Taking Care of Both Mom and the Baby 

Taking Care of Both Mom and the Baby: Recognizing and Treating Post-Partum DepressionDr. David Prescott – Eastern Maine Medical Center Behavioral Medicine ServiceOne in Six New Mothers have at least Mild Depression: Increasingly, post-partum depression, (depression which occurs within 3-4 months after birth) is recognized as a relatively frequent occurrence that benefits from early recognition and treatment. Just under 1 in 6 women will experience some type of significant depression after giving birth. In some cases these feelings resolve by themselves, often with support from family and friends. However, if left untreated, symptoms of depression can persist for up to a year. Where is the Line Between ‘Baby Blues’ and Clinical Depression? Probably the two most important factors in differentiating major depression from ‘baby blues’ are the length of time a new mother feels depressed and the intensity of the depression. The benchmark for diagnosing major depression is 2 weeks of persistent depressed or irritable mood. In addition to feeling sad, depressed, or irritable, other symptoms of major depression include: • Crying frequently• Feeling hopeless, guilty, and overwhelmed• Having trouble focusing or making decisions. • Withdrawing from friends and family.• Loss of appetite• Disrupted Sleep or Excessive SleepPost-Partum Psychosis: A less frequent but more severe problem: In rare cases, usually within the first two weeks after giving birth, a woman experiences frequent confusion or disorientation (not knowing where you are or what day it is), hallucinations, or extreme fear and paranoia. This may indicate the presence of post-partum psychosis and warrants immediate attention from a mental health professional or primary care doctor. What Causes Post-Partum Depression? Child birth, while usually very exciting, is also an event which includes most of the major risk factors for depression. Contributing factors include: • Previous History of Depression: Women who have had previous episodes of major depression are at increased risk for post-partum depression. • Hormone Changes: The usual post-pregnancy decrease in estrogen and progesterone, as well as a decrease in hormones produced by the thyroid gland, are thought to strongly contribute to risk for post-partum depression. • Changes in Brain Chemistry: Researchers suspect that pregnancy and childbirth may alter brain chemicals involved in the onset of depression. • Stressful Life Events: Significant life events, both positive and negative, increase the risk for an episode of major depression. Assessment and Treatment for Post-Partum Depression: Family and friends can provide important help in providing emotional support and caretaking support for new mothers who are struggling with depression. They can also encourage mothers who seem depressed to talk with their doctor or a mental health professional. • Reducing Isolation: Most mothers, whether depressed or not, find that spending time with other new mothers helps improve their mood and get tips for coping with motherhood. • Counseling: Simply talking about the adjustments associated with parenthood and the feelings that develop after childbirth usually results in improved mood. Often counselors can make concrete suggestions about a few small steps that will help reverse depression. • Medications: There are many medications that help with depression or anxiety that can be prescribed by your primary care doctor or a psychiatrist. For More Information: Mayo Clinic Web Site: Psychological Association: www.apa.orgNational Institute of Mental Health: