Postpartum depression: Symptoms, risks and types

Postpartum depression is linked to chemical, social, and psychological changes associated with having a baby. The chemical changes involve a rapid drop in hormones after delivery. The actual link between this drop and depression is still not clear. But what is known is that the levels of estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy. Then, they drop sharply after delivery. By three days after a woman gives birth, the levels of these hormones drop back to what they were before she got pregnant

Symptoms of postpartum depression are similar to what happens normally following childbirth. They include difficulty sleeping, appetite changes, excessive fatigue, decreased libido, and frequent mood changes. However, these are also accompanied by other symptoms of major depression, which are not normal after childbirth, and may include depressed mood; loss of pleasure; feelings of worthlessness, hopelessness, and helplessness; thoughts of death or suicide or thoughts or hurting someone else.

A number of factors can increase the risk of postpartum depression, including:

• a history of depression prior to becoming pregnant, or during pregnancy
• age at time of pregnancy -- the younger you are, the higher the risk
• ambivalence about the pregnancy
• children -- the more you have, the more likely you are to be depressed in a subsequent pregnancy
• having a history of depression or premenstrual dysphoric disorder (PMDD)
• limited social support
• living alone
• marital conflict

There are three types of mood changes women can have after giving birth:

• The "baby blues," which occur in most women in the days right after childbirth, are considered normal. The baby blues may last only a few hours or as long as one to two weeks after delivery. The baby blues do not usually require treatment from a health care provider. Often, joining a support group of new moms or talking with other moms helps.
• Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. A woman can have feelings similar to the baby blues -- sadness, despair, anxiety, irritability -- but she feels them much more strongly than she would with the baby blues. This doctor can screen her for depression symptomsand develop a treatment plan. If a woman does not get treatment for PPD, symptoms can get worse. While PPD is a serious condition, it can be treated with medication and counseling.
• Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first three months after childbirth. Women can lose touch with reality, having auditory hallucinations (hearing things that aren't actually happening, like a person talking) and delusions (strongly believing things that are clearly irrational). Other symptoms include insomnia, feeling agitated and angry, pacing, restlessness, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication. Sometimes women are put into the hospital because they are at risk for hurting themselves or someone else.

How Is Postpartum Depression Treated?

Postpartum depression is treated differently depending on the type and severity of a woman's symptoms. Treatment options include anti-anxiety or antidepressant medications, psychotherapy, and participation in a support group for emotional support and education.

In the case of postpartum psychosis, drugs used to treat psychosis are usually added. Hospital admission is also often necessary.

If you are breastfeeding, don't assume that you can't take medication for depression, anxiety, or even psychosis. Talk to your doctor. Under a doctor's supervision, many women take medication while breastfeeding. This is a decision to be made between you and your doctor.