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Postpartum Distress Syndrome

After your baby is born, you may be surprised by some of the emotions you feel. You have waited so long for this wonderful new life and have anticipated feelings of great joy and happiness. You may be surprised if you find yourself feeling sad or unhappy. You have delivered your baby, and the anticipation and excitement are over. You may wonder if having a baby was a good idea. These feelings, called postpartum distress, are normal in up to 80% of all women after birth.

In the past, postpartum distress was called "postpartum depression," and the entire range of feelings a woman might experience was lumped together under that term. Today the general term is postpartum distress syndrome, and we distinguish between the intensity of the feelings.

Many women experience some degree of postpartum distress. Most of the time, feelings are mild; you may have heard them referred to as "baby blues." The situation is temporary and tends to leave as quickly as it comes. In unusual cases, it may last for several months and even more than a year.

Today, many experts consider some degree of postpartum distress normal. Some of the symptoms include:

• crying for no reason
• exhaustion
• irritability
• lack of confidence
• anxiety
• lack of feeling for the baby
• impatience
• low self-esteem
• oversensitivity
• restlessness

If you believe you are suffering from some of these symptoms, call your doctor. Almost all postpartum reactions are temporary and treatable.

If your baby blues don't get better in a few weeks, or if you feel extremely depressed, call your doctor. You may need medication to help deal with the problem.

Degrees of Postpartum Distress
The mildest form of postpartum distress is baby blues. This situation lasts only a couple of weeks, and symptoms do not worsen. (See the description above.) A more serious form of postpartum distress is called postpartum depression (PPD); it affects about 10% of all new mothers. The difference between baby blues and postpartum depression is in the frequency, intensity and duration of symptoms. Having problems sleeping is one way to distinguish between the two. If you can sleep while someone else tends the baby, it is probably baby blues. If you can't sleep because of anxiety, it may be PPD.

PPD can occur anytime from 2 weeks to 1 year after birth. A mother may have feelings of anger, confusion, panic and hopelessness. Her eating and sleeping patterns may change. She may be fearful she will hurt her baby or that she cannot take good care of the baby. She may think she is a bad mother or feel as if she is going crazy. Anxiety is a major symptom of PPD.

The most serious form of postpartum distress is called postpartum psychosis. In this situation, the woman may have hallucinations, think about suicide or try to harm the baby.

What Causes Postpartum Distress?
We don't know exactly what causes postpartum distress; not every woman experiences it. We believe hormonal changes are part of it. Many demands are placed on a new mother, which can cause distress. Other possible factors being considered include a family history of depression, little support after the birth, isolation and fatigue. Ways to Deal with the Problem
You can help yourself in various ways. Begin before the baby's birth. Set up a support network; ask family members and friends to help. Have your mother or mother-in-law stay with you to help out for a while. Maybe your partner can take some leave from work. Consider hiring someone to come in to help each day. Realizing that many new moms experience these feelings is a step in the right direction.

There is no treatment for baby blues other than emotional support, but there are ways you can help ease symptoms. In addition to asking for help, rest when baby sleeps. Talk to your partner; it may be hard for him to support you if he doesn't know you're having a hard time. Find other mothers in the same situation; it helps to share your feelings and experiences. There may be some support groups in your area—ask your doctor for the names of groups. Keep the number of visitors to a small group. Entertaining guests can be exhausting and very stressful for you. Don't be too hard on yourself. Let some things slide. Take care of yourself. Exercise every day. Eat healthfully, drink plenty of fluids and avoid alcohol. Try to get out of the house every day.

With postpartum depression, the situation is a little more serious. Use the above suggestions. In addition, medication may be necessary to help relieve some symptoms. Research indicates about 85% of all women who suffer from postpartum depression require medication, including antidepressants, tranquilizers and hormones; often they are used together. No single treatment has been shown to be more effective than another.

If you breastfeed, medication selection may be more limited. Certain medications, such as Pamelor, Prozac and Norpramin, can be used by a woman while breastfeeding. The baby's doctor must be advised of the situation, and the baby must be monitored for side effects. Discuss the situation with your OB/GYN and your pediatrician if medication is prescribed to you and you are breastfeeding.

Your Distress Can Affect Your Partner
If you experience baby blues or PPD, it can affect your partner. Prepare him for this situation before your baby is born. Explain to him that if it happens to you, it's only temporary.

There are some things you might suggest to your partner that he can do for himself, if you get blue or depressed.

• Tell him not to take the situation personally.
• Suggest he talk to friends, family members, other fathers or a professional.
• He should eat well, get enough rest and exercise.
• Ask him to be patient with you.
• Ask him to support you. He can provide his love and support to you during this difficult time.