Depression: Managing Postpartum Depression

Overview

It's common to lose sleep, feel irritable, and cry easily during the first few days after childbirth. Hormone changes and the demands of a new baby can cause these "baby blues." The "baby blues" often peak around the fourth day. Then they ease up in less than 2 weeks. If these mood changes last more than 2 weeks, you may have postpartum depression.

Most people with postpartum depression feel very sad or hopeless and stop finding pleasure in life. Other symptoms may include trouble sleeping and poor appetite.

Depression is a medical condition that requires treatment. Medicine and counseling often work well to reduce depression. You can still breastfeed while taking certain medicines for depression.

When should you call your doctor?

Call 911, the National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453), or other emergency services immediately if:

• You or someone you know is thinking seriously of suicide or has recently tried suicide. Serious signs include these thoughts:
  • You have decided on how to kill yourself, such as with a weapon or medicines.
  • You have set a time and place to do it.
  • You think there is no other way to solve the problem or end the pain.
• You feel you can't stop from hurting yourself, your baby, or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Call a doctor now if:

• You hear voices.
• You have been thinking about death or suicide a lot, but you don't have a suicide plan.
• You are worried that your feelings of depression or thoughts of suicide aren't going away.

Seek care soon if:

• You have symptoms of depression, such as:
  • Feeling sad or hopeless.
  • Not enjoying anything.
  • Having trouble with sleep.
  • Feeling guilty.
  • Feeling anxious or worried.
• You have been treated for depression for more than 3 weeks, but you are not getting better.

Your pregnancy health professional may be the first person to note and diagnose postpartum depression. This is one of many reasons why it's important to have a medical check 3 to 6 weeks after childbirth.

How is postpartum depression treated?

Treatment choices include:

• Counseling. It can give you emotional support and help with problem solving and goal setting. Others in your family may also benefit from counseling.
• Antidepressant medicine. It relieves symptoms for most people.

Doctors recommend that people with moderate to severe postpartum depression combine counseling with medicine. People with mild depression may get better from counseling alone. You can still breastfeed while taking certain antidepressants.

Antidepressants are typically used for 6 months or longer. They're taken first to treat postpartum depression and then to prevent symptoms from coming back.

Getting regular exercise, eating well, and getting enough sleep may also help you feel better. Support from family, friends, or other parents may also help.

Talk to your doctor about your symptoms. Together you can decide what treatment is right for you.

How can you care for yourself?

Here are some tips for taking good care of yourself when you have postpartum depression.

• Schedule outings and visits with friends and family.

  Ask them to call you often. Isolation can make depression worse, especially when it's combined with the stress of caring for a newborn.

• Get as much sunlight as you can.

  Keep your shades and curtains open. And get outside as much as you can.

• Eat a balanced diet.

  Avoid alcohol and caffeine. If you don't feel hungry, eat small snacks throughout the day.

• Get some exercise every day, such as outdoor stroller walks.

  Exercise helps improve mood.

• Ask for help with preparing food and doing other daily tasks.

  Family and friends are often happy to help when you have a newborn.

• Don't overdo it.

  And get as much rest and sleep as you can. Fatigue can increase depression.

• Join a support group for people who have new babies.

  To find a support group in your area, talk to your doctor. Or go to the website for Postpartum Support International at www.postpartum.net for more information.

• Play upbeat music throughout your day and soothing music at night.