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Having a baby can be a joyous occasion, but being a new mother can also be stressful and difficult. Taking time to adjust to the demands and changes that come with parenting is normal, but about 13% of pregnant women and new mothers feel depressed and have related symptoms. When this occurs following childbirth, it is called postpartum depression. The October 20, 2010, issue of JAMA includes an article reporting that fish oil capsules taken during pregnancy did not result in lower levels of postpartum depression. This Patient Page is based on one previously published in the February 13, 2002, issue of JAMA.
Many women experience mild sadness, tearfulness, anxiety, irritability, or mood swings after having a baby (baby blues). These symptoms are normal and usually decrease in a matter of days or weeks. Less common but much more severe postpartum (after childbirth) problems include postpartum depression and postpartum psychosis.
Symptoms of postpartum depression include
Severe sadness or emptiness, emotional numbness, or crying a lot
Withdrawal from family, friends, or activities that are pleasurable
Constant fatigue, trouble sleeping, overeating, or loss of appetite
A strong sense of failure or inadequacy
Intense concern and worry about the baby or a lack of interest in the baby
Thoughts about suicide, fears of harming the baby
This is a more rare disorder that usually occurs as a severe form of postpartum depression. Symptoms include
Delusions (false beliefs)
Hallucinations (hearing voices or seeing things that are not real)
Thoughts of harming the baby
Severe depressive symptoms
Although the exact cause of postpartum emotional changes is unknown, they can be treated. If you are feeling a mild case of the blues after having your baby, you can help yourself by getting plenty of rest, napping when your baby naps, asking for help from family and friends, showering and dressing each day, getting out for a walk, and getting a babysitter to watch your baby when you need a break.
More severe depressive symptoms require medical evaluation. Types of interventions may include
Biological: Complete medical examination to rule out medical conditions that may cause depression; antidepressant or antipsychotic medication if appropriate
Psychological: Individual or group therapy; counseling of both parents if possible
Social: Development of social networks with involvement of a partner, family, friends, and support groups
The National Women's Health Information Center (US Department of Health and Human Services) http://www.womenshealth.gov/faq/depression-pregnancy.cfm
American Psychiatric Associationhttp://www.healthyminds.org/Main-Topic/Postpartum-Depression.aspx
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on depression was published in the May 19, 2010, issue.
Sources: American Psychiatric Association, American College of Obstetricians and Gynecologists, National Women's Health Information Center (US Department of Health and Human Services), National Institute of Mental Health
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
Stevens LM, Lynm C, Glass RM. Postpartum Depression. JAMA. 2010;304(15):1736. doi:10.1001/jama.304.15.1736
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