Postpartum Depression

Stacy Gaskin of Baton Rouge, Louisiana, had never heard of postpartum depression. She thought she was just feeling blue because she'd had a rough C-section and a difficult recovery. Plus, she was having a hard time bonding with her newborn. "I was crying all the time," she says. "I had this Little House on the Prairie image of how having a baby should be, and it wasn't that way. Taking care of my son consumed everything, which made it hard to deal with other things in my life."

It took her close to a year, but she eventually got help. She says she was embarrassed to confide in someone because she thought she was a bad mother. "But once I talked to my doctor, I was so excited there was a diagnosis and a treatment."

Stacy's not the only one. According to Linda Sebastian, a psychiatric nurse and author of Overcoming Postpartum Depression & Anxiety (Addicus Books), approximately 15 percent of all new mothers will experience some degree of postpartum depression, or PPD. (The American College of Obstetricians and Gynecologists puts the number at one in 10.) It is the most common complication of pregnancy, yet few understand it or are prepared for it. "These women are often devastated by the unexpected mood changes after delivery," Sebastian explains. "And because they're unaware of how common the problem is, they feel alone and ashamed and try to hide their symptoms," she explains.

Not just the blues. Many women confuse PPD with the "baby blues." This is because PPD is often used to describe the whole spectrum of mood changes after delivery- including the baby blues, postpartum depression, postpartum anxiety disorders, and postpartum psychosis. (Andrea Yates, the Texas mother who killed her five children, suffered from postpartum psychosis. This condition affects one out of 1,000 women and is characterized by violent urges, delusions, hallucinations, and anxiety.)

Baby blues typically occur a few days after childbirth-a direct result of the stress of giving birth and adjusting to a newborn. Often, women feel let down after the buildup of pregnancy. They also tend to feel alone-the attention has shifted from expectant mom to baby. They might become more impatient with their partner or child. These are normal reactions and will generally disappear on their own after a couple of days.

Postpartum depression, on the other hand, is a more severe and longer-lasting mood disorder. Instead of feeling "a little bit down," moms feel miserable, irritable, and listless. These emotions surface months after the birth and can last longer than a year. There is no exact cause, though many experts attribute it to changes in hormone levels that can affect some women more than others.

You might be at greater risk if you've had other kinds of depression or have a family history of depression. Severe premenstrual syndrome (PMS) can increase the risk, as can a history of infertility or repeated pregnancy loss. Giving birth by C-section or giving birth to multiples also puts you at a higher risk.

You can have PPD after the birth of any child, not just your first. Similarly, having it with one child doesn't mean you'll have it with another.

Signs of PPD include:

• Feeling sad, anxious, or irritable
• Loss of interest in things you usually enjoy
• Crying for no clear reason
• Feeling guilty, worthless, helpless, and hopeless
• Sleeping too much or too little
• Eating too much or too little and gaining or losing weight
• Feeling "slowed down," with no energy
• Thinking about death or suicide
• Being unable to concentrate or remember
• Having headaches, stomach problems, or other pains that don't go away with treatment

Life changes might also bring on the symptoms of PPD adds Viktoria Erhardt, a psychiatrist at Mount Sinai Hospital in Chicago. New mothers often feel that they are losing their identity just as they are taking on a new, demanding role.

It's normal. Don't be embarrassed or ashamed of PPD, stresses Cynthia B. Flynn, CNM, PhD, a midwife at the Columbia Women's Clinic and Birth Center in Kennewick, Washington. "I tell my clients if they are having these feelings for more than three days and don't want anyone to know, then they need to call me right away, because left untreated, postpartum depression can have dangerous consequences. If caught early, PPD can usually be treated with antidepressants that allow the woman to continue breastfeeding if she wishes. The need for medication is only temporary; usually the symptoms resolve in a matter of weeks or months."

There are danger signs to be aware of in case things don't get better. Without treatment, PPD can become much more serious over time.

Warning signs include:

• Thinking about suicide or about harming the baby
• Inability to function
• Hallucinating and feeling unable to leave the house

• Get as much rest as you can.
• Give yourself time to learn mothering skills.
• Take your new role one day at a time.
• Find time to do things for yourself, even if it's only for l5 minutes a day. Read, exercise, or take a bath.
• Keep a diary. Write down your emotions.
• Don't spend too much time alone. You need to be around other adults for at least a short time each day.
• Talk to other mothers or join a support group.
• If you're breastfeeding, tell your care provider so she or he can choose the right medication.
• Communicate with your spouse, healthcare practitioner, and friends.
• Eat well, and cut out caffeine, alcohol, and cigarettes.
• If people offer to help, let them!

For Stacy Gaskin, it took a year on medication to get her feeling like her old self. For Linda Sebastian, who wrote the previously mentioned PPD book, it took asking others for help and catching up on her sleep to get back on track. Both women agree on the most important message for other moms: Get help.

*taken from "Feeling the Blues," by Jeannea Muchnick, Every Baby magazine, Issue Four.