Postpartum Blues, Depression, Psychosis – How to Cope

Following the anticipation and anxiety of childbirth, most mothers are relieved and joyous at the new addition to the family. However, not all women experience this elation after giving birth. Days, weeks and even months pass by where a mother is sad, depressed, tearful, anxious or totally detached from the baby. They may feel inadequate as a mother or feel guilty for not caring enough for the baby. This could be a sign of a depressive condition.

Such feelings are not unusual and are often just a temporary phase, which may even go unnoticed by others. It is sometimes just referred to as as the “baby blues”. It is in a way a mild form of postpartum depression with severe cases being known as postpartum psychosis. These are separate yet similar conditions. It “baby blues” is at one end of the spectrum of depressive reactions which may follow childbirth, with the other end being postpartum psychosis, then postpartum depression is in the middle.

Types of Postpartum Depressive Conditions

After delivery of the baby, many women go through a phase of depression and other psychological and psychiatric problems. This varies in intensity in different women and according to the severity of her symptoms, three types of conditions are described:

  • Postpartum blues – the other names being postnatal blues, 3-day blues, and baby blues.
  • Postpartum depression.
  • Postpartum psychosis.

Who is likely to suffer from postpartum depressive problems?

You are more likely to suffer from postpartum depression and psychosis if:

  • You have a family history of similar psychiatric problems.
  • You have a personal history of mental health problems.
  • You have suffered from depressive disorders in previous pregnancies.
  • You are experiencing relationship problems with a partner.
  • The pregnancy was unwanted or you were not prepared for it.
  • You experienced traumatic life events such as recent death of a loved person.
  • Stillbirth or death of the newborn baby occurs.
  • The baby was born with congenital defects or is severely ill.
  • You have feelings of guilt that the baby’s death or illness is somehow your fault, even if that is not so.
  • You are experiencing financial difficulties especially when it is attributed to pregnancy or childbirth.

What is Postpartum Blues (Baby Blues)?

This is the mildest form of depressive symptoms following delivery and often resolves on its own. There is temporary mood disturbance, usually from the third to the tenth day after delivery, with fits of crying, sadness, anxiety, irritability or forgetfulness. It is related to the hormonal changes that occur in the body after delivery and may last from a few days to two or three weeks.

No medical treatment is usually necessary. Support and understanding from friends and family members, especially a partner, helps the mother cope with the baby blues until the conditions resolves spontaneously. If the symptoms persist or show no improvement beyond two weeks then the condition needs to be re-evaluated because it could be a more serious case of depression.

What is Postpartum Depression?

This condition usually develops in the weeks and months following childbirth and may even occur after a year. Mood swings, sleep disturbances, intense sadness, lack of concentration and loss of appetite is common. Lack of interest in the baby or fear of harming the baby or herself may be present too. Women who suffered from postpartum depression in previous pregnancies or those who have a history of past psychiatric problems are more likely to be affected.

Relationship problems with a partner or the father, unwanted pregnancy, events such as recent death of a loved person, or a family history of similar problems may be risk factors for developing postnatal depression. Psychotherapy and antidepressants may be needed in addition to support from her loved ones.

If a mother shows suicidal tendencies or if there is any chance of her hurting the baby then proper assessment may need to be done and steps taken accordingly. The mother should not be left on her own or be alone with the baby. In extreme cases, hospitalization may have to be needed. In most cases, the mother is encouraged to be with the baby and breastfeed. If mother needs medication, then the doctor will consider drugs that will not harm the baby.

What is Postpartum Psychosis?

Postpartum psychosis is a rare occurrence but of a more severe nature. It is a severe mental disruption where there are greater chances of the mother trying to harm herself or her baby. Admission in a mental institution may become necessary. The symptoms usually develop within a few days to a few weeks after delivery but may have been observed from the third trimester (last 3 weeks) of pregnancy.

Postpartum psychosis may start suddenly and dramatically within a day or two after childbirth. Obsessional or delusional thoughts (often leading to trying to harm herself of her baby), sleep disturbances, confusion, mood swings, unusual behavior, irritability or lack of interest in her surroundings may be present.

Psychotherapy and antidepressants are the usual mode of treatment after hospitalization. Electroconvulsive therapy (ECT) may become necessary in extreme cases, especially when there are pronounced suicidal tendencies. ECT is a safe and highly effective form of treatment but the pros and cons need to be discussed with a mental health professional.

How can mothers help themselves?

  • Mothers must be aware and remember that postpartum depression is a common problem and many women go through this condition.
  • Try to overcome any feelings of guilt that you are not a good mother.
  • Baby blues occur as a result of changing levels of hormones in your body and is not in your control. Within a few days or so it will most likely ease and eventually resolve.
  • Talk to loved ones and a doctor if you have any concerns about your condition. Do not be embarrassed or secretive about being depressed.
  • Get enough rest and sleep as much as possible. The body has been through a major stress with childbirth and needs time to recuperate.
  • Ensure proper nutrition with regular balanced meals. Remember that this nutrition is not only needed by your body but also by the baby if you are breastfeeing.
  • Find activities that can help relieve the stress, such as reading, listening to music or mild exercise like walking.
  • Join a support group to meet other mothers who may be going through the same experience.
  • Follow your doctor’s advice regarding counseling and medicines. If the condition is worsening, then do not hesitate to seek a second opinion.

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