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How Is Postpartum Depression Different From the Baby Blues?

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Having a baby is a big change in your life

You probably expect to feel happy and proud about the new member of your family, but many moms feel moody and overwhelmed instead. It’s normal to feel this way for a little while. After you give birth, your hormone levels drop, which impacts your mood. Your newborn is probably waking up at all hours, too, so you aren’t getting enough sleep. That alone can make you irritable. You might simply be worried about caring for your baby, and it makes you feel a kind of stress you haven’t dealt with before.

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The majority of women experience at least some symptoms of the baby blues immediately after childbirth

It’s caused by the sudden change in hormones after delivery, combined with stress, isolation, sleep deprivation, and fatigue. You might feel more tearful, overwhelmed, and emotionally fragile. Generally, this will start within the first couple of days after delivery, peak around one week, and taper off by the end of the second week postpartum. The baby blues are perfectly normal, but if your symptoms don’t go away after a few weeks or get worse, you may be suffering from postpartum depression. Unlike the baby blues, postpartum depression is a more serious problem—one that you shouldn’t ignore. In the beginning, postpartum depression can look like the normal baby blues. In fact, postpartum depression and the baby blues share many symptoms, including mood swings, crying jags, sadness, insomnia, and irritability. The difference is that with postpartum depression, the symptoms are more severe (such as suicidal thoughts or an inability to care for your newborn) and longer lasting.The emotional bonding process between mother and child, known as attachment, is the most important task of infancy. The success of this wordless relationship enables a child to feel secure enough to develop fully, and affects how he or she will interact, communicate, and form relationships throughout life. A secure attachment is formed when you as the mother respond warmly and consistently to your baby’s physical and emotional needs. When your baby cries, you quickly soothe him or her. If your baby laughs or smiles, you respond in kind. In essence, you and your child are in synch. You recognize and respond to each other’s emotional signals.

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A wise strategy for a nursing mother is to start an antidepressant at the lowest possible dose and increase dose only as necessary, while watching the infant for signs of adverse reactions — such as irritability, grogginess, failure to gain weight, or changes in feeding schedule (Figueiredo B, 2011). Infants most vulnerable to drug reactions are those younger than 8 weeks, those who were born prematurely, and those with other medical problems. Electroconvulsive therapy. When symptoms of postpartum depression are severe, when postpartum psychosis occurs, or when suicide is a possibility, electroconvulsive therapy (ECT) may be a sensible choice because it is effective and works faster than drugs. While sedated, a patient undergoing ECT receives a short-acting anesthetic to prevent awareness of the procedure and to reduce discomfort

Once the patient is sleeping, the psychiatrist uses a special device to deliver an electrical impulse that stimulates the brain and causes a seizure. There are no outward signs of this seizure, but the doctor can watch it on a monitor (similar to an electroencephalogram) that measures electrical activity of the brain. The mechanism of ECT action is not understood, but the seizure seems to restore the brain's ability to regulate mood (Yonkers KA, 2011).

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As shown above, postpartum depression is depression that occurs after having a baby. Feelings of postpartum depression are more intense and last longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby.

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Figueiredo B, et al. "Anxiety and Depression in Women and Men from Early Pregnancy to 3-Months Postpartum," Archives of Women's Mental Health (June 2011): Vol. 14, No. 3, pp. 247–55.

Paulson JF, et al. "Prenatal and Postpartum Depression in Fathers and Its Association with Maternal Depression: A Meta-Analysis," Journal of the American Medical Association (May 19, 2010): Vol. 303, No. 19, pp. 1961–69.

Yonkers KA, et al. "Diagnosis, Pathophysiology, and Management of Mood Disorders in Pregnant and Postpartum Women," Obstetrics & Gynecology (April 2011): Vol. 117, No. 4, pp. 961–77.

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