Post-partum depression: What it is, what can help

Occasionally, during a well baby visit in the first months of an infant's life, I will notice that a mother seems tearful, exhausted, or unduly anxious. Sometimes it is the father who is worried about his wife. On further questioning, I may uncover an emerging post-partum depression.

More than half of women who've recently had a baby endure the weepy, anxious, emotional time known as the "baby blues." Yet, unlike the baby blues, which usually last no more than a few weeks, postpartum depression continues and deepens. About 10%-15% of new mothers experience depression within three to six months after childbirth.

Sleep deprivation, the dramatic changes and stresses that accompany motherhood, and shifts in hormones all seem to have a hand in postpartum depression. Physical discomfort, a colicky or sick baby, financial hardship, and scant social support may also be factors.

Postpartum depression has many features in common with major depression. A new mother can become sad or hopeless. She may be anxious and especially worried about the baby's well-being. She may not be able to function and may be overwhelmed by caring for her baby. She may experience changes in appetite that lead to weight loss or gain. She may also lose interest in everything, including the baby, and feel guilty or worthless as a result.

If you suffer postpartum depression, treatments (including medications and psychotherapy) can make a big difference for both you and your baby. Sadly, many mothers feel shame about their feelings and are reluctant to seek help. If you or someone you know is experiencing these symptoms after childbirth, tell your health care provider. Untreated maternal depression can lead to child neglect, child abuse, and lifelong psychological problems for the baby-not to mention the harm it does to the mother and other family members. If you have had prior depression, you may be more at risk for post-partum depression. While having a new baby is a wonderful blessing, it is not uncommon to have negative feelings both about your baby and the changes he or she has brought to your life. It is important to discuss these mixed feelings if they begin to overwhelm you. While weepiness, fatigue, and negative feelings are common, if they begin to prevent you from enjoying your baby, it is important to seek help. Most women can successfully surmount post-partum depression with time, counseling, and perhaps medication.

Did you or anyone close to you suffer from post-partum depression? How did you know to seek help? What treatments worked well for you?  

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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