Signs and symptoms of postpartum depression

Postpartum depression is a mood disorder that can affect women after childbirth. The feelings of sadness and anxiety that stem from postpartum depression can even interfere with a woman’s ability to properly care for her newborn.

Postpartum depression symptoms can start and stop at different times for different women. It is important for everyone involved in the birth of a baby to be aware of the symptoms of postpartum depression. An obstetric nurse and clinical assistant professor at the Texas A&M College of Nursing, Elizabeth Wells-Beede, PhD, MSN, RN, explains the signs and symptoms of postpartum depression and gives you tips on how to manage it.

What are the baby blues?

Right after birth, a woman’s hormones are in flux because her body is used to functioning with high levels of estrogen and progesterone (pregnancy hormones). A drop in these hormones could be to blame for many depressive-type symptoms that immediately follow a birth.

“A mother is coming off the ‘high’ of pregnancy and is experiencing a type of ‘withdrawal’ after a decline in pregnancy hormones,” Wells-Beede said.

Still, there are other factors at work that shouldn’t be overlooked.

In the first two weeks after giving birth, many new mothers suffer from the baby blues, a precursor to postpartum depression. The baby blues, a popular term for the mood swings after a recent birth, are not uncommon due to various hormonal and physical changes. Many women may feel confused about struggling with sadness or anxiety about adding a new family member.

Symptoms of the baby blues include…

• Crying for no apparent reason
• Impatience
• Anxiety
• Fatigue
• Insomnia
• Sadness
• Mood changes

“Baby blues affect approximately 50 to 80 percent of women,” said Wells-Beede. “However, if a woman experiences the baby blues for more than 10 days after her delivery, then red flags may be raised. If the baby blues do not naturally go away by that time, then postpartum depression is likely.”

What is postpartum depression?

The most common signs of postpartum depression is wen women feel symptoms of depression that last more than two weeks within one year of delivery. Women may experience symptoms like excessive crying, severe mood swings or depressed mood, anxiety, overwhelming fatigue and reduced interest in activities.

In addition to feeling the above symptoms, women may feel like they are unable to care for themselves or the baby. In severe cases of postpartum depression, they may consider hurting themselves or the baby.

If you are concerned about yourself or your partner, reach out to your physician, nurse or midwife. Most health care providers can screen for depression, then refer you to a mental health professional, if needed.

 When does postpartum depression start? How long does postpartum depression last?

Postpartum depression is most likely to occur within four weeks after giving birth, and severe cases may last up to a year if not treated appropriately. Much like other types of depression, symptoms can range in severity. Some women may experience only a few symptoms, but other women with postpartum depression may struggle to even make a connection with their new baby.

“Most moms innately have some kind of emotional connection with their baby,” Wells-Beede said. “However, with postpartum depression, detachment can occur if she is feeling especially overwhelmed and stressed. When mothers feel these ‘inadequacies,’ then that feeling can progress into extreme irritability—another sign of postpartum depression.”

How is postpartum depression treated?

Treatment of postpartum depression varies from person to person. For some women, health care providers will recommend therapies like a support group or psychotherapy before pursuing medications. Most psychotherapists will see patients at least once a week.

For other women, they may need a treatment including therapy and medication.

“In most cases, providers want to try psychotherapy before prescribing antidepressants, which in some cases, can be harmful to a baby if mom is breastfeeding,” Wells-Beede said. “However, if medication is needed, certain drugs for depression are safe for breastfeeding mothers and their babies.”

Who is at risk for postpartum depression?

Postpartum depression is a non-discriminatory disease and can affect any mother. However, women who have already been diagnosed with conditions like anxiety and depression may be more at risk. “These are underlying disorders that can amplify it,” Wells-Beede said.

Even if predisposed, postpartum depression is still a multifaceted problem. Is it purely medical, or more psychological? Researchers are still trying to determine the cause.

“We still don’t know all the risk factors,” Wells-Beede said. “Diabetes and thyroid imbalances can play a part, and women who receive fertility treatments could develop it as a result of compounding hormones and the anticipation of birth. Unfortunately, postpartum depression is not like cancer. We can’t draw blood and determine markers about who’s most at risk. It just doesn’t work like that.”

How can you help someone with postpartum depression?

A woman’s friends and family are often on the front lines when postpartum depression hits.

“Family will normally be the people who spot the symptoms first,” said Wells-Beede. “It’s important to be aware of what’s happening in a mother’s life post-delivery, without smothering or overwhelming her. A strong support system is invaluable for women who experience this condition.”