Beating the baby blues: emotional changes after childbirth can overwhelm even the best new mom. Here's how to help yourself and your family

giving birth may be a miracle, but it doesn't automatically turn on a "happy" hormone in our bodies that keeps going 24/7. Some emotional roller coasters are natural and expected after childbirth--even if your baby sleeps like an angel and you truly love your visiting in-laws--and many new moms have conflicting or troublesome feelings. Here's what you and your partner should know.

Baby Blues

Some 60%-80% of new mothers get this mild form of depression that begins a few days to a week after delivery and lasts no longer than about two weeks. You may feel weepy, anxious, irritable and unable to sleep, feelings thought to be caused by a plunge in the ovaries' production of estrogen and progesterone. Try getting more rest and help with the baby; having a good cry after all the stress and excitement of childbirth may help, too.

Recognizing Postpartum Depression

This more serious condition affects 10%-20% of mothers within a few days after birth and can last from two weeks to as long as a year. Experts say the cause is a combination of hormonal, biochemical, environmental, psychological and genetic factors. The precipitous drop in hormone levels immediately after childbirth may be partly to blame, as well as lack of sleep and/or lack of help with new parenting responsibilities.

Mothers with postpartum depression (PPD) may suffer from insomnia, lethargy, crying spells, anxiety or fleeting thoughts of harming their baby. The risk is greater among single and homeless mothers, and those with a strained marriage and financial problems. In addition, the chance of postpartum depression jumps 30% in women who have been depressed before, and 50%-70% in women with a previous history of postpartum depression.

Knowing the difference between normal emotional changes after childbirth and a need for further support is important. It's not just what you're feeling that indicates whether something may be amiss, but the frequency, intensity and duration of your feelings. Many new mothers periodically feel sad and anxious the first few months after giving birth, but if you're crying all day long for several days and having panic attacks, you should call your doctor.

Don't feel ashamed about getting help, and do it sooner rather than later--early intervention will benefit both you and your child. For mild cases, a mother may heal using relaxation and coping techniques to confront and reject distorted thinking, such as, "If my baby isn't always happy, I'm a bad mother." Couples counseling and support groups may help as well. For moderate to severe cases of PPD, antidepressant drugs might be prescribed. Patients often improve in 2-4 weeks but usually remain on the drugs for 6-12 months. Mothers on most antidepressants can nurse without risk to the baby.

Beyond the Blues: Postpartum Psychosis

A separate disorder from PPD, postpartum psychosis affects about one in 1,000 new mothers. Symptoms include hallucinations, confusion, paranoia, extreme agitation, and suicidal or homicidal thoughts. The onset is often abrupt, but it rarely occurs within the first 72 hours after giving birth. Among women who have psychosis, 75% will have symptoms within the first two weeks and 85% within the first month. Postpartum psychosis requires immediate medical treatment; the disorder is treatable and prognosis is good with early intervention.

Keeping the Blues at Bay

Time, patience and support from family and friends are all helpful when you're adjusting to life with a newborn. All symptoms of depression--from the mild to the most severe--are temporary and treatable with skilled professional help and support, such as that from a childbirth educator, doctor, registered nurse or postpartum specialist. Being prepared before giving birth can help you control the situation and make the symptoms less severe should they arise.

* Talk to your spouse about your concerns, and discuss what might make things easier. Establish a support plan. Who will be there to help: mother, mother-in-law, baby nurse, doula, other friend or family member?

* Take extra precautions against fatigue and stress. Make sure you rest, eat well and make time for mild exercise, with your doctor's approval.

* Set limits. Protect yourself from overdoing it, both during your pregnancy and afterward. Overextending yourself can tire you out, making you more vulnerable.

* If you've had postpartum depression before, contact the healthcare practitioners who helped you through the previous episode. Discuss your options and make a plan to prepare for it. If your PPD was successfully treated with medication, you may be advised to take medication immediately after delivery to reduce the possibility of a recurrence.

resources

DEPRESSION AFTER DELIVERY INC.

www.depressionafterdelivery.com; (800) 944-4773

THE NATIONAL WOMEN'S HEALTH INFORMATION CENTER

www.4woman.gov/faq/postpartum.htm

AMERICAN ACADEMY OF FAMILY PHYSICIANS

http://familydoctor,org/handouts/379.html

COPYRIGHT 2003 Weider Publications
COPYRIGHT 2004 Gale Group