Tips for dad

Your partner may feel discouraged or tense after giving birth. She can cry over little things that would not usually bother her. Don’t worry about it, these feelings are common. They won’t last forever.

She may also have trouble sleeping. If she does, encourage her to at least take time to rest. She’s under a lot of stress and getting some rest may help her handle her feelings.

It may help her to talk about her feelings so make her feel like she can. If you feel you’re not the one she wants or needs to talk to you can encourage her to talk with family and friends. You can find out if there are any parent groups in your community. You may also want to talk to your doctor in case the feelings last more than 2 weeks or are very serious.

Help as much as you can. Be attentive and help doing household chores. If you have friends or family who will help your partner with meals, housework or shopping, now is the time to ask them.

If your symptoms can’t be controlled with counseling or medicine, and you are thinking about hurting yourself or your baby, then your doctor may consider admitting you to the hospital.

Follow the recommendations of your doctor. If he or she prescribes medication and/or counseling, be sure to follow through.

If you are given medication, take it as directed. Do not stop taking your medication until you have consulted with you doctor.

For postpartum depression, the severity of the illness will guide the health care provider in choosing treatment. Milder forms may be treated with psychological therapy. More severe forms may require medication. A combination is sometimes helpful.

• Your doctor may refer you for psychological help and individual or group therapy.
• Support groups are helpful.
• Marriage counseling may be part of your treatment plan.
• It’s important for friends and family to understand the illness so they can help.
• Medications can be helpful.

Medications

Vitamins: It is probably a good idea to continue to take prenatal vitamins and iron after delivery.

Antidepressants: Drugs such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), escitalopram (Lexapro), or venlafaxine (Effexor) may be given for as long as a year (possibly longer). Other medications that might be used include lithium or valproic acid (Depakote).

Hormone therapy: Estrogen, often in combination with an antidepressant, sometimes helps with postpartum depression. Some women also need thyroid treatment.

If you are breastfeeding, medicine you take can be passed to your baby. Some antidepressants can be used safely with little risk to your baby. We do recommend that you check with your doctor if you want to take non-prescription drugs, even if they are freely available in pharmacies or drug stores.

• When you have mood swings or feel depressed for more than a few days after the birth of your baby
• When you feel you are unable to cope with the daily activities in your life, including caring for your newborn or your other children
• When you have strong feelings of depression or anger 1 to 2 months after childbirth

Call a neighbor, friend, or loved one who is nearby AND YOUR DOCTOR right away if you are experiencing any of the following:

• Inability to sleep more than 2 hours per night
• Thoughts of hurting or killing yourself
• Thoughts of hurting your baby or other children
• Hearing voices or seeing things
• Thoughts that your baby is evil

If you have these, it is important to see a health care provider, who will look for other conditions that can cause similar symptoms.

• Sad mood, crying often
• Not enjoying activities that once gave pleasure
• Sleep disturbance
• Weight loss
• Loss of energy
• Agitation or anxiety
• Feelings of worthlessness or guilt
• Trouble concentrating or making decisions
• Thoughts of death or suicide
• Decreased interest in sex
• Feelings of rejection

Physical symptoms (headaches, chest pain, rapid heart beat, numbness, shakiness or dizziness) suggest anxiety. Postpartum anxiety disorder is different from postpartum depression, but the two often occur together.

Hormone imbalance is likely to play a role. Levels of the hormones estrogen, progesterone, and cortisol fall dramatically within 48 hours after delivery. Women who go on to develop postpartum depression may be more sensitive to these hormonal changes.

Risk factors

• History of depression, anxiety, panic, obsessive thoughts or behavior, mania
• Family history
• Marital conflict
• Prior episode
• Low confidence as parent
• Baby’s personality, health or disability
• Single parent
• Super woman syndrome
• Hormonal risks (thyroid imbalance, PMS, infertility, etc)
• Pregnancy loss such as miscarriage or stillbirth

The risk of major depression after miscarriage is high for women who are childless. It occurs even in women who were unhappy about being pregnant. The risk for developing depression after miscarriage is highest within the first few months after the loss.

Childbirth is a time when everything changes. Adjusting to these changes can contribute to depression.

Physical changes after delivery

• Many changes occur after delivery, including changes in muscle tone and difficulty losing weight.
• Many new mothers are very tired after giving birth and in the weeks afterwards.
• Soreness and pain in your perineal area (area around the birth canal) makes many women uncomfortable. Physical recovery after cesarean delivery may take even longer than after vaginal delivery.
• Changes in hormones can affect mood.

Emotional changes after delivery

• Feelings of loss of an old identity, feeling trapped at home
• Feeling overwhelmed with responsibilities of motherhood
• Feeling stress from changes in routine
• Feeling fatigue because of broken sleep patterns
• Feeling less attractive physically and sexually

A mother’s age and the number of children she has had have nothing to do with getting postpartum depression.

For most women, the symptoms are mild and go away on their own during the months after delivery. But 10 to 20% of these women develop a more disabling form of mood disorder called postpartum depression. Some have these symptoms for months or even years.

It’s good to know and recognize the differences between the pretty innocent baby blues, the more serious postpartum depression and the postpartum psychosis.

Baby Blues

• The baby blues is a state of intensified emotions that about half of women experience in the first days and weeks after the birth of their baby.
• With breast milk, especially colostrums, your baby’s immunity is strengthened. This means excellent protection against infections like diarrhea, colds, bronchitis and pneumonia.
• This state is reached 3 to 5 days after delivery and lasts from several days to 2 weeks.
• A woman with the blues may cry more often than usual and may have trouble sleeping or feel irritable, sad and on edge.
• Because baby blues are so common and expected, they are not considered an illness.
• Postpartum blues does not interfere with a woman’s ability to care for her baby.
• The tendency to develop postpartum blues is unrelated to a previous mental illness and is not caused by stress. However, stress and a history of depression may influence whether the blues go on to become major depression.

Postpartum depression

• Postpartum depression is depression that occurs soon after having a baby, usually within a few months.
• This condition occurs in about 10 to 20% of women.
• Risk factors include previous major depression, psychosocial stress, inadequate social support, and previous premenstrual dysphoric disorder.
• Symptoms are crying often, inability to enjoy, trouble sleeping, fatigue, appetite problems, suicidal thoughts, feelings of inadequacy as a parent and impaired concentration.
• If you experience postpartum depression, you may worry about the baby’s health and well-being. You may have negative thoughts about the baby and fears about harming the infant.
• Postpartum depression interferes with a woman’s ability to care for her baby.
• When a woman with severe postpartum depression becomes suicidal, she may consider killing her infant and young children. Not from anger, but from a desire not to abandon them.

Postpartum psychosis

• Postpartum (puerperal) psychosis is the most serious postpartum disorder. It requires immediate treatment.
• This condition is very rare.
• A woman with this condition experiences psychotic symptoms within 3 weeks of giving birth.
• This condition is associated with mood disorders such as depression, bipolar disorder, or psychosis.
• Symptoms include false beliefs, hallucinations, or both and the inability to sleep, agitation and mood swings.
• A woman experiencing psychosis can seem fine temporarily, fooling caregivers into thinking that she has recovered, but she can continue to be severely depressed and ill even after periods of seeming well.
• Women who harbor thoughts of hurting their infants are more likely to act on them if they have postpartum psychosis.
• If untreated, postpartum psychotic depression has a high likelihood of coming back after the postpartum period and also after the birth of other children.