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How Do I Know If I Have Postpartum Depression?

Despite the fact that postpartum depression has been evident for centuries, many experts believe it is underdiagnosed. As knowledge about postpartum depression grows, more doctors are beginning to look for the risk factors in pregnant women as early as their first prenatal care visit. If a woman is at risk, her doctor can evaluate her moods throughout the pregnancy. After a woman gives birth, she and those close to her should watch for signs and symptoms and her doctor should look for signs at her six-week postpartum visit.

If you experience the symptoms of postpartum depression, your doctor will first determine your risk for harming yourself or your baby. Your doctor will also check your thyroid functioning. Hypothyroidism can cause the same symptoms as postpartum depression. Your doctor will also ask you about your symptoms to determine whether you are suffering from postpartum depression or another condition.

What Are the Treatments?

Postpartum depression sometimes goes away on its own within three months of giving birth. But if it interferes with your normal functioning at any time, or if "the blues" last longer than two weeks, you should seek treatment. About 90% of women who have postpartum depression can be treated successfully with a combination of medication and psychotherapy. Participation in a support group may also be helpful. In cases of severe postpartum depression or postpartum psychosis, hospitalization may be necessary. Infrequently, electroconvulsive (ECT) therapy may be used to treat particularly severe depressions with hallucinations.

It is best to seek treatment as soon as possible. If it's detected late or not at all, the condition may worsen. Also, experts have found that children can be affected by a parent's untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

While you are recovering from postpartum depression, you will probably see an improvement from month to month. Be aware that your symptoms may flare up before a menstrual period because of fluctuations in your hormones.

Medications
The first step in treatment is to resolve immediate problems such as sleep and appetite changes. Antidepressants are usually quite effective for this. You and your doctor will need to make a careful decision about your use and choice of antidepressants if you are breastfeeding. Some antidepressants are secreted only in small amounts in breast milk and many doctors believe that their benefits outweigh their risks. Other medications, such as lithium, more seriously contaminate breast milk and may affect your baby. If you take an antidepressant, you will probably be advised to take it for at least a year and then taper off your use to avoid a relapse.

Also, if you have had a previous episode of postpartum depression, your doctor may suggest that you start preventive medicine shortly after your baby is born. Some antidepressants can be taken safely during pregnancy.

Many women who have given birth do not want to become pregnant again right away. However, if you are being treated for postpartum depression, you may want to choose a contraception method other than birth control pills, which may aggravate the symptoms of depression. Talk with your doctor to decide which contraception method is best for you.

Psychotherapy
Psychotherapy, or talk therapy, is commonly prescribed alone or with antidepressants to treat PPD. Your doctor can refer you to a qualified counselor who specializes in treating postpartum depression. A counselor can give you emotional support and help you understand your feelings and develop realistic goals, which are critical to overcoming postpartum depression.

Support Groups
Support groups may be very helpful if you are experiencing PPD. They may provide useful information along with ideas about how to cope better with day-to-day stresses. Postpartum Support International (www.chss.iup.edu/postpartum) and Depression After Delivery (www.depressionafterdelivery.com) may be able to connect you with a support group in your area.

At Home
While you are recovering from postpartum depression, try to take time for yourself. Get out of the house every day, even if it's just for a walk around the block. Reach out to supportive family and friends for both emotional and household help. Don't try to do everything yourself. Consider joining a new mothers support group or starting one in your area.

Exercise
Exercise works well to lift all kinds of depression. Once you've recovered physically from giving birth, try to get some exercise every day. One study has shown that vigorous exercise after recovering from childbirth is associated with an increased feeling of well-being. Your doctor can help you plan an exercise program that's right for you.