Emotional Lows After Giving Birth

Postpartum Blues

Women who have just given birth may have the 'baby blues,' a period of emotional distress that often begins suddenly, three or four days after birth. For many women, the postpartum blues start when their milk comes in. Women may feel teary, overwhelmed, irritable or impatient. These feelings are unpleasant but they usually last only a few days and go away on their own, often as suddenly as they began. However, for some new mothers, this emotional low becomes a more severe postpartum depression.

Postpartum Depression

Postpartum depression can be an extension of the postpartum blues or can appear gradually in the months after the birth, sometimes up to a year later. At least one in 10 new mothers experiences some degree of postpartum depression. If the following symptoms occur for more than 10 days and seem to be getting worse rather than better, you may be experiencing postpartum depression:

• fatigue, yet can't sleep when given the opportunity
• depressed mood, deep sadness, frequent crying
• loss of interest or pleasure
• significant weight change
• feelings of worthlessness and helplessness
• inability to concentrate
• recurrent thoughts of death or suicide
• anxiety
• lack of interest in the baby or obsession with the baby

A woman suffering from postpartum depression will usually experience several of the above symptoms. The symptoms can range from mild to severe. She may have 'good days' and 'bad days.' Although postpartum depression is different for every woman, the symptoms are always distressing and often leave a woman feeling ashamed and isolated.

We do not completely understand why postpartum depression occurs but it seems to involve both biological factors (like hormones) and social factors (including the considerable changes and challenges to a woman’s life after she gives birth). Whatever the cause, even the most severe symptoms are treatable with skilled professional help and support. If you or someone close to you is experiencing these symptoms, do not assume they will go away with time. Talk to your family doctor about these symptoms.

Women with symptoms of postpartum depression should have a physical exam to rule out problems like a thyroid disorder as well as a psychological assessment. Treatments can include:

• one-on-one counselling
• support groups
• anti-depressants like SSRIs

Other Postpartum Mood Disorders

There are several other forms that postpartum mood changes can take. Some women experience postpartum anxiety. It is natural that new parents will have concerns, even some anxiety, about their new baby and parenting, but women with postpartum anxiety experience debilitating panic attacks. These may include feelings of anxiety and fear, rapid breathing, and shakiness or dizziness. Some women experience postpartum mania, which may include an expansive or irritable mood, decreased need for sleep and very rapid speech. Women may also experience signs of obsessive compulsive disorder, including repetitive, intrusive thoughts or impulses and compulsive behaviours, which are distressing and interfere significantly with a woman’s life. If you experience any of these conditions, contact your health-care provider.

Postpartum Psychosis

Postpartum psychosis is the most severe and, fortunately, the rarest postpartum reaction. It affects about 1 in 1000 women, and usually develops within the first three weeks after the birth. Women may have hallucinations or delusions. Other symptoms include severe insomnia, agitation, and bizarre feelings and behaviours. Postpartum psychosis is a serious condition that requires immediate medical help.

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