I’m concerned about my 31-year old niece who is pregnant. In the past five years or so, she has had two or three mild bouts of depression that lasted for a few weeks each time. I’d like to know what sorts of symptoms to look for in case she begins to experience postpartum depression.

Having a baby is a time of great joy and change. Up to 90% of all moms will experience an episode of the "baby blues" which lasts for no more than the first six weeks, and includes mood swings, crying spells, feeling out of sorts, mild anxiety, and sometimes trouble with eating or sleeping. The "baby blues" is a reaction to the dramatic drop in estrogen and progesterone that women have after giving birth and is a normal response to these changes. But, if these symptoms last beyond six weeks, and if they get worse, it may be postpartum depression (PPD).

 About 15% to 20% of all moms will experience an episode of PPD. Unlike the "baby blues," women with postpartum depression feel worse over time, and changes in mood and behavior do not go away on their own. Women with PPD hesitate to tell anyone or talk with their health care provider because they feel ashamed of what they are going through. Women with PPD are likely to think that it is because they are weak, flawed or incompetent that they are having these problems. PPD is not the woman’s fault! Research and clinical experience indicate that the hormonal changes women go through following childbirth set the stage for PPD to develop. Add to these the psychological, relationship, and situational stressors women encounter after childbirth, and it’s not surprising that depression can occur. Childbirth, more than any other major life change, increases the odds of a woman having an episode of depression. For women who have previously had some depressive symptoms, childbirth can bring on the first full-blown episode.

Here’s a checklist of symptoms for PPD.

• Depressed mood most or all of the time
• Crying or feeling weepy
• Difficulty falling asleep or returning to sleep
• Fatigue, exhaustion, no energy
• Loss of appetite; nauseated by food
• Frequent irritability; frequent mood change
• Negative thoughts about self and motherhood
• Lack of self-esteem
• Loss of interest in activities previously enjoyed
• Inability to concentrate

What follows are symptoms of a severe postpartum disorder. If these occur, a woman should immediately consult her health care provider.

• Thoughts of harming self or baby
• Feeling there is no hope left
• Strange or irrational beliefs about baby or self
• Feeling extremely confused or not in touch with reality

The good news about PPD is that with treatment, women get better. Many options exist; treatment depends on severity and length of symptoms, as well as previous health status. Admitting there is a problem and seeking help may seem scary, but the sooner a woman acts, the sooner she will get better and have a happier life with her newborn.

Diane Sanford, Ph.D.
Women’s Healthcare Partnership
314-991-5666

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