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Depression after pregnancy affects many women and can be dangerous
Take symptoms seriously and ask for help, warns psychiatrist Nine long months of
morning sickness, swollen ankles and food cravings are over. You finally
have the healthy, beautiful baby you wanted. Your husband is proud. The new
grandparents are thrilled. Life is perfect. So why do you feel so miserable? "After my twins were born, I knew something wasn't right, but I didn't know what it was," says Laura Allegoet, of Brighton, Mich. "I couldn't sleep. I wasn't eating. And it just got to the point where I didn't want to be here anymore. I felt like I was in a big, black hole and I would never get out." Allegoet was one of the 10 percent to 15 percent of women with postpartum depression - one of the most common complications of pregnancy and delivery. A few days to a few weeks after giving birth, women with postpartum depression begin to experience appetite changes, sleep disturbances, heightened anxiety about their baby and feelings of overwhelming helplessness and hopelessness. Postpartum depression
is much more serious and long-lasting than ordinary "baby blues," according
to Sheila M. Marcus, M.D., a psychiatrist at the University of Michigan
Health System and a clinical assistant professor of Psychiatry in the U-M
Medical School. |
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"Between 60 percent
and 80 percent of pregnancies result in something called the baby blues,
which is a very transient condition with similar, but much less severe,
symptoms," Marcus explains. "These symptoms usually pass within a week or
two, unlike postpartum depression, which lasts longer and is more intense." The good news is that postpartum depression is fairly simple to treat with the help of lifestyle changes, family support, psychotherapy and medication. Some women have a greater risk of becoming depressed after pregnancy, according to Marcus. These are women with a personal history or family history of depression, those with other medical problems, women who use alcohol during pregnancy, and those without an emotionally supportive partner. |
"There is a common belief that feeling depressed after having a baby is something you can just snap out of, or something that will go away in time," Marcus says. "But this simply is not true."
Getting enough sleep and regular exercise are important in overcoming postpartum depression, according to Marcus. Family members or friends may need to come in and help with night feedings, so the mother can sleep without interruptions. "I stress the importance of maintaining good sleep habits, because this helps stabilize the axis in the brain that is vulnerable to depression." A nutritious diet and cutting back on caffeine and alcohol are important, too.
Psychotherapy or cognitive therapy can be very helpful, especially for women dealing with other psychological issues. Antidepressant medications called SSRIs, which stands for Selective Serotonin Reuptake Inhibitors, have been shown to be safe and effective in the treatment of postpartum depression. These medicines - including Prozac, Paxil, Zoloft and Celexa -- correct biochemical changes in the brain that are related to depression. Women usually show improvement within two to four weeks. In severe cases, however, hospitalization may be necessary.
If women are nursing, they often are reluctant to take antidepressants, because they worry about their effects on the baby. "We know that very small amounts of medicine are secreted in breast milk," Marcus says. "Though more research is necessary, one significant study shows no major changes in development, learning or IQ in children exposed to this medicine during nursing when compared to their brothers or sisters."
Women must balance the small risk of taking medication against the larger risk of not treating their depression, Marcus emphasizes. "Moms who are depressed and who don't get treatment may have more difficulty with their symptoms and in parenting their baby and other children," she says.
The first and most important step is don't be afraid to ask for help. If symptoms last longer than two weeks or are increasing in severity, tell your obstetrician or health care provider right away to get the support and treatment you need.
Facts about postpartum depression:
- Postpartum depression is not related to the mother's age.
- If you, or a close family relative, have had previous episodes of depression, you have a higher risk of developing postpartum depression.
- Levels of the female hormones estrogen and progesterone drop sharply after childbirth and can trigger depression.
- Antidepressant medications are not "uppers" and they are not addictive.
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