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Having a baby can be one of the biggest and happiest events in a woman's
life. While life with a new baby can be thrilling and rewarding, it can also
be hard and stressful at times. Many physical and emotional changes can happen
to a woman when she is pregnant and after she gives birth. These changes
can leave new mothers feeling sad, anxious, afraid, or confused. For many
women, these feelings (called the baby blues) go away quickly. But
when these feelings do not go away or get worse, a woman may have postpartum
depression. This is a serious condition that requires quick treatment from
a health care provider.
Postpartum depression is a condition that describes a range of physical
and emotional changes that many mothers can have after having a baby. PPD
can be treated with medication and counseling. Talk with your health care
provider right away if you think you have PPD.
There are three types of PPD women can have after giving birth:
The baby blues happen in many women in the days
right after childbirth. A new mother can have sudden mood swings, such
as feeling very happy and then feeling very sad. She may cry for no reason
and can feel impatient, irritable, restless, anxious, lonely, and sad.
The baby blues may last only a few hours or as long as 1 to 2 weeks after
delivery. The baby blues do not always require treatment from a health
care provider. Often, joining a support group of new moms or talking
with other moms helps.
Postpartum depression (PPD) can happen a few days
or even months after childbirth. PPD can happen after the birth of any
child, not just the first child. A woman can have feelings similar to
the baby blues - sadness, despair, anxiety, irritability - but she feels
them much more strongly than she would with the baby blues. PPD often
keeps a woman from doing the things she needs to do every day. When a
woman's ability to function is affected, this is a sure sign that she
needs to see her health care provider right away. If a woman does not
get treatment for PPD, symptoms can get worse and last for as long as
1 year. While PPD is a serious condition, it can be treated with medication
Postpartum psychosis is a very serious mental illness
that can affect new mothers. This illness can happen quickly, often within
the first 3 months after childbirth. Women can lose touch with reality,
often having auditory hallucinations (hearing things that aren't actually
happening, like a person talking) and delusions (seeing things differently
from what they are). Visual hallucinations (seeing things that aren't
there) are less common. Other symptoms include nsomnia (not being able
to sleep), feeling agitated (unsettled) and angry, and strange feelings
and behaviors. Women who have postpartum psychosis need treatment right
away and almost always need medication. Sometimes women are put into
the hospital because they are at risk for hurting themselves or someone
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The signs of postpartum depression include:
- Feeling restless or irritable.
- Feeling sad, depressed or crying a lot.
- Having no energy.
- Having headaches, chest pains, heart palpitations (the heart being fast
and feeling like it is skipping beats), numbness, or hyperventilation (fast
and shallow breathing).
- Not being able to sleep or being very tired, or both.
- Not being able to eat and weight loss.
- Overeating and weight gain.
- Trouble focusing, remembering, or making decisions.
- Being overly worried about the baby.
- Not having any interest in the baby.
- Feeling worthless and guilty.
- Being afraid of hurting the baby or yourself.
- No interest or pleasure in activities, including sex.
A woman may feel anxious after childbirth but not have PPD. She may have
what is called postpartum anxiety or panic disorder. Signs
of this condition include strong anxiety and fear, rapid breathing, fast
heart rate, hot or cold flashes, chest pain, and feeling shaky or dizzy.
Talk with your health care provider right away if you have any of these signs.
Medication and counseling can be used to treat postpartum anxiety.
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Postpartum depression (PPD) affects women of all ages, economic status,
and racial/ethnic backgrounds. Any woman who is pregnant, had a baby within
the past few months, miscarried, or recently weaned a child from breastfeeding
can develop PPD. The number of children a woman has does not change her chances
of getting PPD. New mothers and women with more than one child have equal
chances of getting PPD. Research has shown that women who have had problems
with depression are more at risk for PPD than women who have not had a history
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No one knows for sure what causes postpartum depression (PPD). Hormonal
changes in a woman's body may trigger its symptoms. During pregnancy, the
amount of two female hormones, estrogen and progesterone, in a woman's body
increase greatly. In the first 24 hours after childbirth, the amount of these
hormones rapidly drops and keeps dropping to the amount they were before
the woman became pregnant. Researchers think these changes in hormones may
lead to depression, just as smaller changes in hormones can affect a woman's
moods before she gets her menstrual period.
Thyroid levels may also drop sharply after giving birth. (The thyroid is
a small gland in the neck that helps to regulate how your body uses and stores
energy from foods eaten.) Low thyroid levels can cause symptoms that can
feel like depression, such as mood swings, fatigue, agitation, insomnia,
and anxiety. A simple thyroid test can tell if this condition is causing
a woman's PPD. If so, thyroid medication can be prescribed by a health care
Other things can contribute to PPD, such as:
Feeling tired after delivery, broken sleep patterns, and
not enough rest often keeps a new mother from regaining her full strength
for weeks. This is particularly so if she has had a cesarean (C-section)
Feeling overwhelmed with a new, or another, baby to take
care of and doubting your ability to be a good mother.
Feeling stress from changes in work and home routines. Sometimes
women think they have to be "super mom" or perfect, which is not realistic
and can add stress.
Having feelings of loss - loss of identity (who you are,
or were, before having the baby), loss of control, loss of a slim figure,
and feeling less attractive.
Having less free time and less control over time. Having
to stay home indoors for longer periods of time and having less time
to spend with the baby's father.
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It is important to know that postpartum depression (PPD) is treatable and
that it will go away. The type of treatment will depend on how severe the
PPD is. PPD can be treated with medication (antidepressants) and psychotherapy.
Women with PPD are often advised to attend a support group to talk with other
women who are going through the same thing. If a woman is breastfeeding,
she needs to talk with her health care provider about taking antidepressants.
Some of these drugs affect breast milk and should not be used.
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The good news is that if you have PPD, there are things you can do to take
care of yourself.
- Get good, old-fashioned rest. Always try to nap when the baby naps.
- Stop putting pressure on yourself to do everything. Do as much as you
can and leave the rest! Ask for help with household chores and nighttime
- Talk to your husband, partner, family, and friends about how you are
- Do not spend a lot of time alone. Get dressed and leave the house -
run an errand or take a short walk.
- Spend time alone with your husband or partner.
- Talk to your health care provider about medical treatment. Do not be
shy about telling them your concerns. Not all health care providers know
how to tell if you have PPD. Ask for a referral to a mental health professional
who specializes in treating depression.
- Talk with other mothers, so you can learn from their experiences.
- Join a support group for women with PPD. Call a local hotline or look
in your telephone book for information and services.
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National Institute of
After Delivery, Inc.
Postpartum Education for
American Psychological Association
American College of Obstetricians
and Gynecologists (ACOG)
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