DEAR MAYO CLINIC: What causes postpartum depression, and is it possible to have it immediately after giving birth? Are some women more likely to have postpartum depression than others, and at what point does it require treatment? My sister does not seem like herself after having her baby a month ago, but I don’t want to offend her by suggesting she get help.
ANSWER: Postpartum depression can happen from the time a baby is two weeks old, all the way through the first year of life. It is important that women who suspect they might have postpartum depression seek help as soon as possible. If you think postpartum depression may be affecting your sister, gently suggest that she talk with her health care provider about how she’s feeling.
Women at highest risk for postpartum depression are those who had depression during the pregnancy or who have a history of postpartum depression. A number of other factors can raise a woman’s risk of postpartum depression, as well, such as a complicated pregnancy or birth, an unexpected birth outcome, a high-need baby, and unrealistic expectations of motherhood. Issues that are not directly related to pregnancy or childbirth may also increase the likelihood of postpartum depression. Examples include relationship problems with a spouse, partner or another family member; financial concerns; or lack of a social support system, among others.
New mothers often feel a wide range of emotions in the days and weeks following the birth of a baby. Mood swings, crying spells, anxiety and difficulty sleeping are all typical after a baby arrives. Often called the “baby blues,” these emotional responses usually begin within the first two to three days after a baby’s delivery and may last for up to two weeks. When those symptoms last beyond two weeks — especially if they seem to get worse over time rather than better — the condition is considered postpartum depression.
No clear cause for postpartum depression has been identified. It is likely to be a combination of hormonal fluctuations, lack of sleep and the significant lifestyle changes that come with the birth of a baby.
It’s crucial that women who have postpartum depression receive treatment, especially if they are having trouble with daily activities or if they are having difficulty bonding with the new baby. Treatment usually involves discussing feelings and concerns with an obstetrics provider or mental health professional, such as a psychiatrist or psychologist who is familiar with postpartum depression. Antidepressant medication may be helpful, too. A variety of antidepressants that are safe for breastfeeding mothers are available, so the medications do not need to interfere with nursing.
Healthy lifestyle choices also can aid in recovery. Eating a healthy diet, avoiding alcohol, exercising regularly and getting enough sleep can all help improve mood and may ease some symptoms of postpartum depression. In addition, ask your health care provider if there are support groups for new moms or parenting networks in your community.
As in your situation, it can sometimes be hard for a family member or friend to raise the topic of postpartum depression with a loved one who has just given birth. But if someone you care about seems to be struggling with difficult emotions several weeks or more after a baby is born, encourage her to talk with her health care provider. Prompt treatment of postpartum depression can make a big difference for a mother and her family. — Julie Lamppa, C.N.M., A.P.R.N., Obstetrics, Mayo Clinic, Rochester, Minn.
For more information, visit Mayo Clinic's "Pregnancy and You" blog, written by Julie Lamppa, Certified Nurse Midwife.