Parenting

By Dimpy Bakshi, Pharm.D.

Sad After Your Baby's Birth? You Are Not Alone

The birth of a baby can be the most exciting time in a woman’s life. But for some women, that joy can be clouded by feelings of sadness or depression. Having recently had a baby, depression is definitely not a foreign concept to me. It is critical to realize that what you are feeling is not abnormal and that many women have shared similar postpartum experiences.

Types of Postpartum Issues
Depression after the birth of a child can be present in several forms, such as postpartum “blues,” a more serious condition called postpartum depression, and the most severe form called postpartum psychosis. The levels of estrogen and progesterone in a woman’s body increase tenfold during pregnancy and then drop back down to pre-pregnancy levels within three days after delivery. The cause of postpartum depression appears to be the rapid decline in these hormone levels.

Postpartum blues, also known as “baby blues” affects approximately 50 to 75 percent of new mothers. Some symptoms you might experience are mood swings, anxiety, irritability and frequent crying spells. These symptoms usually begin during the first few days after delivery and can last for up to two weeks.

Postpartum depression is a more serious condition and affects approximately 10 percent of new mothers. These symptoms include mood swings, crying, anxiety, changes in appetite, changes in sleep patterns, loss of interest in activities that normally bring pleasure, irritability, feelings of guilt and an inability to care for your baby or yourself. These symptoms can range from mild to severe and can occur within days of the delivery or gradually thereafter. They can last from several weeks to a year. Women suffering from this condition often require the assistance of antidepressants and psychotherapy.

Postpartum psychosis is a very severe form of postpartum depression and requires emergency medical attention. This form of postpartum depression is rare, occurring in approximately 1 in 1000 women after delivery. Some symptoms that may occur include severe agitation, confusion, feelings of hopelessness and shame, insomnia, paranoia, delusions or hallucinations, hyperactivity and mania. The symptoms are usually seen very quickly after delivery and can last for a few weeks to several months. Postpartum psychosis requires immediate medical attention as there is an increased risk of suicide or harming the baby.

Risk Factors
Certain individuals are more at risk for postpartum depression than others. Risk factors during pregnancy include:
- history of depression or substance abuse
- family history of mental illnesses
- little support from family and friends
- anxiety about the fetus
- problems with previous pregnancies/births
- marital or financial problems
- young age.

Additional factors that can contribute to postpartum depression include:
- exhaustion
- feelings of overwhelm with regards to taking care of a baby
- stress related to changes in one’s work/home routine
- feeling the loss of one’s identity
- feeling less attractive
- lack of time for yourself or your spouse.

Women often don’t share their feelings after having a baby because they feel ashamed, embarrassed or guilty. Society and the media lead you to believe that you are supposed to be ecstatic when your baby is born. Women often believe that others will view them as unfit to take care of a baby if they share their true feelings. However, they are not unfit mothers, and their feelings are absolutely normal. There is help out there for women suffering from postpartum depression. If you are struggling with the symptoms of depression, you should speak to your obstetrician, primary care physician or midwife. They will be able to help you seek treatment.

In addition to seeing your physician, below are some other helpful tips:
- Get as much as rest as possible (nap when your baby sleeps).
- Ask for help from family members, relatives or friends. If this is not a possibility, consider hiring some support for at least part of the day (postpartum doula, nanny, or housekeeper). Trust me—it will be well worth the investment!
- Try not to spend too much time alone at home. Take a walk with your baby or ask your partner or a friend to watch the baby while you run some errands.
- Try to spend time with the people you care about. Make time for them when possible.
- Talk to other mothers or try to join a support group.
- Try not to put so much pressure on yourself to do everything. Just do what you can!

My Personal Experience
When I had my second child last July, I thought that things would be different this time around. I was more experienced so I assumed that the postpartum depression I had felt with my first daughter would not be present after my second pregnancy. I was clearly wrong, because the depression hit me almost immediately after giving birth. I expected to have the “postpartum blues” for a couple of weeks, but unfortunately the blues continued. Eventually, the feelings of sadness and lack of sleep took a toll on me. My primary care physician prescribed me an anti-anxiety medication called Xanax, which proved to be very helpful when I needed it.

Additionally, I saw a therapist a few times, who told me that I had several risk factors for postpartum depression. Having been on bed rest for a few weeks and not having enough support at home negatively contributed to the situation. As my husband was gone for twelve hours a day and worked some weekends, I really did not have much help. Moreover, I was waking up every three hours at night and not taking naps during the day.

My daughter is now one, and I couldn’t be happier. I faced a tough year, with the first six months proving to be the most difficult. Even while I knew that the trauma of the first year would be over soon, it was very difficult to see the light at the end of the tunnel while I was going through this grueling experience. I truly felt as if I was in this cold, dark place all alone. I felt jealous of everyone who was not in my shoes. What I didn’t know at that time, however, was that many of my friends had gone through similar experiences. It is a shame that only after we’ve gone through such a terrible experience we find out that we are not alone.

Postpartum depression seems to be such a taboo topic that it is completely avoided in our culture. I sincerely hope that anyone going through such difficult times can hang onto hope, know that it will get better, and take solace in the fact that others have been through that dark tunnel and made it out safely.

ABCDlady does not provide medical advice, diagnosis or treatment. See additional information.

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