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No Hype. Just the Facts.
By Allison Van Heusen
ou have just experienced one of the most amazing moments of your life, the birth of your baby. You’re thrilled, excited, scared, exhausted and happy. As you settle into your new routine with your new baby at home, you have highs and lows. Your lows are getting lower, your ability to keep up with household chores and responsibilities is diminishing and you begin having thoughts of leaving your husband and newborn because you just can’t handle it all. Stop. It’s time to see your physician and discuss these thoughts.
The Baby Blues
There is a big difference between postpartum blues, “baby blues,” and the more serious condition called postpartum depression (PPD). Your ability to distinguish common baby blues from PPD is crucial. Most new mothers feel overwhelmed, scared, alone and fragile; and these feelings aren’t what they were expecting. “I have a perfect new infant and a loving family, what do I have to be depressed about?” Having these and other similar feelings are very normal and in fact occur in 70-80 percent of new mothers. These feelings typically occur 2-3 days after birth, and although inexplicable and frightening, will dissipate within a few hours to a week or so without treatment. It is important to remind yourself that you have taken on a challenging new role, and should expect to feel anxious and overwhelmed. Talk to your partner, chances are he feels the same way. These feelings do not make you a bad mother; they simply mean your body is going through normal postpartum changes.
depression often have severe anxiety and even panic attacks. Maternal attitudes toward the infant are highly variable but can include disinterest, fearfulness of being alone with the infant, or over intrusiveness that inhibits adequate infant rest. As defined above, these symptoms most likely occur within 4 weeks of birth, but the onset can occur beyond 4 weeks and up to 1 year after delivery. Postpartum psychosis is rare, only occurring in approximately 0.1 percent of all deliveries; and is more common in women with bipolar disorder. It resembles a manic or mixed (manic and depressive) episode, with decreased sleep, psychosis
There are three types of postpartum mood disorders described in medical literature: postpartum blues, postpartum depression and postpartum psychosis. For some women, about 10 percent, the postpartum blues continue and evolve into true postpartum depression. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines postpartum depression as an onset of symptoms occurring within 4 weeks after childbirth and lasting two weeks or longer. Symptoms that are common in postpartumonset episodes include fluctuations in mood, mood liability (crying for no reason) and preoccupation with infant well-being, the intensity of which may range from over concern to frank delusions. Women with postpartum
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(delusions or prominent hallucinations), and agitation. If you experience any of these symptoms, contact your physician immediately.
Postpartum Depression: Signs and Symptoms
• Baby blues lasting for more than 2 weeks • Strong feelings of depression or anger that come 1-2 months after birth • Feelings of sadness, doubt, guilt, or helplessness that get worse each week and get in the way of daily life • Not sleeping, even if you are extremely tired • Sleeping most of the time, even when your baby is awake • Eating much more or much less than normal • Not finding pleasure in things that used to make you happy • Intense concern and worry about the baby • Lack of interest in or feelings for the baby or your family • Panic attacks, such as being afraid to be left alone with the baby • Thoughts of harming the baby or yourself infants exposed to antidepressants. Involvement of the pediatrician is highly recommended, and routine clinical monitoring of the infant should be instituted. Medical studies have also found benefit in the use of Omega-3 fatty acids, particularly EPA and DHA, in treating postpartum depression. There was statistically significant improvement in pre- and post-treatment scores for depression in women taking Omega-3 fatty acids. Max Muscle Sports Nutrition’s Max Neutraceuticals line has both a Concentrated Omega-3 and an EPA & DHA formulation available. Consult your physician prior to starting any supplement. Your MMSN team can provide you with the product information to show to your physician. Other treatment options that have shown clinical benefits include bright light therapy, moderate exercise for 30 minutes 6-7 days/week, joining a new mothers group, meditation and talk therapy with a licensed practitioner. As always, it is the benefit of treatment versus the risk to the patient/infant, and you should discuss any medications/ supplements or alternative therapy with your physician prior to starting them.
Signs of Postpartum
It is important to be self-aware of your emotions and feelings, and knowing if you are at higher risk for developing PPD is crucial. Postpartum depression is more likely to occur in women who have had one or more of the following: • Mood disorders (depression, bipolar disorder, or mania) before pregnancy • Postpartum depression after a previous pregnancy • Recent stress, such as losing a loved one, family illness, or moving to a new city • Hyper or Hypothyroidism prior to pregnancy If you are prone to depression, discuss this with your OB during your pregnancy, and involve your partner and family in the discussion. Your physician can often advise those around you of signs of depression and ways to help you cope and thrive.
lead to impairment in the children. Risks of exposure to postpartum depression appear to outweigh at least the short-term risks of exposure to antidepressants during breast-feeding, although more research is needed to firmly support this statement.
So, what can you do about PPD? There are many options including both pharmaceutical and non-pharmaceutical treatments. A number of open-label studies (the patients and doctors knew what the patient was taking) have supported the use of antidepressants to treat PPD including Zoloft, Paxil, Wellbutrin, Effexor and Luvox. They all showed improvement in postpartum depression although, to date there is no consistent evidence that any one class of antidepressants is superior to another. What about breast-feeding on these medications? The benefits of breast-feeding are well documented: The American Academy of Pediatrics advocates breast-feeding through the first 6 months of life. Most of these medications do pass into breast milk. In general, however, studies have not found high rates of adverse events in
Postpartum and Children
Postpartum depression has been shown to have harmful consequences for the infants and children of affected mothers. Obviously it is important to treat PPD for your own wellbeing, but data has shown that it is extremely important to treat it for the good of your child/children. PPD can cause impaired bonding (especially during this critical time of development), and has been linked to attachment insecurity in the child. Other studies show impaired emotional development, language development, attention, and cognitive skills in children of depressed mothers. And these children are more likely to develop long-term behavioral problems. In short, impairment in the mother can
The Baby Blues: Signs and Solutions
What To Expect:
• Feelings of anxiety and worry: “Am I a good mom?” “What if I make a mistake?” • Feeling anger toward the baby for lack of sleep, interruption of your normal life • Loss of identity, feeling that you are just and extension of the infant • Mood swings, highs and lows, crying for no reason
What To Do:
• Talk to your partner, parent, or a friend about how you feel • Get plenty of rest • Ask your partner, family, and friends for help • Take time for yourself • Get out of the house each day, even if it’s for a short while • Join a new mothers group or fitness class
This action might not be possible to undo. Are you sure you want to continue?