Introduction

If you have the “baby blues” after childbirth, you’re not
alone. About half of women have a few days of mild depression after they have a
baby. This can be upsetting, but it’s normal to have some insomnia, irritability, tears, overwhelmed feelings, and mood swings. Baby blues usually peak around the fourth day after the baby is born. They tend to improve in
less than 2 weeks, when hormonal changes have settled down. But you can have
bouts of baby blues throughout your baby’s first year.

If your
depressed feelings have lasted more than 2 weeks, your body isn’t recovering
from childbirth as expected. Postpartum depression:

  • Is a serious medical condition. Without treatment, it can last a long time and make it hard for you to function. And it can affect your baby’s development.
  • Is best treated with counseling and an antidepressant
    medicine.
  • Can further improve with home treatment.

To prevent serious problems for you and your baby, work with your doctor now to treat your symptoms.

If you
are having thoughts of hurting yourself, your baby, or anyone else,
see your doctor immediately or call 911 for emergency medical
care.

How is postpartum depression treated?

Depression is
a medical condition that requires treatment. It’s not a sign of weakness. Be
honest with yourself and those who care about you. Tell them about your
struggle. You, your doctor, and your friends and family can team up to treat
your postpartum depression symptoms.

Talk to your doctor about
your symptoms. Work together to decide what type of treatment
is right for you. (You may also have your
thyroid function checked. This test is to make sure that a thyroid
problem isn’t causing your symptoms.)

Treatment options

  • Cognitive-behavioral therapy with a
    supportive counselor. This is recommended for all women who have postpartum
    depression. It can also help prevent postpartum depression. A cognitive-behavioral counselor can
    also teach you skills to help you manage anxiety. These skills include deep breathing and
    relaxation techniques.
  • Interpersonal counseling. It focuses on your
    relationships and the personal changes that come with having a new baby. It
    gives you emotional support and helps you solve problems and set goals.
  • Antidepressant medicine, ideally along with counseling.
    Even if you breastfeed, you can take an antidepressant
    for postpartum depression. Breastfeeding offers many emotional and physical benefits for both
    baby and mother. So experts are studying which antidepressants are most safe for
    breastfeeding babies. Whether or not you breastfeed, your doctor is likely to recommend a selective serotonin
    reuptake inhibitor (SSRI).
    Tricyclic antidepressants, excluding doxepin (Silenor,
    Zonalon), can also be used by women who breastfeed.

Breastfeeding babies whose mothers take an antidepressant
do not often have side effects. But they can. If you are taking an antidepressant
while breastfeeding, talk to your doctor and your baby’s doctor about what
types of side effects to look for.

Home treatment

  • Schedule outings and visits with friends and
    family. Ask them to call you often. Isolation can make depression
    worse, especially when it’s combined with the stress of caring for a
    newborn.
  • Get as much sunlight as you can. Keep your shades and
    curtains open. And get outside as much as you can.
  • Eat a balanced
    diet. Avoid alcohol and caffeine. If you don’t feel hungry, eat small snacks
    throughout the day. Nutritional supplement shakes are also useful for keeping
    up your energy.
  • Get some exercise every day, such as outdoor
    stroller walks. Exercise helps improve mood.
  • Ask for help with preparing food and doing other daily tasks. Family and friends are often happy to help a
    mother with a newborn.
  • Don’t overdo it. And get as much rest
    and sleep as you can. Fatigue can increase depression.
  • Join a
    support group of moms with new babies. An infant massage class is another great
    way of getting out and spending time with others whose daily lives are like
    yours. You will also learn new ways to bond with your baby. To find a support group
    in your area, talk to your doctor. Or see the website of Postpartum Support
    International at www.postpartum.net.
  • Play upbeat music
    throughout your day and soothing music at night.

References

Other Works Consulted

  • Cunningham FG, et al. (2010). Psychiatric disorders section of neurological and psychiatric disorders. In Williams Obstetrics, 23rd ed., pp. 1175-1184. New York: McGraw-Hill.
  • O’Hara MW, Segre LS (2008). Psychologic disorders of pregnancy and the postpartum period. In RS Gibbs et al., eds., Danforth’s Obstetrics and Gynecology, 10th ed., pp. 504-514. Philadelphia: Lippincott Williams and Wilkins.

Credits

ByHealthwise Staff
Primary Medical Reviewer Patrice Burgess, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD – Psychiatry

Current as ofMay 3, 2017