Understanding postpartum depression

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Everyone wants to believe that being pregnant and giving birth changes a woman instantaneously into a kind, nurturing, and patient person called Mommy. But for many women, the birth of a baby may be a distressing time, fraught with a wide range of emotions including sadness, anxiety and confusion. Sometimes, these feelings can be an indication of postpartum depression (PPD). PPD does not mean that you are crazy, or a bad mother. You are not alone, and there are a variety of support options available to you.

Different experiences after birth

The "baby blues." The baby blues are a very common reaction after giving birth, with up to 60 per cent of women experiencing them. Symptoms usually start three to four days after delivery and last several days, or sometimes as long as two weeks. You may experience mood swings, have trouble concentrating, lose your appetite, and feel irritability and lack of confidence. This condition is a minor disorder and is considered a normal part of early motherhood. Usually, it does not require any treatment and will disappear on its own within a short time.

Postpartum depression. Postpartum depression (PPD) affects approximately 10 to 20 per cent of new mothers. Its onset can begin days, weeks or even months after delivery. Serious depression that occurs in the months after childbirth may be PPD and should be assessed by a physician or qualified mental health practitioner. PPD is different from the "baby blues" as it may start later, last for a longer period of time, can feel overwhelming and debilitating and can prevent daily functioning.

Postpartum psychosis. Postpartum psychosis is a rare disorder that affects approximately one out of every thousand women who give birth. It normally occurs within the first two weeks of childbirth and is marked by insomnia, hallucinations, hyperactivity/mania, rapid speech, paranoia, extreme confusion, agitation and depression. Postpartum psychosis is a serious condition that requires immediate medical attention.

Symptoms of postpartum depression

Though each woman's experience of PPD is different, women may experience many of the symptoms listed below, ranging from mild to severe.

• Insomnia and exhaustion
• Changes in appetite and weight loss
• Difficulty concentrating or making decisions
• Feeling restless, irritable or anxious (may experience anxiety/panic attacks)
• Persistent sadness and increased or uncontrollable crying
• Loss of interest in pleasurable activities
• Feelings of despair, worthlessness and hopelessness
• Feelings of guilt and being a "bad mother"
• Lack of interest in the baby
• Feeling that life isn't worth living and thoughts of harming yourself
• Fears of harming your baby

Causes of postpartum depression

The exact causes of postpartum depression are not known. Current research points to several factors that may contribute to or "trigger" PPD.

Physiological changes. Almost immediately after birth, there is a rapid change in hormone levels. It is thought that these hormone changes may produce chemical changes in the brain and play a part in causing depression.

Physical exhaustion. The physical drain from giving birth and the sleep deprivation that comes from having a newborn can significantly impact a mother's mood and ability to cope and may contribute to the emergence of PPD.

Sociological factors. Being a new mother can be emotionally gratifying, but in our society there is also a lot of pressure put on new mothers to be "super moms". Mothers are expected to know intuitively how to be a great parent. Sometimes, this can lead to feelings of guilt, inadequacy and isolation. Feeling overwhelmed by responsibilities and expectations may trigger PPD.

Other risk factors

• Previous or family history of depression
• Previous postpartum depression
• Severe PMS
• Early childhood trauma or a history of abuse
• A difficult marriage or unsupportive partner, family or friends
• Unplanned pregnancy
• Obstetrical complications
• Major life changes or stressful life events during the pregnancy or after the birth (e.g., job loss, relocation, death in the family)

Remember that it is OK to feel overwhelmed—almost every new mother does. Having a child is a major life event and one that can bring with it a lot of stress and anxiety. It is a learning process and it will get easier.