BABY BLUES AND POSTPARTUM DEPRESSION

BABY BLUES AND POSTPARTUM DEPRESSION

BABY BLUES

Baby blues are a very common problem many women live with after the birth of their child. About 15% to 85% of women present baby blues in the first 10 days after giving birth (Henshaw, 2003). Most of them start experiencing baby blues around the 5th day after giving birth (Henshaw, 2003). The symptoms include:

  • Fatigue: feeling very tired that it is hard for you to eat, drink, or take care of yourself (for example having a shower) (Henshaw, 2003).
  • Your spirit changes very quickly. One minute you might be happy about the job you are doing as a new mom, and the next crying because you think you cannot do it (Henshaw, 2003).
  • You feel irritable, anxious, and have difficulties thinking clearly and sleeping (Henshaw, 2003).

Baby blues are transitory, which means that they normally resolve on their own without the help of a doctor or pills, usually taking up to two weeks (Robinson & Stewart, 1986). However, in some cases these feelings and symptoms last longer than 2 weeks, or they might get worse. For this reason, it is important to know if someone is experiencing baby blues as they are a risk factor for postpartum depression (Reck et al., 2009). This means that the onset of baby blues symptoms leads, in some cases, to postpartum depression.</>

In other words, some people experience baby blues feelings and symptoms for more than 2 weeks, and the symptoms and feelings get worse rather than better: if that is the case, one might be developing postpartum depression (Reck et al., 2009).

POSTPARTUM DEPRESSION

Postpartum depression (abbreviated as PPD) affects up to 20% of mothers (Werner et al., 2015) and it is an official depressive disorder that starts about 1 month after delivery (American Psychiatric Association, 2013). However, some women develop depression while pregnant (when the baby is still in the womb), or 1 month before delivery (Gavin et al., 2005). The symptoms of PPD include (American Psychiatric Association, 2013):

  • Depressed mood – Feeling extremely down (must be present for at least 2 weeks)
  • Loss of interest and pleasure in activities (must be present for at least 2 weeks)
  • Sleep disturbances – for example difficulties falling asleep or staying asleep
  • Loss of energy and feeling tired
  • A feeling of being useless
  • Diminished concentration – difficulty concentrating and maintaining active attention
  • Suicidal thoughts might also be present (thoughts about ending your own life)

When a new baby arrives in the family everything changes, especially for the mother: the way one sleeps, the appetite and so on. Because of this reason, the diagnosis of PPD is often difficult (Boyd et al., 2005). In other words, many symptoms of PPD are similar, or very close, to the natural life changes happening after the arrival of a baby.

Like in other diseases, PPD has different risk factors. There are individual risk factors and social risk factors. For example, some individual risk factors are being overweight or obese, the type of diet, experiencing a negative birth (for example with medical complications), or history of depression (i.e. you have suffered from depression before getting pregnant) (Zhao & Zhang, 2020). Social risk factors, on the other hand, include history of violence and abuse, immigrant status (someone who comes to live permanently in another country), and lack of social support (Daoud et al., 2019; Falah-Hassani et al., 2015; Ganann et al., 2016; Zhao & Zhang, 2020). A recent research made in Canada has shown that immigrant and indigenous (distinct ethnic groups who are native to a place) women suffer from PPD more often than Canadian-born non-indigeous women (Daoud et al., 2019).

When a new baby arrives in the family everything changes, especially for the mother: the way one sleeps, the appetite and so on. Because of this reason, the diagnosis of PPD is often difficult (Boyd et al., 2005). In other words, many symptoms of PPD are similar, or very close, to the natural life changes happening after the arrival of a baby.

Like in other diseases, PPD has different risk factors. There are individual risk factors and social risk factors. For example, some individual risk factors are being overweight or obese, the type of diet, experiencing a negative birth (for example with medical complications), or history of depression (i.e. you have suffered from depression before getting pregnant) (Zhao & Zhang, 2020). Social risk factors, on the other hand, include history of violence and abuse, immigrant status (someone who comes to live permanently in another country), and lack of social support (Daoud et al., 2019; Falah-Hassani et al., 2015; Ganann et al., 2016; Zhao & Zhang, 2020). A recent research made in Canada has shown that immigrant and indigenous (distinct ethnic groups who are native to a place) women suffer from PPD more often than Canadian-born non-indigeous women (Daoud et al., 2019).

PPD is a disease that must be cured and treated, as it can affect yourself, the baby, and also the entire family.

  • If not cured, PPD can last for months or longer, turning into a chronic depressive disorder and can make you more likely to have depression in the future (Bruce, 2020).
  • The mental health of fathers before and after the birth of a baby has received less attention compared to the mothers, research suggests that fathers can also experience depression, also known as “paternal perinatal depression ” or PPND (Bruno et al., 2020). PPND is not very known or researched, and it is not an official psychiatric disorder (Bruno et al., 2020). It is not well known how many fathers experience PPND, but it is estimated that between 4 to 25% suffer from this condition (Goodman, 2004). Additionally, if the mother is suffering from PPD, fathers are also more likely to experience PPND (Goodman, 2004). The symptoms of PPND are different from PPD and include: exhaustion and fatigue (extreme tiredness), self-criticism (tendency to do negative evaluations about yourself and your abilities), irritability, restlessness (feeling the need to constantly move, being unable to calm your mind, or a combination of the two), and anger (Bruno et al., 2020).
  • If the mother is suffering from PPD, babies are more likely to have problems with sleeping and eating, crying more than usual, and delays in language development (speech) (Bruce, 2020).

Many mothers suffer from PPD in silence, because they are often afraid to talk and seek help about their discomfort and illness because of its stigma: when a new baby is born, everyone is expected to be happy, and not everyone knows what PPD is (Werner et al., 2015). Also, some mothers might not want to take antidepressant medications during breastfeeding (Werner et al., 2015).
But treatment can help you feel like yourself again, so it’s important to seek help quickly. So, if the baby blues do not go away within two weeks after your baby has arrived, or you start feeling worse, it is important to contact your doctor immediately.

Here are some tips that can help you cope with bringing home a newborn (Bruce, 2020):

You might not want to tell anyone you feel depressed after your baby’s birth, but it is important to ask for help. Let others know how they can help you!
Be realistic about your expectations for yourself and your baby
Exercise within your limits or restrictions: take a walk, and get out of the house.
Expect some good days and some bad days: it is normal
Eat well and do not drink alcohol and caffeine
Develop the relationship with your partner and keep in touch with family and friends: do not isolate yourself, but also feel free to limit visitors when you first go home
Try to sleep or rest when your baby sleeps

At SAMHA ry we work to help people affected by mental health issues by listening to you and your situation and assisting you in finding the best way forward. If you wish, we can help you find the right center to receive medical support and counseling.

Remember: it can, and will get better, the first step is yours.

If you need help don’t hesitate to contact us right away. We are available Monday-Thursday 10-17.00 for an appointment, reserve your spot today.

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REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5). American Psychiatric Pub.
Boyd, R. C., Le, H. N., & Somberg, R. (2005). Review of screening instruments for postpartum depression. Archives of Women’s Mental Health, 8(3), 141–153. https://doi.org/10.1007/s00737-005-0096-6
Bruce, D. F. (2020). An Overview of Postpartum Depression. WebMD. https://www.webmd.com/depression/guide/postpartum-depression
Bruno, A., Celebre, L., Mento, C., Rizzo, A., Silvestri, M. C., De Stefano, R., Zoccali, R. A., & Muscatello, M. R. A. (2020). When Fathers Begin to Falter: A Comprehensive Review on Paternal Perinatal Depression. International Journal of Environmental Research and Public Health, 17(4). https://doi.org/10.3390/ijerph17041139
Daoud, N., O’Brien, K., O’Campo, P., Harney, S., Harney, E., Bebee, K., Bourgeois, C., & Smylie, J. (2019). Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada. Canadian Journal of Public Health = Revue Canadienne de Santé Publique, 110(4), 440–452. https://doi.org/10.17269/s41997-019-00182-8
Falah-Hassani, K., Shiri, R., Vigod, S., & Dennis, C.-L. (2015). Prevalence of postpartum depression among immigrant women: A systematic review and meta-analysis. Journal of Psychiatric Research, 70, 67–82. https://doi.org/10.1016/j.jpsychires.2015.08.010
Ganann, R., Sword, W., Thabane, L., Newbold, B., & Black, M. (2016). Predictors of Postpartum Depression Among Immigrant Women in the Year After Childbirth. Journal of Women’s Health, 25(2), 155–165. https://doi.org/10.1089/jwh.2015.5292
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106(5 Pt 1), 1071–1083. https://doi.org/10.1097/01.AOG.0000183597.31630.db
Goodman, J. H. (2004). Paternal postpartum depression, its relationship to maternal postpartum depression, and implications for family health. Journal of Advanced Nursing, 45(1), 26–35. https://doi.org/10.1046/j.1365-2648.2003.02857.x
Henshaw, C. (2003). Mood disturbance in the early puerperium: A review. Archives of Women’s Mental Health, 6, s33–s42. https://doi.org/10.1007/s00737-003-0004-x
Reck, C., Stehle, E., Reinig, K., & Mundt, C. (2009). Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum. Journal of Affective Disorders, 113(1–2), 77–87. https://doi.org/10.1016/j.jad.2008.05.003
Robinson, G. E., & Stewart, D. E. (1986). Postpartum psychiatric disorders. CMAJ: Canadian Medical Association Journal, 134(1), 31–37.
Werner, E., Miller, M., Osborne, L. M., Kuzava, S., & Monk, C. (2015). Preventing postpartum depression: Review and recommendations. Archives of Women’s Mental Health, 18(1), 41–60. https://doi.org/10.1007/s00737-014-0475-y
Zhao, X.-H., & Zhang, Z.-H. (2020). Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian Journal of Psychiatry, 53, 102353. https://doi.org/10.1016/j.ajp.2020.102353

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