The weeks after a woman gives birth can be exciting and joyful for her and her family. But for many women, the stresses of new motherhood, combined with the physiological changes that occur in their bodies after pregnancy, can lead to conflicting emotions and wide mood swings.
Although a woman may become depressed at any time in her life, she is especially vulnerable to depression after the birth of a baby. Depression is a mood disorder characterized by negative thinking and feelings of sadness, despair, and dejection. People who are depressed sometimes describe the experience as being in a “gray fog,” or feeling “numb.” They may have difficulty sleeping, feel extremely fatigued, and find it difficult to concentrate on complex tasks. Depression may affect a person’s appetite, immune system, physical movements, and general physical health.
The signs and symptoms of depression after pregnancy, or postpartum depression, are generally the same as for any kind of depression. However, women suffering from postpartum blues or depression are often overly fearful, without good cause, that their baby will be harmed. They may also fear that they are “bad” mothers and feel guilty that they are not “good enough.”
An episode of postpartum psychosis is a crisis situation, and medical help should be sought immediately if a new mother is experiencing delusions, hallucinations, disorganized speech, or grossly disorganized behavior.
Generally, depression after pregnancy is divided into three major types, depending on the severity of the symptoms and how long they last:
Symptoms Of The Baby Blues
The baby blues usually occur one to two days after a woman gives birth and may last up to three weeks. The disorder is so common among new mothers that it is considered “normal,” although a woman suffering from the baby blues does not feel normal. She may feel fine one minute and then burst into tears the next. She may feel irritable and generally depressed or down. Other symptoms include:
- Lack of energy
- Inability to sleep
- Loss of appetite
- Feeling tired even after sleeping
- Excessive worrying
- Excessive concern over physical changes
- Lack of confidence
- Feeling overwhelmed
True postpartum depression affects 10 to 15 percent of women who give birth. Postpartum depression is best described as the baby blues that deepen and last beyond the first month. Women who suffer from postpartum depression may feel profound sadness, have obsessive thoughts, and be unable to shake troublesome worries.
The appearance of postpartum depression varies from woman to woman. It may appear as depression, anxiety, obsessive-compulsiveness, or any combination of these. Women may be suffering from postpartum depression if they feel depressed, lose interest in daily life and activities they used to find pleasurable, and suffer from at least four of the following symptoms almost continuously for at least two weeks:
- Extreme fatigue/sluggishness/exhaustion
- Hopelessness and helplessness
- Sleeplessness despite exhaustion
- Changes in appetite (i.e., loss of appetite, food cravings)
- Anxiety, fear, guilt
- Difficulty concentrating
- Difficulty making decisions
- Heart palpitations, tingling, numbness, or feelings of dread, all of which signal a panic attack sudden experience of fear, often accompanied by the physiological"fight or flight"response. The panicky feelings are not attached to any obvious source. During a panic attack, a person may begin to sweat, have an increased heart rate, feel dizzy, have diarrhea, and show other signs of fear.
- Impulses to harm baby or self
- Disinterest in personal hygiene/appearance
- Obsession recurring, unwanted idea that cannot be eliminated. Obsessive ideas are often unreasonable and disturbing. Preoccupation with an obsessive idea can interfere with normal daily activities. with baby’s health
- Inability to cope with everyday situations
Postpartum depression varies in severity and may last for several months. Major depression common type of depression. Major depression is a serious disorder marked by sadness, fatigue, changes in sleep patterns, difficulty thinking and concentrating, changes in appetite, feelings of dejection and hopelessness, and sometimes suicidal thoughts. is the most common kind of depression that occurs after pregnancy. Other women suffer from dysthymia mild but long lasting form of depression. Dysthymia is often associated with early childhood trauma or abuse, and is sometimes seen in adults who are in abusive situations., a mild but long-lasting depression that may stem from childhood trauma or a current abusive relationship.
Women with mild to moderate postpartum depression, whose anxiety and troublesome thoughts come and go, may still be able to care for their babies and maintain daily activities. Others may be so overwhelmed by anxiety that they may not have the energy to care for themselves or their babies.
Symptoms Of Postpartum Psychosis
Postpartum psychosis is a rare but severe illness that affects one in every thousand women who give birth. The woman with postpartum psychosis may experience delusions, such as thinking her baby is evil, or hallucinations, which involve seeing, hearing, smelling, or otherwise sensing things that aren’t really there.
Psychosis is often termed “a break from reality.” Its hallmark symptoms are delusions and hallucinations. Postpartum psychosis is thought to differ from other types of psychosis and is generally considered a severe form of depression called bipolar depression. It is not known whether postpartum psychosis is one illness or a combination of illnesses.
Postpartum psychosis usually occurs soon after a woman gives birth, within three to 10 days. Postpartum psychotic episodes are generally brief, lasting for at least one day and less than a month. The new mother may experience periods of relatively normal behavior. A psychotic episode that occurs more than a month after a woman gives birth is not considered postpartum, but may be caused by other factors.
Besides experiencing delusions and hallucinations, the woman suffering from postpartum psychosis may also:
- Be extremely agitated
- Lose weight quickly without dieting
- Go without sleep for more than 48 hours
Revision date: June 14, 2011
Last revised: by Jorge P. Ribeiro, MD