Postpartum Blues or “Baby Blues”
Most women who have given birth can comment on the normal changes in moods, fatigue, and doubt about their ability to parent. They may also have irrational fears such as excessive concern about the baby’s health and physical appearance. Sometimes the early postpartum period is associated with a phase where the mother has a feeling of disappointment. She may lament over the fact that the baby does not look quite the way she had imagined or hoped for. She may feel weepy or crabby for no apparent reason. She may snap at well meaning friends or family members. This phase is commonly known as postpartum blues. It occurs in about 70-80% of all mothers. It is believed to be caused in part by the sudden drop in hormones that occurs following delivery. There is also evidence to suggest that the stress associated with transitioning to parenthood is enough to cause some of these mood changes. Postpartum Blues usually resolves on its own without treatment. It does not generally last more than 3-10 days. The symptoms are not usually of enough severity to cause problems functioning.
Postpartum Depression: A Treatable Medical Disorder
When the symptoms of postpartum blues do not resolve after 2 weeks or if there is a significant change in the ability to do every day activities then postpartum depression may be the cause. Postpartum depression is a mood disorder caused by a chemical imbalance in the brain. The physical stress of pregnancy, labor and delivery and other social issues contribute to cause a more serious mood disturbance. A mother may find that she is too tired to care for herself let alone her infant or other children in the home. She may find that though she is exhausted, she is unable to sleep at all. She may not have an appetite. This of course may cause the fatigue to worsen. She may come to be convinced that she and her child are an unnecessary burden on the family. If left untreated, the major cause of maternal mortality with this disorder is suicide. There is also evidence to suggest that untreated depression can lead to ineffective bonding and developmental delays in the infant.
Postpartum Psychosis: A Medical Emergency
Rarely a woman who has symptoms of a mood disorder may develop a loss of contact with reality, which is known as postpartum psychosis. For example, family members may notice that she is severely unfocused and disorganized. The may have completely irrational fears about the baby. She may be afraid to even touch the baby. She may think that her infant or other children are possessed by the devil or are just crying in order to manipulate her or take control over her life. She may begin to act on these irrational beliefs by yelling at the infant or trying to punish the infant. Sometimes affected individuals may hear voices in their head telling them that they are no good or useless. Despite these symptoms, a woman suffering from postpartum psychosis may not recognize that these behaviors are not normal. The chemical imbalance responsible for causing this disorder may affect the part of the brain that controls insight. This is when friends or family need to intervene and bring the individual to the attention of a Physician. A Physician will be able to rule out possible life threatening medical causes of Psychosis and also refer the patient for other appropriate follow up. Left untreated, postpartum psychosis is dangerous. It can lead to suicide and infanticide if the mother begins to act on paranoid beliefs about herself or the infant.
FREQUENTLY ASKED QUESTIONS:
- What should I do if I think I am suffering from symptoms of postpartum depression? Tell your Doctor. He or she may give you a screening Questionnaire to help determine if you are at risk. Additionally, your doctor may order blood tests or review your medications to make sure that a different medical problem is not the cause of your symptoms.
- What other medical problems can look like postpartum depression? Anemia (due to excessive bleeding), various hormone imbalances and certain infections to name a few. It is important to be seen by a Physician initially so that these problems can be ruled out or treated.
About the author of this article:
Kim B. Jones-Fearing, MD is a Board-Certified Psychiatrist in private practice in Burtonsville and Columbia Maryland.