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Postpartum Depression, Postpartum Major Depression & the Baby Blues

by Angela Allen-Peck, Psy.D.,   click for print version

All Rights Reserved- Clinical Psychology Associates of North Central Florida  CPANCF.COM    352-336-2888   Gainesville - Ocala

 

What is Postpartum Depression (PPD)?

Postpartum Disorder is sometimes referred to as Postpartum Major Depression (PMD). However, it is a serious mood disorder which may actually involve prominent symptoms of depression or anxiety. Onset may occur 24 hours to several months after delivery. It usually does not resolve on its own.

Symptoms can involve loss of pleasure or interest, mood swings, depressed mood, anxiety, guilt, crying spells, agiation, fears about being left alone with the baby, panic, as well as sleep and appetite changes. When symptoms are severe, start to feel unmanageable, impact functioning, or stick around for longer than 2 weeks, it isn’t just the baby blues – it may be Postpartum Major Depression. 

Left untreated it can last several months to more than a year and can interfere with functioning. 

Postpartum disorder is not technically a separate diagnosis from Major Depressive Disorder in the DSM-IV classification system of mental and nervous disorders. When onset is within 4 weeks of delivery, a coding specifier can be added.

While very rare, postpartum psychosis, involves psychotic symptoms like delusions or hallucinations. This is a different disorder from postpartum depression.

Postpartum Depression can involve some or all of the following symptoms:

 

       -        You don’t take pleasure in

              relationships, activities, or things

              you used to enjoy.

-        You feel sad or cry even though you may not know why.

-        It feels difficult to bond with your baby.

-        You have excessive anxiety or worry, often about your abilities to take care of the baby.

-        Feeling guilty or worthless.

-        It seems that you are more irritable or agitated than usual; you may find yourself getting angry over things that never used to bother you.

-        You may feel afraid to be left alone with your baby.

-        It’s hard to concentrate, focus, or make decisions.

-        Your sleep and appetite levels are much higher or lower than normal.

-        You’ve had thoughts about hurting yourself or your baby.

The Edinburgh Postnatal Depression Scale has been used as a screening instrument.  We have provided links to the scale below.  Individuals with scores above 12 or 13 should promptly consult their physician, psychiatrist or psychologist about the possibility of postpartum depression.

 

Disclaimer:   The purpose of the  questionnaires below are to help you become aware of the kinds of issues that women with postpartum depression often encounter. It is not a substitute for medical advice and is not intended to be a psychological test, psychological or professional adive.  Consult with your doctor or psychologist.

 

Edinburgh PostNatal Depression Scale (English)

 

Edinburgh PostNatal Depression Scale (Spanish)

In the movies, those first few months of motherhood look positively blissful.  Mom may feel tired from childbirth, slightly worried about caring for her newborn, or too busy with all her new responsibilities to get the shower she so desperately wants. Yet her face is filled with peaceful contentment as she nurses her newborn, so in love with her little one, so satisfied with her life.  The glow of pregnancy has been replaced with the sweet glow of motherhood and it looks beautifully serene.  For some lucky women, this is their experience following childbirth.  For an estimated 1 out of 7 women struggling with Postpartum depression, (APA) the reality feels very different.  Unfortunately, many may be reluctant to seek help for fears someone may think they are a bad mother or that they are “going crazy”.

 

During pregnancy, the woman’s body is flooded with hormones that impact emotions. After childbirth, hormone levels drastically change, which may also trigger mood changes.  As these hormones change, many women experience a form of the “baby blues”.  The baby blues occur in the first two weeks following childbirth and are not always serious.  The symptoms usually involve minor mood swings, sadness, crying spells, appetite/sleep disturbances, and feeling anxious or overwhelmed. 

Postpartum depression does NOT mean you are a bad mom or ungrateful for your child.  Postpartum depression is NOT the same as being a little tired or moody from childbirth.  It is a serious condition that impacts women regardless of income, age, race, ethnicity or education level. 

 

Celebrities who have come forth as having been diagnosed with Postpartum depression include: Gwyneth Paltrow, Brooke Shields, Courtney Cox, Bryce Dallas-Howard and Lisa Rinna.


What are Some Causes snd Risk Factors for Postpartum depression?

While family history of postpartum depression, previous depression and/or anxiety, and previous episodes of postpartum depression are common risk factors for Postpartum Depression, half of the women who have PPD have never had depression before.

Risk Factors:

-        Hormone changes during and after pregnancy

-        Social isolation (especially during maternity leave)

-        Previous history or family history of anxiety or depression

-        Having a child who is difficult to soothe, has special needs, or a premature birth

-        Other stressors: difficulty breast feeding, financial issues, deaths in the family, illness, etc.


What Does Getting Help for Post-Partum Depression Look Like?


Many women may avoid getting help because they fear others might judge their mothering abilities or be critical because they aren’t happy during a time that is supposed to be happy. Some moms put off getting help because they are hoping it will just go away. 

  • Remember you are not alone in this. Many women have struggled with this.  You can feel better.
  •  
  • If you have any concerns about Postpartum depression, call and talk to a professional (psychologist, family doctor, etc.).  There are psychologists trained to treat PPD and they want to support women who struggle with this.
  •  
  • Your doctor may want to do lab tests to rule out underlying medical causes.
  • Counseling and/or medication can help. 
  • Try to maintain healthy eating, sleeping and exercise routines. 
  •  
  • Educate yourself about postpartum depression. 
  • Consider a support group. 
  •  Don’t be afraid to ask a friend or family member for help. 
  •  
  • Remember, you are setting a powerful example for your child by taking care of yourself and addressing Postpartum depression.

     

References and Support:

Click on Postpartum Support International for their website which has articles about pregnancy and postpartum mood disorders, a list of free support groups, as well as “Warmline” a phone support service offering information and resources in English and Spanish.

 

Information about Postpartum Depression from the American Psychological Association.

 

Information on Postpartum Depression and what you can do to help yourself from the American Academy of Family Physicians.

 

Epperson, C.N.  Postpartum Depression: Detection and Treatment.  Published in American Family Physician, 1999.

 

If you live in the North Central Florida area, and it is not an immediate emergency involving danger to yourself or your baby, feel free to call our office for an intake appointment (352) 336-2888.

 

If you are feeling like you might harm yourself or your baby, put your baby in a safe place (like a crib) and call 911 or one of the following numbers for immediate help (7 days a week, 24 hrs a day).

National Hopeline Network

1-800-SUICIDE

1-800-784-2433

National Lifeline for Suicide Prevention

1-800-273-TALK

1-800-273-8255

About the Author: 

Angela Allen-Peck, Psy.D. wrote this article as a psychology resident with Clinical Psychology Associates of North Central Florida


We provide counseling and psychotherapy for a range of psychological issues, including depression, issues of identity, and bipolar disorder.  We help adults and adolescents discover their natural resiliencies to thrive and to better cope with stress and crises.  

We have counselors who provide assistance for a number of women’s issues including intimacy, post-partum depression, identity issues, adolescent self-image, and providing therapeutic assistance to individuals who have been victims of abuse or domestic violence.

  Visit our Articles and Archives for more Educational Articles on psychology, health psychology and neuropsychology.

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