Q: I am 29 years old and am expecting my first child in six months. I am concerned about the possibility of postpartum depression because my mother experienced depression after two of her children’s births. Is it likely to happen to me as well?
A: Baby blues, the milder version of postpartum depression,is common but usually only lasts for a few days or weeks. You may experience mood swings and irritability, difficulty sleeping, anxiety and periods of crying. This is considered almost normal.
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Postpartum depression is more serious and may require professional help or medication. It lasts longer than the baby blues and may be severe enough to make you unable to take proper care of the baby. It is even possible to have thoughts of suicide or of harming the child. Fortunately, most women never harm their baby.
The symptoms include loss of sleep and appetite, feelings of guilt and unworthiness, lack of bonding with the child, severe mood swings and a loss of interest in sex.
About one in 1,000 women will have the most severe type of illness known as postpartum psychosis. This psychiatric condition often requires hospitalization and is characterized by delusions, hallucinations, paranoia and confusion. The mother is at greater risk of harming herself or the baby and should not be left alone.
There are various factors influencing the likelihood of getting postpartum depression. Heredity does not appear to play a major role, except perhaps for the rare form of psychotic illness.
A sudden drop in the level of pregnancy hormones immediately after childbirth is one factor that contributes to depression.
Researchers at a California university recently discovered that a placental hormone present during pregnancy called pCRH is present in higher levels midway through the pregnancy in women who later develop postpartum depression. The researchers speculated that a blood test performed at 25 weeks gestation could predict the likelihood of depression in 75 percent of cases.
Another reason for postpartum depression is lack of support from a spouse or other family members. Women who have to make major lifestyle changes, particularly career women who give up their jobs, or who have children later in life when they are more set in their ways, are also more likely to be depressed.
If you are concerned, it is important to see your family doctor as soon as possible after the birth of the child so that he can provide any treatment that might be necessary.
It is also important to set realistic expectations of yourself as a new mother. Enlist the aid of your husband, sisters or mother.
If possible, get together with friends who have babies or join a support group for first-time mothers. Most importantly, make some time for yourself away from the baby. If you are a career woman and this is important to you, take advantage of the maternity leave allowed and then go back to work, even if it is just part time.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
