Postpartum Depression
Feeling down is a common postpartum emotion that typically passes in a few weeks. For many women, however, these feelings go beyond the basic baby blues and signal a more serious depressive or endocrine disorder.
The Baby Blues
The majority of new mothers experience what is commonly known as “the baby blues,” a short-lived period of mild depression that appears in up to 85 percent of postpartum women. A severe shortage of sleep, disappointment with the birth experience, seesawing hormone levels, anxieties about baby's health and well-being, and shaky confidence in your own parenting skills all can lead to feelings of sadness or inadequacy. Fortunately, most cases of the blues resolve themselves between a few days to two weeks after birth as balance returns to the new mother's life.
When It's More Than the Blues
More serious is postpartum depression (PPD), which occurs in about 10 percent of new mothers and can drag on for up to a year. If you're experiencing one or more of the following symptoms, talk to your doctor about PPD:
Feelings of extreme sadness and inexplicable crying jags
Lack of pleasure in things you would normally enjoy
Trouble concentrating
Excessive worrying about the baby or, conversely, a lack of interest in the baby
Feelings of low self-esteem
Decreased appetite
Fortunately, PPD can be effectively treated with counseling and/or antidepressant drugs, so ask your doctor for a referral to a mental health professional. Even if you're breastfeeding you have medication options; there are several antidepressant drugs on the market that are thought to have minimal effect on nursing infants. A number of studies involving sertraline (Zoloft), for example, found that even though the drug passes into breast milk, the levels it reaches in the nursing infant are clinically insignificant, in some cases too low even to be detected in standard laboratory blood tests.
Several studies have indicated that low postpartum hemoglobin levels (iron-deficiency anemia) increase the risk of postpartum depression. Ask your doctor about your blood hemoglobin levels, especially if you have a history of iron-deficiency anemia. Increasing dietary iron intake and taking daily iron supplements improves hemoglobin levels and may alleviate depressive symptoms.
Safety cannot be guaranteed, however; studies on how antidepressants affect a breastfed child in the long term are not available. On the other hand, clinical research has demonstrated a measurable detrimental effect on children of depressed mothers when PPD goes untreated. Each woman must evaluate the risks of treatment versus the benefits when deciding whether drug therapy is right for her.
Postpartum Psychosis
An estimated one in every 1,000 women experiences a severe form of PPD known as
Thyroid Problems
Thyroid problems are fairly common after childbirth, but the symptoms can be confused with other postpartum conditions. Milk supply difficulties, extreme fatigue, hair loss, depression, mood changes, problems losing weight or unusually rapid weight loss, heart palpitations, menstrual irregularities, and sleep disorders are all common signs of postpartum thyroid conditions.
Some women have temporary postpartum hyperthyroidism (an overactive thyroid), with the result of weight loss, diarrhea, racing heart, anxiety, and other symptoms of a revved-up metabolism. Your doctor may prescribe drugs to ease symptoms, although this condition often resolves itself quickly.
Other women can develop temporary postpartum hypothyroidism (an underactive thyroid), resulting in fatigue, weight gain, constipation, depression, and other symptoms of a slowed-down metabolism. Again, medication may be prescribed depending on the severity of symptoms, and frequently the thyroid returns to normal within six months to a year after the birth.
New mothers with a family or personal history of autoimmune or thyroid disease can benefit from routine thyroid testing in the first month postpartum. It can be hard to tell what's normal after having a baby, but if any of the aforementioned symptoms become debilitating, a thyroid test can quickly rule out or diagnose a thyroid problem.
Women who experience temporary postpartum thyroid problems are at a higher risk to develop thyroid disease later in life and should talk to their doctor about regular follow-up screening.
