Many women experience changes in mood while pregnant or after they’ve given birth. They can
be happy one minute and sad the next; may have difficulty sleeping and eating, even while their babies are asleep; and may
feel depressed part or all of the time. These symptoms can begin anywhere from early pregnancy to a year after giving birth.
Depending on when they start, how long they last, and how severe they get, these symptoms could result from Depression, the
Baby Blues, Postpartum Depression, or Postpartum Psychosis.
What is Major Depressive
Disorder (commonly referred to as Depression)?
Major Depressive Disorder (commonly referred to as Depression) is more than just feeling
sad, blue, or down in the dumps for a few days. It can last weeks, months, or years and, without treatment, can seriously
interfere with your ability to function properly. Someone who’s depressed experiences one or both of the following symptoms
most of the day, nearly every day:
He or she also experiences at least three
of the following symptoms nearly every day:
- depressed mood (feeling sad, blue, down in the dumps,
empty, helpless, or hopeless);
- anhedonia, (an inability to experience pleasure, enjoyment, or
What are the Baby Blues?
- decreased or increased appetite or significant
weight loss or gain;
- difficulty falling asleep or staying asleep, or waking up too early;
- sleeping much longer at night, napping during the day, or fighting off falling asleep during the day;
- mental and physical excitation, racing thoughts, flight of ideas, or restlessness;
and moving as if you’re in slow motion;
- fatigue or loss of energy;
- feelings of worthlessness or guilt;
- difficulty thinking, concentrating, or deciding;
- and/or recurrent thoughts of death or suicide, a suicide plan, or a suicide attempt.
The Baby Blues are a short-lasting condition experienced
by 50% to 80% of women who’ve given birth. It begins within a few days of giving birth and goes away within a couple
of weeks. Women with the Baby Blues might experience any or all of the symptoms of Depression, but also might:
The Baby Blues aren’t severe, don’t significantly interfere with a new mother’s ablity to care for herself
or her newborn, don’t last long, and therefore don’t really need treatment.
- feel angry with their babies, partners, or other children;
- and/or question whether
or not they can adequately care for themselves or their babies, partners, or other children.
What is Major Depressive
Disorder with Peripartum Onset (commonly referred to as Postpartum Depression)?
MDD with Peripartum Onset (commonly referred to
as Postpartum Depression) is a longer-lasting condition experienced by 10% to 15% of women who’ve given birth. It begins
anywhere between two weeks and a year after giving birth and, without treatment, can last for years. Women with MDD with Peripartum
Onset might experience any or all of the symptoms of Depression and the Baby Blues, but also might:
Major Depressive Disorder with Peripartum Onset and Psychotic Features (commonly referred to as Postpartum Psychosis)?
- lose interest in caring for themselves or their babies, partners, or other children;
excessively and/or inappropriately anxious or worried about their babies, partners, or other children;
- and/or have thoughts of harming or killing themselves or their babies, partners, or other children or plan how to
do so or try to do so.
MDD with Peripartum Onset and
Psychotic Features (commonly referred to as Postpartum Psychosis) is a rare but serious condition experienced by anywhere
from 0.1% to 0.4% of women who’ve given birth. It begins within a few weeks of giving birth and, without treatment,
can last for years and have very serious consequences. Women with MDD with Peripartum
Onset and Psychotic Features might experience any or all of the symptoms of MDD
with Peripartum Onset, but also might:
can I do if I experience any of these?
- refuse to eat;
little or not at all;
- exhibit frantic energy;
- have rapid mood
- see, hear, feel, taste, or smell things that aren’t really there;
- hear voices telling them to harm or kill themselves or their babies, partners,
or other children;
- and/or believe that people, even family members, are out to get them or their
babies, partners, or other children.
If you experience the Baby Blues or mild MDD with Peripartum Onset, you can help
yourself feel better by doing some or all of the following :
- rest as much as you can, including
sleeping whenever your baby is sleeping;
- don’t try to do everything or to be perfect;
- ask your partner, family, and friends for help or help if it’s offered;
time for yourself to go out and visit friends family or to just enjoy being alone;
- make time
to be alone with your partner;
- discuss your thoughts and feelings with your partner, family,
- talk with other more experienced mothers;
- join a support
group for mothers;
- and/or don’t make any major life changes while pregnant or too quickly
after having given birth.
If you experience moderate or severe MDD with Peripartum Onset you can also help
yourself feel better by doing some or all of the above but, in addition, you should seek professional help immediately. Call
your Obstetrician/Gynecologist (OB/GYN ), your Primary Care Provider (PCP), or a Psychologist. Your OB/GYN or PCP may either
treat you by prescribing an appropriate medication or refer you to a Psychologist experienced in treating MDD with Peripartum Onset.
IF YOU FIND YOURSELF THINKING ABOUT
HARMING OR KILLING YOURSELF OR YOUR
BABY, PARTNER, OR
OTHER CHILDREN CALL
911 OR GO TO AN EMERGENCY ROOM IMMEDIATELY.
What happens if I experience Major Depressive Disorder while I’m pregnant, or MDD with Peripartum
Onset or MDD with Peripartum Onset and Psychotic Features after I've given birth, and don’t
During pregnancy a depressed woman may not care for herself properly. This may result in:
- failure to gain enough weight or excessive weight gain;
- missed prenatal visits;
- failure to follow medical recommendations;
- and/or the use of alcohol, tobacco, or recreational drugs.
Any of the above may result in problems during the pregnancy or delivery or
afterward, such as:
- gestational diabetes, hypertension, or preeclampsia;
- fetal distress necessitating an emergency c-section;
- premature birth:
- low birth weight;
- birth defects such as fetal alcohol syndrome;
- and/or low IQ, delayed language acquisition, learning difficulties, behavior problems, or medical disorders.
After delivery a depressed woman may not be able to parent her new baby properly.
This may result in:
- impaired mother/child bonding;
infant crying or fussiness;
- feeding problems, including an inability to breast feed;
- and/or failure-to-thrive syndrome.
How are Major Depressive Disorder and MDD with Peripartum Onset treated?
The two prevalent treatments for Depression, including Postpartum Depression,
Prescription medication: Your OB/GYN or PCP can prescribe an antidepressant medication or anti-anxiety medication
or both, depending upon your symptoms and history. Such medications have the advantage of requiring little effort on your
part except taking the medication as prescribed. However, they may not begin to relieve your symptoms for up to eight weeks
after you begin taking them, may not work at all, and come with sometimes significant side-effects, such as decreased interest
in sex, drowsiness, dry mouth, fatigue, headache, impaired memory, insomnia, nausea, sleepiness, and weight loss or gain.
Psychotherapy: A Psychologist can’t prescribe medication, but can help you think and talk about being
depressed and suggest things that you can do to change your thoughts and feelings so that your depression lifts. Psychotherapy
can begin to relieve your symptoms immediately, has a high rate of success, and comes with few if any side-effects.
These two treatments can be employed either individually or together. Research indicates that the combination of the two tends
to work better and faster than either alone.
How do I find a Psychologist?
You can find a Psychologist
by talking to your OB/GYN or PCP about a referral; by getting recommendations from friends or family; by calling the Customer
Service number on the back of your insurance card; or by using a Psychologist referral service. These include:
- The American Psychological Association’s Psychologist Locator on the
Internet at http://locator.apa.org/ or by phone at 1-800-964-2000.
Thomas E. Hranilovich, Ed.D.
Psychiatric Associates / 4084 Okemos Rd. / Suite A / Okemos, MI 48864
Phone: (517) 347-4848 / Fax: (517) 347-4844