 	        			What is depression?

Depression can be described as feeling sad, blue,
unhappy, miserable, or down in the dumps. Most of
us feel this way at one time or another for short
periods. But true clinical depression is a mood
disorder in which feelings of sadness, loss,
anger, or frustration interfere with everyday life
for an extended time. Depression can be mild,
moderate, or severe. The degree of depression,
which your doctor can determine, influences how
you are treated.
How common is depression during and after
pregnancy?

Depression that occurs during pregnancy or within
a year after delivery is called perinatal
depression. The exact number of women with
depression during this time is unknown. But
researchers believe that depression is one of the
most common complications during and after
pregnancy. Often, the depression is not recognized
or treated, because some normal pregnancy changes
cause similar symptoms and are happening at the
same time. Tiredness, problems sleeping, stronger
emotional reactions, and changes in body weight
may occur during pregnancy and after pregnancy.
But these symptoms may also be signs of
depression.

What causes depression?

There may be a number of reasons why a woman gets
depressed. Hormone changes or a stressful life
event, such as a death in the family, can cause
chemical changes in the brain that lead to
depression. Depression is also an illness that
runs in some families. Other times, it’s not clear
what causes depression.

During Pregnancy

During pregnancy, these factors may increase a
woman’s chance of depression:

    * History of depression or substance abuse
    * Family history of mental illness
    * Little support from family and friends
    * Anxiety about the fetus
    * Problems with previous pregnancy or birth
    * Marital or financial problems
    * Young age (of mother)

After Pregnancy
Depression after pregnancy is called postpartum
depression or peripartum depression. After
pregnancy, hormonal changes in a woman's body may
trigger symptoms of depression. During pregnancy,
the amount of two female hormones, estrogen and
progesterone, in a woman's body increases
greatly. In the first 24 hours after childbirth,
the amount of these hormones rapidly drops back
down to their normal non-pregnant levels.
Researchers think the fast change in hormone
levels may lead to depression, just as smaller
changes in hormones can affect a woman's moods
before she gets her menstrual period.

Occasionally, levels of thyroid hormones may also
drop after giving birth. The thyroid is a small
gland in the neck that helps to regulate your
metabolism (how your body uses and stores energy
from food). Low thyroid levels can cause symptoms
of depression including depressed mood, decreased
interest in things, irritability, fatigue,
difficulty concentrating, sleep problems, and
weight gain. A simple blood test can tell if this
condition is causing a woman's depression. If so,
thyroid medicine can be prescribed by a doctor.

Other factors that may contribute to postpartum
depression include:

    * Feeling tired after delivery, broken sleep
patterns, and not enough rest often keeps a new
mother from regaining her full strength for
weeks.
    * Feeling overwhelmed with a new, or another,
baby to take care of and doubting your ability to
be a good mother.
    * Feeling stress from changes in work and home
routines. Sometimes, women think they have to be
"super mom" or perfect, which is not realistic
and can add stress.
    * Having feelings of loss — loss of identity
of who you are, or were, before having the baby,
loss of control, loss of your pre-pregnancy
figure, and feeling less attractive.
    * Having less free time and less control over
time. Having to stay home indoors for longer
periods of time and having less time to spend with
the your partner and loved ones.

What are symptoms of depression?

Any of these symptoms during and after pregnancy
that last longer than two weeks are signs of
depression:

    * Feeling restless or irritable
    * Feeling sad, hopeless, and overwhelmed
    * Crying a lot
    * Having no energy or motivation
    * Eating too little or too much
    * Sleeping too little or too much
    * Trouble focusing, remembering, or making
decisions
    * Feeling worthless and guilty
    * Loss of interest or pleasure in activities
    * Withdrawal from friends and family
    * Having headaches, chest pains, heart
palpitations (the heart beating fast and feeling
like it is skipping beats), or hyperventilation
(fast and shallow breathing)

After pregnancy, signs of depression may also
include being afraid of hurting the baby or
oneself and not having any interest in the baby.
What is the difference between “baby
blues,”postpartum depression, and postpartum
psychosis?

The baby blues can happen in the days right after
childbirth and normally go away within a few days
to a week. A new mother can have sudden mood
swings, sadness, crying spells, loss of appetite,
sleeping problems, and feel irritable, restless,
anxious, and lonely. Symptoms are not severe and
treatment isn’t needed. But there are things you
can do to feel better. Nap when the baby does. Ask
for help from your spouse, family members, and
friends. Join a support group of new moms or talk
with other moms.

Postpartum depression can happen anytime within
the first year after childbirth. A woman may have
a number of symptoms such as sadness, lack of
energy, trouble concentrating, anxiety, and
feelings of guilt and worthlessness. The
difference between postpartum depression and the
baby blues is that postpartum depression often
affects a woman’s well-being and keeps her from
functioning well for a longer period of time.
Postpartum depression needs to be treated by a
doctor. Counseling, support groups, and medicines
are things that can help.

Postpartum psychosis is rare. It occurs in 1 or 2
out of every 1000 births and usually begins in the
first 6 weeks postpartum. Women who have bipolar
disorder or another psychiatric problem called
schizoaffective disorder have a higher risk for
developing postpartum psychosis. Symptoms may
include delusions, hallucinations, sleep
disturbances, and obsessive thoughts about the
baby. A woman may have rapid mood swings, from
depression to irritability to euphoria.
What steps can I take if I have symptoms of
depression during pregnancy or after childbirth?

Some women don’t tell anyone about their symptoms
because they feel embarrassed, ashamed, or guilty
about feeling depressed when they are supposed to
be happy. They worry that they will be viewed as
unfit parents. Perinatal depression can happen to
any woman. It does not mean you are a bad or “not
together” mom. You and your baby don’t have to
suffer. There is help.

There are different types of individual and group
“talk therapies” that can help a woman with
perinatal depression feel better and do better as
a mom and as a person. Limited research suggests
that many women with perinatal depression improve
when treated with anti-depressant medicine. Your
doctor can help you learn more about these options
and decide which approach is best for you and your
baby. The next section contains more detailed
information about available treatments.

Speak to your doctor or midwife if you are having
symptoms of depression while you are pregnant or
after you deliver your baby. Your doctor or
midwife can give you a questionnaire to test for
depression and can also refer you to a mental
health professional who specializes in treating
depression.

Here are some other helpful tips:

    * Try to get as much rest as you can. Try to
nap when the baby naps.
    * Stop putting pressure on yourself to do
everything. Do as much as you can and leave the
rest!
    * Ask for help with household chores and
nighttime feedings. Ask your husband or partner to
bring the baby to you so you can breastfeed. If
you can, have a friend, family member, or
professional support person help you in the home
for part of the day.
    * Talk to your husband, partner, family, and
friends about how you are feeling.
    * Do not spend a lot of time alone. Get
dressed and leave the house. Run an errand or take
a short walk.
    * Spend time alone with your husband or
partner.
    * Talk with other mothers, so you can learn
from their experiences.
    * Join a support group for women with
depression. Call a local hotline or look in your
telephone book for information and services.
    * Don’t make any major life changes during
pregnancy. Major changes can cause unneeded
stress. Sometimes big changes cannot be avoided.
When that happens, try to arrange support and help
in your new situation ahead of time.

How is depression treated?

There are two common types of treatment for
depression.

    * Talk therapy. This involves talking to a
therapist, psychologist, or social worker to learn
to change how depression makes you think, feel,
and act.
    * Medicine. Your doctor can give you an
antidepressant medicine to help you. These
medicines can help relieve the symptoms of
depression.

Women who are pregnant or breastfeeding should
talk with their doctors about the advantages and
risks of taking antidepressant medicines. Some
women are concerned that taking these medicines
may harm the baby. A mother’s depression can
affect her baby’s development, so getting
treatment is important for both mother and baby.
The risks of taking medicine have to be weighed
against the risks of depression. It is a decision
that women need to discuss carefully with their
doctors. Women who decide to take antidepressant
medicines should talk to their doctors about which
antidepressant medicines are safer to take while
pregnant or breastfeeding.
What effects can untreated depression have?

Depression not only hurts the mother, but also
affects her family. Some researchers have found
that depression during pregnancy can raise the
risk of delivering an underweight baby or a
premature infant. Some women with depression have
difficulty caring for themselves during pregnancy.
They may have trouble eating and won’t gain enough
weight during the pregnancy; have trouble
sleeping; may miss prenatal visits; may not follow
medical instructions; have a poor diet; or may use
harmful substances, like tobacco, alcohol, or
illegal drugs.

Postpartum depression can affect a mother’s
ability to parent. She may lack energy, have
trouble concentrating, be irritable, and not be
able to meet her child’s needs for love and
affection. As a result, she may feel guilty and
lose confidence in herself as a mother, which can
worsen the depression. Researchers believe that
postpartum depression can affect the infant by
causing delays in language development, problems
with emotional bonding to others, behavioral
problems, lower activity levels, sleep problems,
and distress. It helps if the father or another
caregiver can assist in meeting the needs of the
baby and other children in the family while mom is
depressed.

All children deserve the chance to have a healthy
mom. All moms deserve the chance to enjoy their
life and their children. Don’t suffer alone. If
you are experiencing symptoms of depression during
pregnancy or after having a baby, please tell a
loved one and call you doctor or midwife right
away.

For More Information . . .

You can find out more about depression during and
after pregnancy by contacting the National
Women's Health Information Center (NWHIC) at
1-800-994-9662 or the following organizations.

National Institute of Mental Health, NIH, HHS
Phone: (301) 496-9576
Internet Address: http://www.nimh.nih.gov

National Mental Health Information Center, SAMHSA,
HHS
Phone: (800) 789-2647
Internet Address: http://www.mentalhealth.org

American Psychological Association
Phone: (800) 374-2721
Internet Address: http://www.apa.org

National Mental Health Association
Phone: (800) 969-NMHA
Internet Address: http://www.nmha.org

Postpartum Education for Parents
Phone: (805) 564-3888
Internet Address: http://www.sbpep.org

Postpartum Support International
Phone: (805) 967-7636
Internet Address: http://www.postpartum.net
Source: Womenshealth.gov