, Dec. 2005

“Postpartum depression” is an ill-defined term that refers to a broad range of symptoms and conditions, from “baby blues” which can from time to time affect almost all new moms; to “postpartum depression,” which may actually begin during pregnancy but usually occurs during the three months afterward and manifests with symptoms similar to any depression; to postpartum psychosis, a rare but dangerous condition during which the mother loses touch with reality and may attempt to harm herself or her baby.

“Baby blues,” familiar to many women who have given birth, is probably a result of shifting hormones; lack of sleep; discomfort from swollen, engorged breasts, stitches in the perineum, or pain at the incision site of a cesarean birth; stress over the responsibility of caring for a new baby … just having the world turned upside-down.  Symptoms may include anxiety, mood swings, irritability, crying spells, an inability to cope with usual tasks, and exhaustion. These difficult feelings may come and go, may last for a few days, but usually fade completely once the physical symptoms resolve, the mother is able to get some sleep, and the changes that arrived with the baby become more routine (and more manageable).  Occasionally, this unhappy state persists, in which case it may be redefined as postpartum depression.

Postpartum depression “is moderate to severe depression in a woman after she has given birth. It may occur soon after delivery or up to a year later. Most of the time, it occurs within the first 3 months after delivery (Ntional Library of Medicine).”  The symptoms are basically the same as those of depression that occurs at other times of life:
•    Agitation or irritability
•    Changes in appetite
•    Feelings worthless or guilty
•    Feeling withdrawn or unconnected
•    Lack of pleasure or interest in most or all activities
•    Loss of concentration
•    Loss of energy
•    Problems doing tasks at home or work
•    Significant anxiety
•    Thoughts of death or suicide
•    Trouble sleeping (PubMed Health,
Treatment for postpartum depression is medication and/or psychotherapy. Medical conditions may precipitate a depression and should be ruled out at the time of diagnosis.  Postpartum depression should not be ignored, as it can last for months or years if left untreated.  A strong support system (family and friends), the opportunity for adequate sleep and for relaxing activities, and help with tasks at home are all important to any new mom, and even more so to one who is experiencing symptoms of depression.

The most severe postpartum mental disorder is postpartum psychosis, occurring in 1 to 2 out of every thousand new mothers.  A mother who experiences this condition is described as “losing touch with reality,” experiencing delusions or hallucinations, suspiciousness and/or paranoia, irritation and hyperactivity, an inability to sleep, and a compulsion to hurt herself or her baby.  Five percent of women with this condition will in fact hurt or kill themselves or their babies.  Postpartum psychosis is temporary and treatable but it is an emergency!  It is essential that the mother with any of these symptoms receive immediate help from a trained professional.    Unfortunately, even with expert treatment, support and concern from family members, and close attention, there are occasional tragic events caused by postpartum psychosis.  Two articles in the New York Times describe the condition and tell the story of a mother who fell victim to this most unfortunate disorder.  (After Baby, an Unraveling:  A Case Study in Maternal Mental Illness by Pam Belluck, June 16, 2014;
Postpartum Support International is an organization dedicated to helping women with any degree of postpartum depression.  Visit their website for more information and resources.