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New moms are supposed to be joyful. But, maybe, instead, you’re feeling weepy, empty and you’re not enjoying your baby or anything else.

Many new mothers sometimes feel moody and overwhelmed at first, even if they are enjoying their baby.  It’s called the “baby blues,” and it doesn’t last more than a couple of weeks. It happens to more than half of women who give birth.  

But if you’re having symptoms such as

• Tearfulness, hopelessness, and feeling empty inside,
• Loss of pleasure in daily activities,
• Sleep problems, even when your baby is sleeping,
• Feelings of worthlessness or guilt,
• Difficulty concentrating and making decisions,.
• Having trouble caring for and bonding with your baby

and they don’t get better, you may have postpartum depression (PPD). 

“Symptoms are different for different women,” says Tracy Flanagan MD, Director of Women’s Health, Northern California, Kaiser Permanente, “but they don’t come and go as symptoms of “baby blues” do.”   

Postpartum depression, a serious illness, can last for months after childbirth. It also can happen after miscarriage and stillbirth. Symptoms can begin right away or even months later. Without treatment, PPD can last for months, even more than a year.

Some women feel ashamed or guilty about feeling depressed when they are supposed to be happy. But, it’s important to talk to your doctor about these feelings. The earlier you are treated, the more quickly you will recover. 

What causes postpartum depression?
A drop in progesterone and estrogen after childbirth from “sky-high levels,” says Katherine Wisner, MD, can trigger depression for some women. A woman is at high risk if this hormonal withdrawal is combined with:

• previous depression (including bipolar disorder),
  
• a family history of depression,
  
• a sick or colicky baby.
  
• little support from your partner or others
• extreme stress.

Your doctor might check your thyroid-stimulating hormone (TSH) levels to make sure a thyroid problem isn't contributing to your symptoms.

How is postpartum depression treated?
Postpartum depression is treated with counseling and antidepressant medications. Women with milder depression may choose counseling alone, but many women need both. Counseling for both you and your partner is a good idea.

Talk to your doctor about which drugs are safe for breastfeeding mothers. First-choice drugs are nortriptylene (a tricyclic), and the SSRIs paroxetine (Paxil) and certralene (Zoloft), says Wisner, Director of Women’s Behavioral HealthCARE program, University of Pittsburgh Medical Center.

Breast-feeding is good for your baby's health and your baby's bond with you too. But if you decide to choose between taking medicine and breast-feeding, treat your depression.

It’s important to take care of yourself by getting help; getting out; and getting enough sleep, exercise and healthy food.

Here are
Ten tips for taking care of yourself

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Sources
Tracy Flanagan MD, Director of Women’s Health, Northern California, Kaiser Permanente.
Katherine Wisner, MD, Director of Women’s Behavioral HealthCARE program, Western Psychiatric Insitute and Clinic of University of Pittsburgh Medical Center.
U.S. National Library of Medicine/National Institutes of Health
Women’s Health.gov
Kaiser Permanente health care organization 

Page updated June 1, 2009