Column: When is it more than the “baby blues?”

By Carrie Keane, CNM, MSN

Arriving home with your new infant should be a happy start to a new life for your family. But, it isn’t always a happy time for every mom. After childbirth, some moms can feel sad. The so-called “baby blues” often only last for a week or so and then the mom can bounce back to a more normal feeling.

However, in some cases, moms do not bounce back. In these cases, it might be time to talk to a doctor about postpartum depression.

Unlike the baby blues, postpartum depression is a more serious problem—one that is often ignored due to shame or a feeling of helplessness. In the beginning, postpartum depression can look like the normal baby blues. In fact, postpartum depression and the baby blues share many symptoms, including mood swings, crying, sadness, insomnia, and irritability. The difference is that with postpartum depression, the symptoms are more severe, such as suicidal thoughts or an inability to care for your newborn, and longer lasting. So, when it begins to seem that the skies never lift after the initial week or two postpartum, it may be time to seek help. 

Signs and symptoms of postpartum depression include:

•           Lack of interest in your baby

•           Negative feelings towards your baby

•           Worrying about hurting your baby

•           Lack of concern for yourself

•           Loss of pleasure

•           Lack of energy and motivation

•           Feelings of worthlessness and guilt

•           Changes in appetite or weight

•           Sleeping more or less than usual

•           Recurrent thoughts of death or suicide

Postpartum depression usually sets in soon after childbirth and develops gradually over a period of several months. If depression occurs within the first year of giving birth, it is usually diagnosed as postpartum depression.  It can come on quite suddenly, and in some women, the first signs don’t appear until months after they’ve given birth.  Some studies suggest that as many as 1 in 4 women will have some degree of postpartum depression.  For some, symptoms of postpartum depression can resolve with non-medical interventions including exercise, psychotherapy, breastfeeding, social interactions with other adults, return to work, or diet. But for more serious cases, anti-depressants are offered in combination with counseling and the aforementioned interventions. Positive family and friend support certainly improve symptoms of depression in new moms, but depression can occur in women that have all kinds of help because it can be caused by hormones, not by social stressors or circumstance.

Postpartum depression can interfere with a woman's ability to function, including her ability to take care of herself and her child.  When someone is consumed with symptoms of depression such as fatigue, irritability, apathy, and tearfulness, it is difficult—if not impossible—to properly look after a newborn’s needs. And, the baby will be affected if the depression is left untreated.  Family members or partners may begin to feel frustrated with the inability to help, and consequently, will pull away their support.

Postpartum depression can cause behavioral problems in children, including sleep problems, temper tantrums, aggression, and hyperactivity. It can also cause:

•           Social problems

•           Emotional problems

•           Delays in cognitive development, including delayed walking and talking

•           Depression early in life

The best thing you can do if you have postpartum depression is self care. The more you care for your mental and physical well-being, the better you’ll feel. Do your best to get enough sleep, napping when your baby naps and keeping as much of a routine as possible with your newborn. Poor sleep makes depression worse, so enlist the help of family members to help with the baby if you need to catch up on rest.

When you’re depressed, nutrition often suffers. What you eat has an impact on mood, as well as the quality of your breast milk, so do your best to establish healthy eating habits.

Try to get at least 10-15 minutes of time outside each day. Sunshine and fresh air both have positive benefits to improve depression. Also, exercise, such as a 30-minute walk, has been proven in research to be as effective as some medications to treat depression.

Carrie Sz. Keane, CNM, MSN, received her Master’s degree in Nursing and Midwifery from Yale University. She is currently a midwife at Delmed Health in Lewes and has been employed at Beebe Healthcare since 2004. For more information or to make an appointment, call (302) 644-9080.