It can be a cruel irony; as you cradle your beautiful bundle of joy, instead of feeling elated, you feel sad. Postpartum depression (PPD) affects about 15 percent of women after giving birth, causing symptoms that can include deep sadness and crying, not enjoying things that usually give you pleasure, anxiety, insomnia, changes in appetite, poor concentration, low self-esteem, and thoughts of harming yourself or your baby.
Sounds scary, but by knowing and understanding your risks and working with your doctor, you can minimize or avoid PPD if you are at risk for it — and if you already have PPD, seek treatment to overcome it. Here, five things you need to know:
1) Postpartum depression doesn’t always happen immediately
Sometimes it can occur several months or even up to a year after your baby is born. Unlike “the baby blues” which affect as many as half of all women postpartum, arise within the first three days of giving birth and usually go away within one to two weeks, true postpartum depression can occur as much as one year after giving birth and lasts longer than two weeks – even for months if left untreated. PPD strikes most often within the first three months after giving birth. About half of women who develop PPD experience mild or moderate depression and around 7 percent experience major depression.
2) If it happened before, it can happen again
If you have had one episode of PPD you have a 50 percent chance of experiencing it with a second pregnancy, according to the National Alliance on Mental Illness (NAMI). Similarly, if you have a history of depression at other times in your life you are at increased risk of depression right after pregnancy. Studies suggest that women who experience postpartum depression often have had previous episodes of depression that may not have been diagnosed and treated. Talk to your doctor about your own risks.
3) PPD can have many causes
Many factors can contribute to the development of postpartum depression, including fatigue/lack of sleep, the support of people around you, your baby’s and your overall health, your economic circumstances, and other issues. Hormonal changes are often the biggest trigger. During pregnancy, your estrogen and progesterone levels surge and then drop abruptly in the first 24 hours after childbirth. This change may contribute to postpartum depression, but estrogen and progesterone aren’t the only hormones that shift dramatically after you give birth. Thyroid hormones may also decrease after childbirth. Low levels of thyroid hormones can cause symptoms of depression. A simple blood test can measure your thyroid hormone level and if it is low, your doctor can prescribe thyroid medicine that may also improve your PPD.
4) Antidepressants may help – even if you’re breastfeeding
Research shows that certain antidepressants may be safe for use during breastfeeding, according to NAMI. If you are experiencing postpartum depression or if you are at risk for it because you have a history of depression, talk to your doctor about whether or not you should take antidepressants after giving birth if you are breastfeeding. Talk therapy may also help improve your PPD. Ask your doctor about counseling resources in your area, or check with your local office of NAMI or by logging onto www.nami.org.
5) Most moms with postpartum depression recover completely
But, how long it takes to feel better can depend on several factors, according to Katherine Stone, founder and editor of the blog, Postpartum Progress. Those factors include: How long you had PPD before you began treatment (the sooner you seek and find an effective treatment for you, the sooner you will begin to feel better); the severity of your PPD symptoms; the support of those around you; how well you care for yourself, and the effectiveness of both your medical professionals (doctor, therapist) and your treatment. No single treatment works for every woman and it can take some trial and error to find the best treatment –medication and/or therapy – for you. If your PPD doesn’t improve with treatment, or if your treatment is making you feel worse rather than better, it’s probably time to try something else. Talk to your doctor.
You are not alone. If you have PPD realize that many other women are experiencing the same symptoms you are and that there is help available. Today experts know more about PPD than ever before and one thing is certain: You can overcome even a severe case of PPD and go on to be a terrific mom.
