by Mary B. Seger, NP Ph.D
Postpartum depression has been cited as occurring 11.7 to 20.4 percent, and as high as 40 percent, in new moms. Reports on the baby blues range from 26 to 85 percent in new mothers. Some reports say this occurs in the first four weeks after the baby is born, while others say it can occur in the first year. Why does it seem most women develop the baby blues or postpartum depression?
One reason we are seeing an increase in postpartum depression and baby blues is that healthcare professionals are assessing for it on a more regular basis. Also there is information available for women, which helps them acknowledge they may have a problem. It is shown in the media: happy parents, happy baby, life is good. What is not shown is what goes on behind closed doors. Hormonal swings, sleep deprivation, and major lifestyle changes all make for an increased occurrence of the baby blues or postpartum depression.
During pregnancy, the placenta produces large amounts of estrogen and progesterone. Toward the end of pregnancy and during labor and delivery, beta-endorphins are produced at high levels. As soon as a woman gives birth, there is an abrupt, dramatic decrease in estrogen and progesterone. The high levels of beta-endorphins hang around for up to five days and then they decrease, too.
What does this mean? Estrogen has over 400 functions in your body. It has an effect on serotonin, a neurotransmitter that helps you feel relaxed, hopeful, and optimistic. It helps you sleep and decreases worry. Estrogen also impacts beta-endorphins, a neurohormone, which are best known in regards to the runner’s high. Beta-endorphins increase during labor and delivery, which can cause feelings of increased self-esteem and euphoria. The thyroid hormones can also be affected postpartum, leading to hypothyroidism or hyperthyroidism. Generally hypothyroidism causes fatigue and depression, while hyperthyroidism can cause anxiety. However, not all fatigue, depression and anxiety is related to thyroid disease.
Sleep deprivation is common in new parents. This can lead to fatigue, poor concentration, depression, anxiety, and irritability. We are also starting to see links to heart disease, weight gain and high blood pressure due to lack of good sleep.
How do you know if you have postpartum depression? The Edinburgh Postnatal Depression Scale is the gold standard for assessment for postpartum depression, http://www.fresno.ucsf.edu/pediatrics/downloads/edinburghscale.pdf. There have been studies comparing three questions to the Edinburgh Scale with good results. The three questions are:
Do you blame yourself whenever something goes wrong?
Have you felt scared or panicky for no apparent reason?
Have you been anxious or worried for no apparent reason?
If you answer yes to these three questions or your score on the Edinburgh Scale indicates postpartum depression, you need to seek medical attention. You may need an antidepressant and hormonal therapy.
Factors that increase your risk of postpartum depression include:
History of depression or bipolar disorder
Depression during pregnancy
Premenstrual mood syndrome
Poor social support
Poor partner relations
Lack of a close confidant
Stressful life events
Other contributing factors are a loss of identity, financial independence, work status, and freedom.
For myself, a complicated pregnancy and a baby at the age of 29 was a shock. I had always worked or gone to school and was in the midst of a master’s degree program when I became pregnant. I assumed I would continue my life as is, and have a baby. Was I surprised! The changes in my life, which started with the complications of pregnancy and then giving birth, were immense. I was no longer in control of my life.
After three months at home with Stephanie, I started the final course for my master’s and took a quilting class. Did I feel guilty about leaving my baby with a sitter? Yes. However, you must remember: If mama ain’t happy, nobody’s happy. I knew in my heart I was not stay-at-home-mom material, and friends supported me in this. Back to school and quilting class I went, where I felt a modicum of control. This filled me up and I was able to be a better mom. Here is a bit of what I learned along the way:
If you have postpartum depression, seek medical attention. After you get medical treatment for postpartum depression or if you have the baby blues, the following suggestions will help get you through.
Seek social support. Join a mom’s group, meet with friends, go to church, go back to work, or take a class. Seek other women.
Take a nap. It is okay to rest. Go to bed early. Ask for help with middle-of-the-night feedings.
Make time for you. The changes in your life that occur when you go from being pregnant to being a mom is something no one can explain to you. I imagined I would be the same person, only I would also be a mom. Wrong! Everything changes. I once read that baby blues/postpartum depression is a grief response from the changes that occur in a woman’s life. I believe there is truth to this. Every day take 20 minutes for you and 10 minutes for your partner, and make the effort to go on regular dates.
Exercise and eat well. Sleep deprivation, hormonal fluctuations, and stress can change your brain chemistry, which can cause anxiety, worry, and depression. Exercise helps balance brain chemistry, decreases depression and anxiety, and blows off stress. Eating a low-carbohydrate diet can bring balance to brain chemistry. Take a good multivitamin and a B-complex (50 to 100 mg) daily.
It would be wonderful if you could go home to a situation where you could get good rest, take care of your baby, and have someone take care of you, as it was in the days of old. This is not likely in this day and age; thus, the increase in postpartum depression and the baby blues. Seek medical attention if you need it, ask for help, and get sleep. Give up on a clean house; you can clean when your kids go to college. Take time for yourself and your husband, eat healthy and get exercise. Know that this too shall pass. As the year progresses, it gets easier. Enjoy your baby, they grow up so fast. My granddaughter has already turned one. How time flies.
About The Author:
Mary B. Seger NP PhD is a wife, mom, grandmother and a certified Nurse Practitioner with a PhD in Natural Health and a Doctorate in Naturopathy.
She has an Integrative Medicine practice at Otsego Memorial Hospital in Gaylord, MI. Dr. Seger is currently working on a Fellowship in anti-aging and regenerative medicine through the American Academy of Anti-Aging Medicine. She is the also the author of Invite Joy into Your Life: Steps for Women Who Want to Rediscover the Simple Pleasures of Living. She is an avid runner and biker, and participates in 5 and 10k races and duathlons. She also enjoys skiing, kayaking, sailing and knitting prayer shawls.