Postpartum Blues

Postpartum Blues
Postpartum blues, also known as baby blues, is a transient condition that affects up to 80 percent
of new mothers just after delivery. The birth of a baby is a joyful and happy time, but for
various reasons, many women (60-80%) experience a mild and temporary form of
depression commonly referred to as the "Baby Blues." Possible triggers include the
sudden hormonal changes following delivery, the stress and lack of sleep that occur
while caring for a newborn who is completely dependent on his or her mother, as
well as worries about whether you will be a good mother.
Most new mothers (perhaps as many as 90%) will have periods of weepiness, mood swings,
anxiety, unhappiness, and regret. Usually this lasts for a few days or less and is quickly
forgotten. It's not unusual, however, for the blue period to come and go for six weeks. For some
moms, the blues don't begin until the baby stops nursing (another time of major hormonal shifts).
Hormones, however, are not the entire story.
Symptoms
Javilinar: 1.MAJOR DEPRESSIVE DISORDER jan
anthony estolas: 2. BIPOLARshiela
anthony estolas: 3.OTHER MOOD DISORDERSnylan
anthony estolas: A.DYSTHYMIC DISORDERpatrich
anthony estolas: B.CYCLOTHYMIC DISORDERann
anthony estolas: C.ALCOHOL INDUCED MOOD DISORDERbaby boy
anthony estolas: SEASONAL AFFECTIVE DISORDERmyrmie
anthony estolas: POST PARTUM BLUESace
anthony estolas: POST PARTUM DEPRESSIONkath
anthony estolas: POSTPARTUM PSYCHOSISorvil
To Your Health -- CHRC Newsletter, Fall 2006

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The arrival of a newborn can be a joyous occasion for pregnant women, their families, and
friends. Contrary to popular beliefs, the postpartum period can also be a time of increased stress
and difficulty transitioning into new roles for both parents and their loved ones.
• Postpartum Blues
• Postpartum Depression
• Conclusion
• Resources
Postpartum Blues
Postpartum blues, also known as baby blues, is a transient condition that affects up to 80 percent
of new mothers just after delivery.
Symptoms
Symptoms may include abrupt mood swings from happiness to sadness, anxiety, irritability,
decreased concentration, insomnia, tearfulness, and crying spells that can occur for no
apparent reason. These disturbances in mood can peak on the fifth day after delivery, and
typically resolve within two weeks.
Treatment
Treatment for postpartum blues is focused on providing support for the mother and her family, as
well as reassurance that her feelings are quite normal and experienced by many other women
postpartum. It is important that mothers make time for adequate sleep and rest, eat a well-
balanced diet, and allow others to care for the baby at night if possible.
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Postpartum Depression
There are times when the symptoms of postpartum blues can progress to postpartum depression.
Postpartum depression can occur within the first month after delivery, but may also occur up to
one year after delivery. Unlike postpartum blues, it lasts longer than two weeks. At any given
point in time, it can occur in 15 percent of new mothers, with a lifetime risk as high as 10-25
percent. It can be higher in some populations, but may go undetected due to underreporting.
Postpartum depression may occur for a variety of reasons. It may be related to the abrupt
withdrawal of estrogen and progesterone levels after birth that are much higher during
pregnancy, as well as the risk factors listed below.
Risk Factors
Risk factors may include:

• Personal history of depression prior to, during, or after pregnancy
• Personal history of anxiety or bipolar disorder
• Family history of depression, anxiety, or bipolar disorder
• Marital conflict
• Stressful life events within the preceding 12 months of delivery
• Lack of perceived social support from family and friends for the pregnancy
• Social isolation
• Single motherhood
• Unplanned pregnancy
• Lack of emotional and/or financial support from partner
• Previous oral contraceptive related mood changes, or history of premenstrual
tension
• Previous consideration of terminating current pregnancy
• Previous miscarriage
• Not breastfeeding or abrupt weaning
• A poor relationship with one's own mother
• Unemployment in the mother who held a previous job or unemployment in
the partner who is the main source of income
• Depression in the partner
• Child-care related stressors
• High number of prenatal visits
• Sick leave during pregnancy related to a medical condition
• A congenitally malformed or sick infant
No one hormonal, personal, or external factor has been found to cause the condition
alone. Method of delivery (vaginal vs. Cesarean section), has not been found to
affect the occurrence of postpartum depression.
Symptoms
Symptoms of postpartum depression may include:

• Insomnia or excessive sleep
• Fatigue
• Change in appetite with weight loss or weight gain
• Loss of interest or pleasure in life
• Decreased libido (sex drive)
• Excessive worry or anxiety
• Intense irritability and anger, short temper
• A sense of being overwhelmed or unable to care for the baby
• Difficulty making decisions
• Not bonding with the baby, leading to further shame and guilt
New mothers can have thoughts about harming themselves or their baby. If this
occurs, mothers should seek immediate help from their physicians.
If postpartum depression is left untreated, there may be several adverse outcomes.

Partners can develop depression. Postpartum depression may impact the new
mother's ability to bond with her infant, and may also impact future child
development. It can be associated with behavioral problems in children. These
children may also relapse into major depression later on in their lives.
Treatment
A woman's physician can screen for postpartum depression using the Edinburgh
Postnatal Depression scale, a 10-item self-report questionnaire. This test may be
conducted by an obstetrician, pediatrician, family practice physician, internist,
lactation consultant, or certified nurse midwife. It can also be administered by a
psychiatrist or psychologist. Based on the results, the health care professional can
offer various treatment options.
In general, physical health should be optimized with adequate sleep, nutrition, and
light exercise when possible.A brisk walk, dancing, or biking can help a woman's
mood. Just taking a few steps out of the home to look up at the sky, stretch her
arms out wide, and breathe deeply can help a new mother to feel less enclosed and
weighted down by her condition. It is also often helpful to find supportive people
to help care for the mother and baby, such as partners, extended family,
neighbors, co-workers, friends, or even hired help from nannies and housekeepers.
Contrary to popular belief, a new mother is not selfish for spending time away from
the baby to care for herself. Sometimes it is the only way she is able to recharge
her own batteries so that she can return to the baby with love and energy that is
replenished during her period of rest.
A new mother's psychosocial health also needs to be addressed appropriately with

individual, couples, and/or group counseling, depending on her and her family's
needs. Hotlines, internet chat rooms, and telephone conversations with supportive
family members, friends, or co-workers are also resources to keep in mind when the
new mother cannot leave her baby due to infant care or time constraints. Light
therapy, medications, and/or other therapies may be used depending on the
severity of the mother's symptoms.
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Conclusion
Postpartum depression is often under-diagnosed because women are reluctant to complain about
their mood based on cultural and societal expectations of new mothers. These women suffer in
silence, unaware of their condition and the support in the community available to them and their
families. Several resources are available for information and understanding of postpartum
depression. A short list is included here. This list is not meant to replace open discussion with
health care professionals about each individual's personal needs.
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Resources
Organizations
Postpartum Support International

www.postpartum.net
Provides telephone support (805-967-7636) and an international directory of members.
Massachusetts General Hospital Center for Women's Mental Health

www.womensmentalhealth.org
Postpartum Support Page

www.ppdsupportpage.com
Provides online information, support and assistance to those dealing with postpartum mood
disorders, as well as their families, friends, physicians and counselors.
Bay Area Postpartum Depression Stress Line

1-888-678-2669; toll free, San Francisco Bay Area
Lines are open daily from 9 a.m. to 9 p.m. Leave a message and a trained volunteer will
promptly return your call.
Books
Beyond the Blues, A Guide to Understanding and Treating Prenatal and Postpartum Depression,
S. Bennett and P. Indman, 2003 (www.beyondtheblues.com)
Down Came the Rain, Brooke Shields, 2005
The Hidden Feelings of Motherhood, Kathleen Kendall-Tackett, 2005
Postpartum Survival Guide, A. Dunnewold and D. Sanford, 1994
This Isn't What I Expected, K. Kleinman and V. Raskin, 1994
The Postpartum Husband, K. Kleinman, 2000

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What are some common symptoms of postpartum blues?

What factors can increase the risk of developing postpartum depression?

Postpartum Blues

To Your Health -- CHRC Newsletter, Fall 2006

Risk factors may include:

Symptoms of postpartum depression may include:

If postpartum depression is left untreated, there may be several adverse outcomes.

A new mother's psychosocial health also needs to be addressed appropriately with

Postpartum Support International

Massachusetts General Hospital Center for Women's Mental Health

Postpartum Support Page

Bay Area Postpartum Depression Stress Line

Down Came the Rain, Brooke Shields, 2005

The Hidden Feelings of Motherhood, Kathleen Kendall-Tackett, 2005

Postpartum Survival Guide, A. Dunnewold and D. Sanford, 1994

This Isn't What I Expected, K. Kleinman and V. Raskin, 1994

The Postpartum Husband, K. Kleinman, 2000

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