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Depression: Managing Postpartum Depression

Introduction

If you have the "baby blues" after childbirth, you're not alone. About half of women have a few days of mild depression after they have a baby. This can be upsetting, but it's normal to have some insomnia, irritability, tears, overwhelmed feelings, and mood swings. Baby blues usually peak around the fourth day after the baby is born. They tend to improve in less than 2 weeks, when hormonal changes have settled down. But you can have bouts of baby blues throughout your baby's first year.

If your depressed feelings have lasted more than 2 weeks, your body isn't recovering from childbirth as expected. Postpartum depression:

  • Is a serious medical condition. Without treatment, it can last a long time and make it hard for you to function. And it can affect your baby's development.
  • Is best treated with counseling and an antidepressant medicine.
  • Can further improve with home treatment.

To prevent serious problems for you and your baby, work with your doctor now to treat your symptoms.

If you are having thoughts of hurting yourself, your baby, or anyone else, see your doctor immediately or call 911 for emergency medical care.

How is postpartum depression treated?

Depression is a medical condition that requires treatment. It's not a sign of weakness. Be honest with yourself and those who care about you. Tell them about your struggle. You, your doctor, and your friends and family can team up to treat your postpartum depression symptoms.

Talk to your doctor about your symptoms. Work together to decide what type of treatment is right for you. (You may also have your thyroid function checked. This test is to make sure that a thyroid problem isn't causing your symptoms.)

Treatment options

  • Cognitive-behavioral therapy with a supportive counselor. This is recommended for all women who have postpartum depression. It can also help prevent postpartum depression. A cognitive-behavioral counselor can also teach you skills to help you manage anxiety. These skills include deep breathing and relaxation techniques.
  • Interpersonal counseling. It focuses on your relationships and the personal changes that come with having a new baby. It gives you emotional support and helps you solve problems and set goals.
  • Antidepressant medicine, ideally along with counseling. Even if you breast-feed, you can take an antidepressant for postpartum depression. Breast-feeding offers many emotional and physical benefits for both baby and mother. So experts are studying which antidepressants are most safe for breast-feeding babies. Whether or not you breast-feed, your doctor is likely to recommend a selective serotonin reuptake inhibitor (SSRI). Tricyclic antidepressants, excluding doxepin (Silenor, Zonalon), can also be used by women who breast-feed.

Breast-feeding babies whose mothers take an antidepressant do not often have side effects. But they can. If you are taking an antidepressant while breast-feeding, talk to your doctor and your baby's doctor about what types of side effects to look for.

Home treatment

  • Schedule outings and visits with friends and family. Ask them to call you often. Isolation can make depression worse, especially when it's combined with the stress of caring for a newborn.
  • Get as much sunlight as you can. Keep your shades and curtains open. And get outside as much as you can.
  • Eat a balanced diet. Avoid alcohol and caffeine. If you don't feel hungry, eat small snacks throughout the day. Nutritional supplement shakes are also useful for keeping up your energy.
  • Get some exercise every day, such as outdoor stroller walks. Exercise helps improve mood.
  • Ask for help with preparing food and doing other daily tasks. Family and friends are often happy to help a mother with a newborn.
  • Don't overdo it. And get as much rest and sleep as you can. Fatigue can increase depression.
  • Join a support group of moms with new babies. An infant massage class is another great way of getting out and spending time with others whose daily lives are like yours. You will also learn new ways to bond with your baby. To find a support group in your area, talk to your doctor. Or see the website of Postpartum Support International at www.postpartum.net.
  • Play upbeat music throughout your day and soothing music at night.

References

Other Works Consulted

  • Cunningham FG, et al. (2010). Psychiatric disorders section of neurological and psychiatric disorders. In Williams Obstetrics, 23rd ed., pp. 1175–1184. New York: McGraw-Hill.
  • O'Hara MW, Segre LS (2008). Psychologic disorders of pregnancy and the postpartum period. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 504–514. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer Patrice Burgess, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Current as of June 4, 2014

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