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How to cope with postpartum depression

May 07, 2019 | UCI Health
woman with postpartum depression holding baby

Nearly all women experience of bit of “baby blues” in the first few weeks after delivery as hormone levels change and sleep is disrupted. But as many as 15% of new moms suffer a more serious condition called postpartum depression (PPD).

PPD, which is the most common complication of pregnancy, may emerge days or months after the baby’s birth and interfere with a woman’s ability to care for herself and her child, according the American Psychological Association.

New treatment for postpartum depression

Earlier this year, the U.S. Food and Drug Administration recently approved Zulresso, the first drug specifically for to treat this condition, which can have devastating effects on women and their families.

Zulresso, which is administered as a continuous IV infusion over a total of 60 hours (2.5 days), will be available under doctor supervision in restricted programs. UCI Health will apply to become a registered site to make the drug available for patients who need it, says Julianne Toohey, MD, a professor of Obstetrics and Gynecology at UCI School of Medicine.

“The new drug will be available in June,” says Toohey, a specialist in maternal and fetal medicine who has studied PPD.

“It’s not going to revolutionize how we treat postpartum depression. It will be another tool for helping women who are not responding to regular treatment.”

Recognizing the symptoms

It’s important for women to recognize the signs of PPD. Symptoms include:

  • Exhaustion
  • Sadness
  • Feelings of being overwhelmed and inadequate
  • Lack of self-esteem
  • Trouble concentrating and sleeping
  • Anxiety
  • Crying more than usual
  • Feelings of numbness and disconnection from the baby

Women may also suffer panic attacks or heart palpitations, fears about their baby or their ability to be a good mother.

There is help for PPD

As with other types of depression, there is help.

“There are wonderful ways to treat this condition, with and without medication,” Toohey says. “I tell my patients, ‘You can change your lifestyle, decrease coffee intake, meditate, exercise and increase your support system.’

“If they’re doing all that and it’s not working, drugs may be necessary. Many antidepressants are safe while a mother is breastfeeding and even during pregnancy.”

Symptoms often present during pregnancy

Toohey believes that most women who do suffer depression after the birth of their babies show signs of it during pregnancy. For a number of reasons, including the fact that the symptoms are similar to those most women naturally experience during pregnancy, it’s easy for patients and doctors to miss the signs.

The societal pressure on women to feel wonderful during pregnancy and early motherhood is intense, and women can be especially fearful to let on that they’re having a hard time. The limited time doctors have during offices visits to delve into an expectant mother’s psychological adjustment makes it even easier for the problem to stay hidden. Other factors may also be at work.

“Everybody is pretending it’s not happening,” Toohey says. “In all the years I’ve been practicing, there have been only a few women who do not have a previous history of depression, eating disorders, sexual abuse or other trauma who end up in clinical depression postpartum.”

Revealing these issues during pregnancy to their doctor may help women prepare for the stresses after childbirth.

Baby blues is something else

“Postpartum is such a vulnerable time — there are lots of reasons to be anxious and exhausted, feel overwhelmed or cry for no apparent reason,” Toohey says. “The expectations of motherhood are so fantastically high.”

Women whose baby blues lasts longer than two weeks after delivery should talk with their doctor. In fact, while many obstetricians don’t see their patient until about six weeks after delivery, Toohey schedules a two-week checkup to evaluate her patients’ psychological adjustment.

Whether it’s the blues or more serious PPD, spouses and family members can provide important support. First, they need to understand why the new mother isn’t responding the way they expect her to. They can help by making sure she eats well, gets out for a walk in the sunshine and doesn’t feel alone.

“We need to get everybody on board,” Toohey says. “Treating postpartum depression is important for the entire family. Having a happy, communicative, calm mother who bonds well is vitally important to the baby’s development and health.”

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