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Postpartum Disorders

In recent years, the often-ignored and misunderstood mood imbalance postpartum depression (PPD) has become a household word. As you recover from the birth of your daughter, you should be aware of the symptoms of postpartum depression, but also understand that there are varying degrees of this mood disorder and not all lead to murder. What some call “postpartum blues” or “baby blues” is a mild form that the American College of Obstetricians and Gynecologists says affects about 70 to 85 percent of new moms. Within the first three days after giving birth, feelings of fatigue, nervousness, confusion, detachment from the baby, and anxiety accompanied by frequent bouts of crying set in. Most medical experts agree that these blues are caused by dramatic physiological changes that occur in hormonal levels after birth. (Levels of estrogen and progesterone drop as much as tenfold!) Social factors such as lack of family support and psychological factors such as marital tension can also play a role in causing and/or aggravating this mild form of PPD. Baby blues generally go away without any form of treatment within a week or two Postpartum depression (which affects about 10 percent of new mothers) is more intense and lasts longer than the blues. It can develop at almost any time up to one year after childbirth, but most often appears sometime between the second week and third month after birth. Typically, it can last anywhere from several weeks to several months. Moderate PPD is apparently rooted in negative social and psychological factors. These tensions may include the daily stresses of parenting, feelings of isolation, a colicky infant, chronic lack of sleep, and marital tensions. It is best treated with professional help because it often responds well to a combination of antidepressant medication and cognitive therapy that teaches women to better cope with the stresses of parenthood. If you have feelings of moderate PPD, you should not ignore them or let them go untreated. Dr. Schaefer says that if a few weeks go by and you are not yet feeling any enthusiasm about motherhood, or if you still aren’t experiencing normal eating and sleeping patterns, you should call your physician or the support group (see “Warning Signs of Postpartum Depression” on page 69). In rare cases, the symptoms will persist and greatly increase in severity. This may indicate the onset of the most serious form of PPD, called postpartum psychosis.Postpartum psychosis (PPP) affects only about 1 in 1,000 women and most often occurs during the first four weeks after delivery Women with PPP are severely impaired and may have paranoia, mood shifts, or hallucinations and delusions that frequently focus on the infant’s dying or being demonic. These hallucinations often command the woman to hurt herself or her baby. This condition requires immediate medical attention and, usually, hospitalization. In the book Raising Baby Right Dr. Schaefer suggests that if you are feeling the symptoms listed in the box “Warning Signs of Postpartum Depression” you should follow these two steps: Take care of yourself. Learn to recognize your overload factors and avoid them. If you feel you can’t keep the house clean and take care of the baby, let the house go. If the visits of family and friends send you into a tizzy as you try to be a good host and cater to the needs of your newborn, take the phone off the hook and disconnect the doorbell. Get a sitter and make time to go for a walk, take a warm bath, and then a nap. Stay alert to the signs of depression and talk to your doctor if you start to feel them. Take care of yourself first and foremost. If you do this, you’ll have the emotional and physical strength you need to take care of all your other responsibilities. 2. Seek support. Don’t try to handle your negative feelings alone. These feelings do not mean you are a bad mother. They don’t in any way indicate that you can’t handle motherhood. They are very common feelings shared, to some degree, by approximately eight out of ten new mothers—the majority of whom turn out to be wonderful parents. Talk to your spouse. He can’t understand your feelings and actions unless you explain what’s going on. His emotional support is very important to your ability to overcome your problem. Ask him for that help. Talk to other mothers. Sharing your frustrations lessens their load, and hearing about similar experiences will take away some of the horror and mystery of this trying period. Talk to your doctor. He or she can help you determine the level of your depression and decide on a treatment plan that will give you back your enthusiasm for parenthood. Postpartum depression is very treatable, so you should get medical help promptly if you are depressed most of the time for two weeks or more.

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