes them hesitant to admit their feelings or ask for help.
If you are suffering from postpartum depression, the most important thing you need to know is that it is not your fault! And, you are not alone!
A diagnosis of PPD does not make you an uncaring or unfit mother, and effective treatments are available that will help you deal with all the changes that accompany pregnancy and childbirth – both physical and emotional – so you can feel like yourself again.
The Baby Blues:
Having a baby can be stressful. Not only are there a lot of demands on your body physically, but you will also experience many lifestyle changes. The challenges can sometimes feel overwhelming, especially when you are dealing with fluctuating hormones and lack of sleep. With everything going on both physically and emotionally, it is not surprising that many women experience at least some form of the “baby blues”. The symptoms typically appear within a few days after giving birth and can last for up to two weeks.
Signs that you may be experiencing the baby blues include:
• mood swings
• sadness or feeling “low”
• appetite changes
• exhaustion, difficulty sleeping
• anxiety, concern about your ability to take care of your baby
As mentioned, the “baby blues” are absolutely normal and the symptoms will usually disappear once you get some rest and your body has time to re-balance itself after the stress of delivery.
Sadness and mood swings are quite common in new mothers, but if your symptoms don’t go away after a week or two, or if they get worse, then you may have postpartum depression (PPD). It is estimated that PPD occurs in about 3-20% of births, although it is difficult to get exact statistics since it is a very under-reported condition.
Although it typically begins within the first six months following delivery, PPD can appear anytime during the first year. It can come suddenly, but in most cases, it begins soon after birth and will gradually intensify over a period of several weeks or months. This is the main reason why many people often confuse PPD with baby blues in the beginning. But, unlike the baby blues, PPD can be much more debilitating and can interfere with your ability to take care of your baby. Since it is very difficult to distinguish between the two in the early stages, it is a good idea to mention any sadness, mood swings, anxiety, or insomnia to your doctor right away so that he/she is aware of your symptoms. Even if it ends up being normal baby blues, it is better than waiting until the situation spirals out of control.
While the baby blues and PPD share many similar signs, after a period of time you will notice that the symptoms of PPD are much more intense, last longer, and affect your ability to care for your family or complete everyday tasks.
Signs that you may be experiencing Postpartum Depression include:
• Lack of interest in your baby: some people feel ambivalent or have conflicting feelings about their child, vacillating between love and disinterest. These negative feelings can make it difficult to bond with your baby, which can have long-term effects. According to the World Health Organization (WHO), “children of mothers who had untreated PPD are more likely to have behavioral problems such as sleeping and eating difficulties, tempter tantrums, and hyperactivity. Delays in language development are more common as well.”
• Withdrawal from family and friends, and a sense of despondency.
• Lack of concern for yourself and neglect of your physical needs or appearance.
• Anxiety and worry: Fear that you may hurt your baby or that you cannot properly take care of your child. This is often accompanied by feelings of inadequacy.
• Feelings of worthlessness and hopelessness: You have no value, you are an unfit mother, your baby would be better off with someone else, and there is no hope of things getting better.
• Feelings of guilt and shame: You feel guilty for thinking the way you do and are ashamed to admit what you are experiencing to others.
• Loss of happiness and pleasure in activities you once enjoyed. There is no joy in life.
• Severe mood swings: happy one minute and sad, angry, or despondent the next.
• Thought of harming yourself, or recurring thoughts of death or suicide.
• Irritability: oversensitive, angry, or impatient.
• Frequent crying, or feeling like you want to cry.
• Changes in weight or eating habits: lack of interest in food, overeating, excessive weight gain or loss.
• Difficulty concentrating, even to complete simple tasks.
• Extreme fatigue: feeling tired is not unusual for a new mother, considering sleep deprivation and the demands of meeting the needs of a newborn, but overwhelming fatigue that is accompanied by a lack of energy or motivation can be a sign of a more severe problem.
• Change in sleeping patterns: Again, this is beyond what would be expected for a new mother, and includes difficulty sleeping, insomnia, or difficulty returning to sleep once awakened.
• Headaches, stomach problems, chest pains, hyperventilation, and unexplained muscle or back pain.
This is a very rare form of depression, but is extremely serious and should be treated immediately. Postpartum psychosis usually appears within the first two weeks following delivery. For this reason, many doctors do not believe that it is connected to other types of depression (baby blues or PPD); however, some medical professionals think that if PPD is left untreated, it has the potential to develop into psychosis, depending on the reasons for the onset of symptoms.
Signs that you may be experiencing postpartum psychosis include:
• Hallucinations (seeing things that aren’t real or hearing voices that don’t exist)
• Delusions, paranoia, and irrational beliefs or behavior
• Confusion and disorientation
• Severe anxiety, agitation, or irritability
• Rapid mood swings
• Inability to eat or sleep (or the refusal to do so)
• Suicidal thoughts or thoughts of harming yourself
• Thoughts of harming or killing your baby
It is important to note that those suffering from postpartum psychosis are at a very high risk for suicide or infanticide. For the safety of both mother and baby, help should be sought at the very first warning sign.
Causes of Postpartum Depression
Presently, doctors do not really know what causes PPD. Many experts agree that there is a combination of factors that work together to contribute to the development of PPD; although they cannot explain why some women develop the illness while others do not.
Hormonal changes are believed to play a large role in PPD. After childbirth, there is a significant drop in estrogen and progesterone, as well as a sudden decline in other hormones produced by the thyroid gland that can leave you feeling tired, depressed, and moody. There are also dramatic changes in blood volume and pressure, metabolism, and immune functioning that many believe may trigger PPD.
Many doctors and psychologists also believe that complications during pregnancy or delivery may be a factor, as well as difficulty losing “baby weight” which may make women feel insecure or unattractive. Since new mothers are often sleep deprived, they can become easily frustrated or overwhelmed, making even simple tasks seem difficult. Suddenly, everything has changed completely, and some women feel as if they have lost control over their own lives, which may also trigger depression.
While the exact cause is not known, research has shown that some women are more likely than others to develop PPD. There are several risk factors that may trigger, or contribute to the onset of depression.
Risk Factors for Post Nnatal Depression:
• PPD after a previous pregnancy. Postpartum depression can develop after any pregnancy, not just the first, and someone who has experienced PPD following a previous pregnancy is more likely to suffer a recurrence with subsequent pregnancies.
• Episodes of intense depression or anxiety while pregnant. Research has shown that one of the strongest predictors of PPD is depression during the pregnancy, particularly the third trimester.
• Previous history of depression – either when pregnant or at other times.
• Family history of depression
• Severe PMS
• Relationship difficulties with spouse or partner
• Being single
• Lack of support system – family, friends, or social organizations
• Stressful events such as financial problems, illness, job loss, or death in the family
• Medical complications during pregnancy or delivery
• Low self-esteem
• Unplanned or unwanted pregnancy
• Baby with a difficult temperament (colic, sleeping little, crying a lot)
• Lower socioeconomic status: due to financial difficulties or access to support
• Postpartum blues: some experts believe that, in some cases, “baby blues” can develop into PPD.
Remember, these are not causes, but simply risk factors. Some women experience several of these risks and never develop PPD while others may have only one and suffer a very severe case. However, if you can identify with some of the above risk factors, you should speak with your doctor about the treatment or prevention of PPD.
Coping with Postnatal Depression
The first step in dealing with PPD is admitting that you have the symptoms and seeking the help you need.
Remember: you did not bring it on yourself. You are not to blame, and it is not your fault! This is not an uncommon problem, but it is very treatable. If you think you may be experiencing PPD, consult your doctor right away. There are many treatment options including therapy, support groups, medications, and natural/alternative interventions.
Aside from speaking with your health care professional, there are a few other things that you can do to help cope while you are recovering.
• Try to get enough sleep. Everything seems so much worse when you are tired. This isn’t always easy when you have to work around a baby’s sleeping patterns, and those suffering from PPD can’t always sleep even when they want to. But at least take time to rest and relax. Read a book, take a hot bath, watch a movie, or enjoy a cup of tea. The housework will wait!
• Take time for yourself. Have someone watch your baby while you do something for yourself such as shopping, a manicure, or a massage. And, taking care of your appearance will always make you feel better.
• Eat right. Proper nutrition can have a big impact on how you feel.
• Get outside. Put the baby in a stroller and go for a walk. Or, sit on your porch to feed your baby. Fresh air and sunshine can make a world of a difference.
• Exercise. Even non-strenuous exercise can release endorphins which are thought to improve feelings of depression.
• Stay connected with friends. If you are feeling depressed, you may prefer to be alone, but this is not healthy. Make an effort to maintain your adult relationships.
• Find someone to talk to. It is not good to keep your feelings bottled up inside. Choose someone you can trust who will listen without judging you.
• Join a mother’s group. Most communities have groups for new mothers or for mothers with young children. Not only will you meet people who are in a similar situation, but you will be getting out of the house and interacting with others.
• Don’t be too hard on yourself. Your baby doesn’t expect you to be perfect, so you shouldn’t expect it from yourself either. It doesn’t matter if the house is no longer perfectly clean or if you don’t have a four course dinner on the table each night. Your life has changed, so cut yourself some slack and give yourself some time to adjust.
• Don’t be afraid to ask for help. Admitting that you are overwhelmed or need help is not a sign of weakness and it does not make you a bad mother. If you have someone who is willing to babysit, run a few errands, or help with housework then take them up on their offer.
Postpartum blues are a completely normal occurrence, but if you think your symptoms are more severe, you may feel too embarrassed or guilty to admit it. However, seeking treatment as soon as possible is very important for the well-being of both you and your baby.
If you have signs or symptoms that:
• last longer than two weeks,
• seem to be getting worse instead of better,
• make you feel that simple, everyday tasks are too difficult,
• make you question your ability to care for your baby,
then you may be dealing with PPD. Don’t let shame or fear keep you from receiving the help you need to get healthy. You and your baby have a bright future together, and depression can be conquered successfully so that you can enjoy your life – every step of the way.
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