Understanding Postpartum Depression

Some new mothers -- as many as 18 percent -- experience postpartum depression. See more parenting pictures.
©2006 Publications International, Ltd.

The hard work of pregnancy, labor, and delivery required tremendous effort on your part. However, the moment you bring your new baby home is when the real work begins. In addition to adjusting to the sleepless nights and the constant vigilance required by a newborn, some mothers find they other, emotional hurdles to overcome.

Many women report that after giving birth they enjoy a feeling of euphoria they have never before experienced. This sense of well-being, of having accomplished a miracle, carries them through those first difficult weeks of fatigue and apprehension about their skill in caring for the new baby. Others -- about between 11 and 18 percent [CDC]-- are not so fortunate. These women experience postpartum depression.


Postpartum depression is a very real and often very frightening occurrence that affects up to 18 percent of new mothers, according to the CDC. Symptoms include changes in sleeping and/or eating patterns, irritability, mood swings, feelings of hopelessness and worthlessness, crying jags and difficulty concentrating. Unlike the "baby blues," which typically last only a few weeks, postpartum depression lasts longer and can be more severe. In addition, a lack of energy, withdrawal from family and friends, unexplained anxiety, and certain physical ailments such as headaches and heart palpitations could also be symptoms of depression. Women experiencing postpartum depression may also find that they are uninterested in the new baby or have irrational fears of harming her.

While these feelings my shock or even frighten a new mother, they are normal. In this article, we will explore the phenomenon of postpartum depression, as well as some of the treatment options available. Let's begin with a look at some of the possible causes of postpartum depression.

Causes of Postpartum Depression

For reasons medical experts have not been able to agree upon, you may find you experience postpartum depression beginning a few days or even a few weeks after the birth of your baby. And if you suffered from postpartum depression with one child, you're 50 percent more likely to develop after another child [Health]. Most likely, postpartum depression results from a combination of psychological, sociological, and physiological conditions.

Medical uncertainty. Some authorities say the blues are caused by a drop in the level of maternal hormones and/or, occasionally, thyroid hormones. Others believe they can be the result of an unusually taxing birth with prolonged, difficult labor. Many mothers say the cause is simply the total exhaustion that results from too little sleep and too much responsibility, plus the fact a woman may be attempting to emulate the Supermom standards she has read and heard about -- the standards that say any intelligent, healthy woman can do and handle everything.

Doctors think other factors that may make one woman, rather than another, susceptible to postpartum depression may be an unhappy childhood, perhaps including mental or physical abuse; a history of depression and difficulties in managing stress; an unwanted baby or one whose birth was expected to solve a couple's marital problems; a premature birth; or an ill baby.

Not always love at first sight. First-time parents usually learn a few surprising facts about themselves, finding, for example, that they have more physical stamina or more natural parenting ability than they thought they had. They may also find they are neither as patient nor as perfect in their new jobs as they had expected to be.

Sometimes accompanying the mother's postpartum problems, and perhaps contributing to them, is her feeling she is a bad mother, unnatural and heartless, if she does not feel instant, overwhelming love for this new little creature who depends on her so completely. This feeling is perfectly normal, and she should accept it, with the attitude, "This, too, shall pass." Love at first sight is not a common occurrence, in spite of its frequency in romantic novels. Deep, lifetime love almost always develops slowly over time, and the unique bond of love a parent feels for a child is the deepest and longest-lasting of all.

I can't do this! Also contributing to depression for some women is a feeling of total incompetence and inability to properly care for this tiny, helpless, incessantly demanding human being. These days, expectant parents are rarely ignorant of the habits of babies. So you probably were aware that besides sleeping a great deal, your baby would require feeding from eight to 12 times in a 24-hour period [Mayo Clinic] and a change of diapers several times a day, and he or she might spend some time each day crying.

But now that you are on call every minute of the day and night, you find these habits aren't as simple as you expected. The baby sleeps at the wrong times, for shorter periods than you anticipated and perhaps more often and longer during the day than at night. You worry about the amount of covers to use in the baby's crib, the temperature in the room, and the household noise that may wake the baby. Feedings are sometimes tense as you struggle with the unfamiliar routines of breast- or bottle-feeding and wonder if the baby is taking enough or too much milk or formula. Dressing the baby and changing diapers are not the smoothly-orchestrated operations you imagined them to be, even with cleverly constructed infant clothing and fitted disposables that need no pins. And the baby's crying is more frequent, more distressing, and less explainable than you thought it would be.

So far, we've covered the basics of postpartum depression: who it affects, what it is, and why it happens. On the next page, we'll discuss preventing and treating postpartum depression. Keep reading for some time-tested tips on surviving the baby blues.


Prevention and Treatment

When you are trapped in the throes of postpartum depression it may seem like you will never be happy again. But with treatment, postpartum depression is a temporary condition that will pass in time, and there are steps you can take to relieve its symptoms or even prevent the onset in the first place.


Fortunately, doctors today accept the fact that postpartum depression is real, not just a figment of a woman's imagination, as some of their earlier counterparts insisted. Even though doctors can't explain the condition to their satisfaction and are unable to offer much in the way of concrete help, they take a woman's suffering seriously, offering sympathy, counsel and, in some cases, medication. They assure their patients they are not alone in experiencing depression, so they should not feel embarrassed, ashamed, or alarmed because they have difficulty coping with their new responsibilities. Many physicians discuss these feelings with expectant mothers before delivery and suggest ways to avoid the condition.


To help prevent postpartum depression, prepare yourself for the fact that not everything will be perfect. Remember this: Competence will come, as surely as it has in other areas you have learned about in your life. Infants can't judge the quality of their care, and by the time yours is old enough to know whether you are an expert, you will be one.

Anticipate some mood swings. Consider requesting rooming-in for your baby if your hospital offers such arrangements. Plan to have the best help you possibly can for the first few weeks, and try to cut down on social obligations or avoid them altogether for a time.

Doctors can also assure their patients that for plenty of women, the baby blues are short-lived. As new mothers acquire confidence in their roles as parents and regain their strength, most find their approach to life falls into a sensible perspective. They feel themselves again. It's when these feelings continue that there's cause for alarm.


To accommodate your physical tiredness and the baby's constant demands on you, you may have to review what is most important to you and make some changes in your lifestyle. If you are a perfectionist who has always insisted tasks be done the "right" way, you may find you must relax your exacting standards a bit. If you suffer from inertia, it may be necessary for you to grit your teeth and force yourself to arrange for the rest, moderate exercise, and proper nutrition that are so essential for you and often so difficult to achieve.

Often, helping yourself through this difficult period requires that you accomplish tasks and perform activities you simply don't feel like doing. For example, you should not allow yourself to skimp on good hygiene habits because you are too busy or too tired. To feel more in control, follow your usual daily routine: Dress completely every morning, do your hair, and use whatever cosmetics you usually do. And this is not the time to make demands on your strength and energy by beginning a diet.

Above all, don't try to bottle up your feelings in hopes they will go away if you ignore them. Talk about them with your partner, your doctor, your mother, or a friend who has experienced them already. Be in touch, if only by phone, until life settles down.

Every parent should get away from the routine of house and a new baby on a regular basis, and this escape is even more important if you experience postpartum depression. Even a brisk walk around the block helps when your partner or someone else can care for the baby, but an entire afternoon or evening out occasionally will do even more for you. As long as a reliable babysitter is in charge, do not feel guilty about these breathers.

More than the Blues

For some mothers, the symptoms are more profound. They last for two weeks or more, interfering persistently with sleep and affecting appetite. The mother is mired in hopeless depression and may find herself wishing the baby had never been born or even that he would die. In some cases, but not all, such an extreme reaction may be an indication that serious and unacknowledged psychological problems that existed before the birth were heightened by it. Professional help is needed; a physician can recommend a therapist.

The transition into motherhood is one of the greatest adjustments a woman can undergo in her lifetime. Many women feel down, inadequate and overwhelmed during the first few days or weeks. Fortunately, methods for preventing and curing postpartum depression are often highly effective. And in more profound cases, professional help is available.

©Publications International, Ltd.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.


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