Your body

Feel­ing blue? Post­na­tal de­pres­sion and the blues: know the dif­fer­ence

Your Pregnancy - - Contents -


is turned up­side down when you have a baby. Sud­denly there’s a whole new di­men­sion to your iden­tity as you’ve be­come some­body’s mom – and yet some­times you feel as if that’s all you are, and other iden­ti­ties have been lost. It’s quite nor­mal for this change to af­fect you on an emo­tional level, but when it starts af­fect­ing how you in­ter­act with your baby, there could be some­thing deeper at play.


Don’t be sur­prised if you feel a bit tear­ful around three days af­ter giv­ing birth. The baby blues af­fects around 80 per­cent of new moms, says clin­i­cal psy­chol­o­gist Lana Levin. “The baby blues is a nor­mal change of mood, post-de­liv­ery, and are a re­sult of the sud­den drop in hor­mones,” she ex­plains. “Dur­ing preg­nancy, the pla­centa pro­duces oe­stro­gen, pro­ges­terone and en­dor­phins in over­drive. With the baby’s de­liv­ery, the pla­centa is ex­pelled and so th­ese ‘feelgood’ hor­mones are no longer made in such high quan­ti­ties. It takes a few days for the hor­mones to drop. Add this to the angst of new moth­er­hood and sleep de­pri­va­tion, as well as mom’s breast­milk com­ing in, and it’s no won­der so many women get weepy and feel over­whelmed around day three.” Your mood should sta­bilise within about 10 days. Try not to feel guilty about th­ese feel­ings – you’re a new mom, and you are al­lowed to cry if you need to.


If the baby blues con­tinue for two weeks or longer, you may be ex­pe­ri­enc­ing a con­di­tion called post­na­tal de­pres­sion (PND). It’s im­por­tant to note that PND can de­velop at any point of baby’s first year. Be­sides feel­ings of sad­ness and un­con­trol­lable tear­ful­ness, you may also be feel­ing anx­ious, have sleep dif­fi­cul­ties be­yond those re­lated to car­ing for a new­born, strug­gle to con­cen­trate, ex­pe­ri­ence changes in ap­petite, lose in­ter­est in things you pre­vi­ously en­joyed, have a loss of li­bido, and even have thoughts of sui­cide. Take heart in the fact that PND is com­mon – around 10 to 15 out of ev­ery 100 mothers ex­pe­ri­ence it, says Levin. “PND is as­so­ci­ated with tremen­dous guilt. There’s a sense of doubt­ing whether you can cope with be­ing a mom, even feel­ings of re­gret for hav­ing brought the child into the world – even if you very much wanted the baby and had an easy birth. Th­ese symp­toms aren’t con­nected to the tak­ing care of the baby and ex­tend be­yond the nor­mal changes as­so­ci­ated with new moth­er­hood,” ex­plains Lana. “PND can se­ri­ously im­pact the mother-child bond. For­tu­nately, the con­di­tion is treat­able and highly re­spon­sive to med­i­ca­tion and many women are still able to breast­feed, even on med­i­ca­tion. Hav­ing said that, I feel this de­ci­sion needs to be made in terms of what is in the best in­ter­ests of both mother and child. If the PND is se­vere, stronger med­i­ca­tion is es­sen­tial and breast­feed­ing may not be pos­si­ble. In th­ese cir­cum­stances, the mother’s men­tal health needs to take prece­dence over breast­feed­ing.” Women who have been di­ag­nosed with a mood or anx­i­ety dis­or­der be­fore preg­nancy could be at a higher risk of de­vel­op­ing PND. To pre­vent this, dis­cuss your con­di­tion, as well as any med­i­ca­tion you’re tak­ing, with your gy­nae­col­o­gist and psy­chi­a­trist. Some med­i­ca­tions can be taken dur­ing preg­nancy, and oth­ers pose a risk to the baby, so any de­ci­sions re­gard­ing treat­ment are very im­por­tant. “I would also sug­gest that a clin­i­cal psy­chol­o­gist who is well versed in post­par­tum is­sues be brought on board in terms of psy­chother­apy. The ther­a­pist can look at build­ing up mom’s cop­ing skills, as well as fa­cil­i­tat­ing her un­der­stand­ing of the ill­ness and get­ting her through the feel­ings of guilt that ac­com­pany PND and re­lated dis­or­ders,” adds Lana. “Moms and moms-to-be need to re­alise that some­times PND just hap­pens! Even moms who’ve never had mood dis­or­ders can de­velop PND.” There’s noth­ing shame­ful about hav­ing PND, but it’s a con­di­tion that re­quires med­i­cal at­ten­tion – the sooner, the bet­ter. If you, or the peo­ple around you, have no­ticed any of th­ese symp­toms, speak out and get help. It’s im­por­tant that you ac­cept the help on of­fer, so that you can get well and give your baby your best. “Psy­chi­a­trists are es­sen­tial in treat­ing PND. Many peo­ple go to their GP or even their gy­nae, but I al­ways re­mind my clients that they wouldn’t go to the butcher to get a hair­cut. There­fore, the cor­rect med­i­cal spe­cial­ist needs to be sought for men­tal health is­sues,” says Lana. “PND is best treated with a com­bi­na­tion of psy­chother­apy and med­i­ca­tion.”


On the ex­treme end of the scale is a con­di­tion called post­par­tum psy­chosis. “This is rel­a­tively rare, oc­cur­ring in only one to two out of ev­ery 1 000 preg­nan­cies,” ex­plains Levin. “It’s a con­di­tion that comes on very sud­denly (usu­ally within the first two weeks) and presents as a psy­chi­atric emer­gency. It can in­volve manic (or rac­ing) thoughts, an in­abil­ity to plan or take care of the baby, as well as para­noia and/or se­vere con­fu­sion. There may be hal­lu­ci­na­tions (the ex­pe­ri­ence of sen­sory events with­out there ac­tu­ally be­ing any­thing there, like hear­ing voices or feel­ing things crawl­ing on the skin) or delu­sions (strange or un­usual be­liefs that do not change even though there’s no ba­sis for them in re­al­ity, like the baby is go­ing to die or that mom has some­how poi­soned her child). Again, risk of sui­cide is high. Pa­tients nor­mally re­quire hos­pi­tal­i­sa­tion as well as med­i­ca­tion, in­clud­ing mood sta­bilis­ers, an­tipsy­chotics and an­tide­pres­sants,” she says.


The most im­por­tant thing for new moms to keep in mind, says Lana, is that this too shall pass. “Some­times we all need to fall apart so that we can be put back to­gether. This is never truer than when you’ve had a baby – and par­tic­u­larly if you have other chil­dren at home. Stay con­nected, let go of the guilt, take care of your­self, and al­low oth­ers to help you un­til you are strong again. Al­low peo­ple to cook for you (or bring you meals), don’t worry if your house isn’t per­fect, for­get the washing, and let go of the ex­pec­ta­tions that you need to keep it all to­gether.”

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