FREQUENTLY ASKED QUESTIONS about postpartum depression
- What does “perinatal” mean?
- What are perinatal mood disorders?
- Are mood changes common after childbirth?
- What is postpartum depression?
- What is postpartum psychosis?
- Do women also experience postpartum anxiety?
- Do women also experience depression or anxiety during pregnancy?
- Who gets postpartum depression?
- Why do women get postpartum depression?
- How long does postpartum depression last?
- What kinds of treatments help with postpartum depression?
- If I’m breastfeeding, can I take an antidepressant?
- In addition to counseling and/or medication, what else can I do to take care of myself?
Perinatal refers to the time period surrounding birth; including both pregnancy and the first year of a child’s life. The period after the birth of a child is called “postpartum.”
Postpartum depression or PPD are most commonly used to describe mood changes after a woman has a baby. However, postpartum depression is not the only disorder that women experience during the perinatal period. There are other disorders such as postpartum psychosis and anxiety disorders that also occur during this time. The term ‘perinatal mood disorders’ includes all of these illnesses.
After having a baby, most women experience changes in their mood. One minute you feel happy, the next minute you may start to cry. You may feel a sad, have a hard time concentrating, lose your appetite or find that you can’t sleep well even when the baby is asleep. These symptoms usually start about 3 to 4 days after delivery and may last several days.
New mothers that are experiencing these symptoms have what are called the “baby blues”. The baby blues are considered a normal part of early motherhood and usually go away within a couple weeks after delivery. However, some women have more severe symptoms or symptoms that last longer than a few days. This is called postpartum depression.
Postpartum depression is an illness, like diabetes or heart disease. Depression that occurs within 1 year of childbirth may be postpartum depression. A woman may have postpartum depression if she experiences symptoms for at least two weeks. The symptoms of postpartum depression include:
- Feeling sad or down often
- Frequent crying or tearfulness
- Feeling restless, irritable or anxious
- Loss of interest or pleasure in life
- Loss of appetite or increased appetite
- Less energy and motivation to do things
- Difficulty sleeping or sleeping too much
- Feeling worthless, hopeless or guilty
- Unexplained weight loss or gain
- Feeling like life isn’t worth living
- Showing little interest in your baby
If you are experiencing any of these symptoms it is important to speak with your doctor or a mental health professional as soon as possible.
In rare cases, a woman may develop postpartum psychosis. This is a very serious disorder and considered a psychiatric emergency. Women who have a history of bipolar disorder have an increased risk of developing postpartum psychosis. Symptoms of postpartum psychosis include:
- Extreme cognitive disorganization
- Bizarre behavior
- Unusual hallucinations or delusions
- Extreme mood swings
- These symptoms may come and go quickly
Women experiencing any of these symptoms should call 911 or go to the nearest emergency room immediately.
It is very normal to feel some anxiety after you have a baby; this is a period of many transitions and new responsibility. If you are experiencing any of the following symptoms, however, you may have an anxiety disorder:
- Intrusive, repetitive, or persistent thoughts or mental pictures that interfere with daily tasks
- Excessive or obsessive worries or fears (often related to baby) that do not improve with reassurance and support
- Physical symptoms such as shortness of breath, chest pains, sensations of smothering, or dizziness
- Recurrent nightmares or reliving of past traumatic events.
If you are experiencing any of these symptoms, it is important to talk with your doctor or mental health professional as soon as possible.
Yes. Women may also experience symptoms of depression or anxiety during pregnancy. Pregnancy leads to both physical and emotional changes that can make you more vulnerable to depression or anxiety. If you have symptoms of depression or anxiety like those listed above, it is important to talk with your doctor or midwife as soon as possible so that they can support you during your pregnancy and make a plan with you for the postpartum period.
About 10-15% of women experience postpartum depression. You are have an increased risk of developing postpartum depression if you have experienced any of the following:
- Previous postpartum depression
- History of depression not related to pregnancy
- Severe premenstrual syndrome (PMS)
- A difficult or very stressful marriage or relationship
- Few family members or friends to talk to or depend on
- Stressful life events during pregnancy or after childbirth (such as severe illness during pregnancy, premature birth or a difficult delivery)
The exact cause isn’t known. Hormone levels change during pregnancy and right after childbirth. Those hormone changes may produce chemical changes in the brain that play a part in causing depression. Stressful life events as well as genetic factors may also play a role.
Feeling depressed doesn’t mean that you are a bad person, that you did something wrong or that you brought this on yourself.
It varies for each woman. Some women feel better within a few weeks, but others feel depressed or “not themselves” for many months. The important thing is that postpartum depression is treatable. The sooner a woman begins treatment the sooner she will begin to feel better. Remember, help is available and with treatment, you can feel better.
Postpartum depression is treated much like any other depression. Counseling (“talk therapy”) and medication can help. Talk with your doctor about what treatment is best for you.
In addition to counseling and/or medication, it is very important for a women to get more support from family or friends.
It is important to talk to your doctor about taking any medication while you are breastfeeding. Your doctor can decide which medication you can use while nursing your baby.
If you have given birth recently and are feeling sad, blue, anxious, irritable, tired or have any of the other symptoms of postpartum depression, remember that many other women have had the same experience. You’re not “losing your mind” or “going crazy” and you shouldn’t feel that you just have to suffer through. Here are some things you can do that other mothers with postpartum depression have found helpful:
- Find someone you feel comfortable talking to tell that person about your feelings.
- Get in touch with people who can help you with child care, household chores and errands. This social support network will help you find time for yourself so you can rest.
- Find time to do something for yourself, even if it’s only 15 minutes a day. Try reading, exercising (walking is great for your health and is easy to do), taking a bath or meditating.
- Keep a diary. Every day, write down your emotions and feelings. This is a way to let out your thoughts and frustrations. Once you begin to feel better, you can go back and reread your diary. This will help you see how much better you are.
- Even if you can only get one thing done on any given day, remember that this is a step in the right direction. There may be days when you can’t get anything done, but try not to get angry with yourself when this happens.
- Remind yourself that it’s okay to feel overwhelmed. Childbirth brings many changes and parenting is challenging.
- You’re not expected to be a “supermom.” Be honest about how much you can do, and ask other people to help you when you need it.
Find a support group in your area. They can put you in touch with people near you who have experience with postpartum depression.