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First Morning Sickness, Then Childbirth, Now Depression?!
by Lisa Barroilhet

"It happens more than you would guess," Dr. Petra Kiley, a psychiatrist who practices in Manhattan recently told me. "Childbirth is supposed to be this wonderful, life-changing event. Instead, for many women, it is marked by the onset of depression."

Often referred to as the "baby blues," postpartum depression is not necessarily a transient condition. While it is usually attributed to a combination of hormonal and lifestyle changes, it can evolve into a severe, incapacitating depression that lasts much longer than the weeks following childbirth. Although many women get depressed right after childbirth, some women don't feel "down" until several weeks or months later. Depression that occurs within 6 months of childbirth may be postpartum depression.

The symptoms of postpartum depression often include the following:

  • Loss of appetite
  • Lethargy and lack of motivation
  • Insomnia
  • Feelings of guilt and worthlessness
  • Increased crying or tearfulness
  • Increased anxiety and irritability
  • Unexplained weight loss or gain
  • Inability to perform basic survival tasks
  • Worrying about hurting yourself or your baby

No one knows exactly what causes postpartum depression (also known as PPD), but if the mother has suffered from depression in the past, she is far more susceptible. Normal hormone changes that occur after childbirth may produce chemical changes in the brain that play a part in causing depression. Also, women who experience more severe PMS before pregnancy may be more likely to struggle with PPD.

Dr. Kiley elaborates, "Postpartum depression is an illness, like diabetes or heart disease. It needs to be treated like any other chronic illness, which may mean continuous care from a physician as well as a medication regimen."

The most commonly used treatments for postpartum depression are antidepressant medication, psychotherapy, or a combination of the two. If you are breast feeding, medication may not be the best option (like most medications, anti-depressants do go into the breast milk). A combination of psychotherapy and utilization of available support systems can be adequate to treat more mild forms of postpartum depression.

"It's important to remember that it's normal to feel completely overwhelmed at times," Dr. Kiley says. "Feeling helpless and inadequate is part of being a parent, especially in the beginning. Don't be afraid to ask for help. Friends and family are a huge part of raising a child. Even if they don't take care of the child directly, they can help take care of you."

There are many ways to help make the stressful months following childbirth more psychologically manageable. Remember to make time for yourself, even if that means a fifteen minute walk in the morning. (It's OK not to bring Junior with you. In fact, time away from the baby is valuable too). Keeping a diary is an excellent way to release stress and anger in a controlled environment. Call upon friends and neighbors for child care--time with your partner is of utmost importance now that baby has made three (or four, or five...).

"No one expects you to do everything," Dr. Kiley adds, "'Supermom' is an ideal we should all know better than to strive for."

If you know someone who is suffering from postpartum depression, refer her to a mental health specialist immediately. Waiting for the new mother to "get over it" is not a realistic treatment plan. Much can be done to treat depression, and as in all illnesses, the sooner it is recognized, the more effective the treatment will be.

The National Women's Health Information Center. "Postpartum Depression." On-line: Accessed February 2001.

American Academy of Family Physicians. "Postpartum Depression and the Baby Blues." On-line: Accessed February 2001.

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