Beyond the Baby Blues: New Mothers Require Early and Frequent Evaluation for Postpartum Depression
After having a baby, many women experience mood swings - one moment they feel happy, and the next they start to cry. They may feel a little depressed, lose their appetite, have a hard time concentrating, or find that they are unable to sleep well, even when their baby does. These symptoms usually start 3 to 4 days after delivery and may last several days. This mild form of depression is called the "baby blues," and it is considered a normal part of early motherhood. Some women, however, develop symptoms that are more severe and pronounced or that last a significant amount of time. This is called "postpartum depression."
Postpartum depression affects one in eight women. While it typically lasts more than two weeks, it can interfere with daily living for a longer period of time. According to the American Psychiatric Association symptoms of postpartum depression include sadness, sluggishness, fatigue, feelings of hopelessness, disturbances of sleep or appetite, lack of interest in the baby, uncontrollable crying, mood swings and fear of harming the baby. Many mothers also report significant anxiety.
According to a recent study conducted by the University of Rochester Medical Center and funded by The National Institute of Mental Health, physicians should screen mothers for postpartum depression regularly for at least one year after childbirth in order to better identify women who develop symptoms beyond the immediate postpartum period and those whose depression persists.
"If you only screen early or if you only screen once, you will miss some," said Linda Chaudron, M.D. Dr. Chaudron is an assistant professor of psychiatry, pediatrics and obstetrics and gynecology at the Medical Center and is leading a series of studies focusing on postpartum depression.
In a recent analysis of records from a pediatric clinic that uses a routine postpartum questionnaire, Chaudron found that, of women who scored high on a depression screening scale sometime in the postpartum year, 26 percent did not develop significant symptom levels of postpartum depression until after three months. Moreover, 33 percent had significant levels throughout the year.
"With the increased attention to screening, we ought to have a better idea about when to screen," Chaudron said. "There are a lot more women we need to be thinking about, identifying and helping get treatment." Professionals who refer mothers for treatment of depression also can – and should - help track how mothers are doing.
While the study reported in Ambulatory Pediatrics was limited to only 49 mothers, Chaudron believes that the report highlights that women can develop new symptoms later in the year and can continue to have symptoms for many months.
Understanding postpartum depression is critical to improving care for mothers and infants. Chaudron and her colleagues are currently conducting a variety of studies, including those that focus on the course of postpartum depression, that explore the relationship between postpartum depression and anxiety, and that investigate the use of an antidepressant for the treatment of postpartum depression.
The American Academy of Family Physicians has useful information regarding the differences between the “baby blues” and postpartum depression. If you have concerns that you or a loved one may be experiencing postpartum depression, then you should contact your family physician.