Postpartum Mood Disorders: A Guide for New Mothers and Their Families

Postpartum Mood Disorders
Pregnancy and childbirth are major events in a woman’s life and bring about a wide range of physical and emotional changes. Life with a new baby can be thrilling and exciting, but a woman may also experience feelings of sadness, anxiety, fear or confusion. No matter how prepared a woman is, or how much she looked forward to her pregnancy and the birth of her baby, this time may include some unexpected “lows.” These confusing emotions are postpartum conditions classified as: Baby Blues, Postpartum Depression and Postpartum Psychosis.

Baby Blues
The most common and least severe reaction, Baby Blues occur in the days right after delivery. Most new mothers experience this feeling of “let down” after childbirth. Symptoms may include sadness and weepiness for no apparent reason, irritability, frustration and moodiness, difficulty concentrating and feeling dependent on others. Symptoms of the blues usually disappear on their own within one to two weeks.

Postpartum Depression
At least one in 10 new mothers experiences postpartum depression. Symptoms can begin during pregnancy, right after delivery or appear gradually anytime during the first year. A woman may have postpartum depression if her feelings of sadness, fear or confusion do not go away within three weeks after giving birth. Although postpartum depression does not take the same form in every woman, all of the symptoms can be equally upsetting and often leave the woman feeling ashamed, guilty and isolated.

Symptoms of postpartum depression and postpartum anxiety may include:

• Feeling sad or depressed
• Crying for no apparent reason
• Lack of energy or motivation
• Loss of appetite or overeating
• Changes in sleep patterns
• Difficulty concentrating or focusing
• Feeling hopeless, helpless or worthless
• Feelings of not being a good mother
• Lack of concern or being overprotective toward the baby
• Thoughts of hurting herself or baby
• Headaches, chest pains, heart palpitations, numbness or hyperventilation
• Feeling restless, irritable or “on edge”

If you are experiencing any of the above symptoms, you should contact your health care provider.

Postpartum Psychosis
Postpartum psychosis is the least common but most severe type of postpartum mood disorder (one to two cases per 1,000 births).

A woman with postpartum psychosis may experience:

• Extreme mood swings
• Disorganized, irrational behavior
• Hallucinations or scary thoughts

If any of these apply to you, get help right away.

Postpartum psychosis is a MEDICAL EMERGENCY that requires immediate medical attention because of the immediate risk of self-harm or harm to the baby.

Causes
The exact cause of postpartum mood disorders is unknown. Suspected causes include hormonal imbalances, stress and isolation. Researchers suggest that rapid changes in levels of hormones during pregnancy and after birth may have a strong effect on the moods of women. Thyroid levels may also drop sharply after giving birth, causing symptoms that feel like depression. A simple thyroid test can tell if this condition is causing depression.

Risk Factors
Postpartum mood disorders can affect any childbearing woman regardless of age, income, culture or education. The following risk factors may increase the likelihood of developing a postpartum mood disorder:

• Miscarriage
• Child recently weaned from breastfeeding
• Previous history of postpartum blues or postpartum depression
• Prenatal anxiety or depression
• Stressful life events during pregnancy or after childbirth (such as domestic violence, relocation or divorce)
• Lack of support from family/friends
• Chronic sleep deprivation
• History of depression not related to pregnancy or childbirth
• Family history of depression
• First time mother or teen mother

Treatment
All forms of postpartum mood disorders are real illnesses that can be treated. The treatment plan depends on the severity of the postpartum mood disorder and may include:

• Medical evaluation
• Psychiatric evaluation
• Psychotherapy
• Medication
• Participation in a support group

If you believe you are suffering from a postpartum mood disorder, it is important that you talk with your healthcare provider. All of the symptoms, from mild-to-severe, are temporary and treatable with skilled professional help and support.

What You Can Do

• Talk to someone you trust about how you are feeling
• Get as much rest as possible
• Ask friends and family to help with household chores and child care
• Keep phone numbers for support groups and counseling resources available
• Practice self-care activities as much as possible — eat nutritious meals and find activities you enjoy
• Contact Postpartum Support International at 805-967-7636 or www.postpartum.net for help

Postpartum Organizations

• Fourth Trimester
  Phone: 323-333-2121
  www.fourthtrimester.com
• Postpartum Support International
  Phone: 805-967-7636
  www.postpartum.net
• The National Women’s Health Information Center
  Phone: 800-994-9662
  www.4woman.gov/faq/postpartum.html

Education and Support

• Moms and Babies Support Group at MemorialCare Center for Women
  Free. Wednesdays from 11 a.m. to noon in the Women’s Conference room. No RSVP required.
  Phone: 562-933-0627
• Child Guidance Center
  Parenting Education
  Phone: 562-595-1159
• Family Support Center of Long Beach
  Educational support and practical skills for families at risk of abuse. All services are free.
  Phone: 562-434-6899
• Maternal Outreach Management System (MOMS)
  Orange County residents only. Spanish or English.
  Phone: 714-972-2610
• Moms Helping Moms
  A family support group.
  Phone: 562-933-1670
• Postpartum Stress Support Group
  A postpartum support group in Long Beach and Los Alamitos.
  Phone: 562-489-40460
• Pregnancy and Postpartum Stress Group
  In Tustin on Wednesdays from 11 a.m. to 12:30 p.m.
  Phone: 949-246-5062
• Women Helping Women
  English and Spanish counseling, support and community resources.
  Phone: 323-655-3807 or 877-655-3807

Books

• Beyond the Blues: A Guide to Understanding and Treating Prenatal and Postpartum Depression (2003)
  by Shoshana S. Bennett and Pec Indman
• Conquering Postpartum Depression: A Proven Plan for Recovery
  by Ronald Rosenberg, Deborah Greening and James Windell
• Overcoming Postpartum Depression and Anxiety
  by Linda Sebastian
• Shouldn’t I Be Happy? Emotional Problems of Pregnant and Postpartum Women
  by Shaila Misri, MD
• This Isn’t What I Expected: Overcoming Postpartum Depression
  by Karen Kleiman and Valerie Raskin