What is depression?
Depression can be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. But true clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended time. Depression can be mild, moderate, or severe. The degree of depression, which your doctor can determine, influences how you are treated.
How common is depression during and after pregnancy?
Depression that occurs during pregnancy or within a year after delivery is called postpartum or perinatal depression. Depression can affect women at any time from up to three months after the baby arrives, when her menstrual cycle starts up again, sometimes more than a year after she delivers and when her baby weans, up to two years later. The exact number of women with depression during this time is unknown. But researchers believe that depression is one of the most common complications during and after pregnancy. Often, the depression is not recognized or treated, because some normal pregnancy changes cause similar symptoms and are happening at the same time. Tiredness, problems sleeping, stronger emotional reactions, and changes in body weight may occur during pregnancy and after pregnancy. But these symptoms may also be signs of depression.
Are some mothers more likely to get PND?
- PND is more common in mothers who have previously had episodes of depression.
- A history of depression in family members also increases the risk, probably via genetic (inherited) factors.
- PND is also more common in mothers who have experienced stressful life events during the pregnancy, those who do not have support at home, in those in whom the baby was unplanned or unwanted, and when the baby has been born with some problem.
What are the symptoms of PND?
- Feeling 'low', 'miserable' and tearful for no apparent reason. These feelings persist for most of the time, though they may be worse at certain times of day, particularly the morning,
- Being unable to enjoy yourself. This may be particularly prominent in new mothers who feel that they are not enjoying having a new baby in the way they expected to.
- Irritability is common. This may be with other children, the new baby and particularly with the partner.
- Sleep disturbance is part of looking after a new baby. However in PND there may be additional problems of finding it hard to go to sleep even though you are tired, or waking early in the morning.
- Given that looking after a young baby means having less sleep than usual, it is no surprise that mothers often feel they have no energy. This can be even worse in mothers with PND.
- Appetite is sometimes affected, with mothers not being interested in food. This can be a particular problem since new mothers need all the energy they can get to look after their babies.
- Anxiety frequently occurs in PND. This may take many forms. It may be feeling tense and 'on edge' all the time. Normal concerns and anxieties that any mother feels for a new baby may become overwhelming. In addition mothers may experience 'panic attacks' which are episodes lasting several minutes when they feel as if something catastrophic is about to happen - such as collapsing, having a heart attack or stroke. These are extremely frightening but they get better on their own.
- Depression is often accompanied by feelings of being 'worthless' and 'hopeless'. All mothers are faced with new and sometimes difficult problems with a new baby. However, mothers with PND feel all the more 'not able to cope' and unable to see a way through their difficulties.
- When people are depressed, they sometimes feel that there is no way out of their problems and that they, and their family, would be better off dead.
What is the difference between baby blues, postpartum depression, and postpartum psychosis?
The baby blues can happen in the days right after childbirth and normally go away within a few days to a week. A new mother can have sudden mood swings, sadness, crying spells, loss of appetite, sleeping problems, and feel irritable, restless, anxious, and lonely. Symptoms are not severe and treatment isn’t needed. But there are things you can do to feel better. Nap when the baby does. Ask for help from your spouse, family members, and friends. Join a support group of new moms or talk with other moms.
Postpartum depression can happen anytime within the first year after childbirth. A woman may have a number of symptoms such as sadness, lack of energy, trouble concentrating, anxiety, and feelings of guilt and worthlessness. The difference between postpartum depression and the baby blues is that postpartum depression often affects a woman’s well-being and keeps her from functioning well for a longer period of time. Postpartum depression needs to be treated by a doctor. Counselling, support groups, and medicines are things that can help.
Postpartum psychosis is rare. It occurs in 1 or 2 out of every 1000 births and usually begins in the first 6 weeks postpartum. Women who have bipolar disorder or another psychiatric problem called schizoaffective disorder have a higher risk for developing postpartum psychosis. Symptoms may include delusions, hallucinations, sleep disturbances, and obsessive thoughts about the baby. A woman may have rapid mood swings, from depression to irritability to euphoria.