About half to three quarters of new mothers experience some anxiety, mood swings, and sleep problems for a few days or even a few weeks after giving birth. After all, a new baby is a big responsibility, and represents a major change for a family. This is common enough to have a name, the baby blues.
On the other hand, postpartum depression is more intense and can interfere with a mother’s ability to take care of her child. Depending upon the state where the mother resides, postpartum depression occurs in 1 in 5 to 1 in 8 new mothers. Women who have suffered depression, particularly postpartum depression, earlier in life, or who have family members treated for depression are especially susceptible. Causes are not fully understood, but lowered levels of estrogen and progesterone, female hormones that go down with birth, are thought to contribute. Lowered levels of thyroid hormone can cause fatigue. Stressful situations, such as multiple births, marital problems, sick infants, birth complications, and being a teenage mother can raise the risk of post-partum depression.
Signs and symptoms of postpartum depression are:
- Depressed mood, severe mood swings, feelings of hopelessness
- Inability to bond with baby
- Fear of not being a good mother or of inadequacy
- Changes in appetite; either poor appetite or overeating
- Frequent crying
- Intense anger
- Restlessness or insomnia
- Feeling tired or sleeping too much
- Thoughts of harming oneself or baby, or thoughts of death
- Severe anxiety or panic
- Withdrawal from family and friends
- Loss of pleasure in formerly interesting activities
- Difficulty concentrating
If these signs and symptoms go on longer than two weeks, or if there are thoughts of suicide or of harming the baby, it is important to seek help the National Suicide Prevention Hotline number is 1-800-273-8255. Or you may prefer to chat with them online at suicidepreventionlifeline.org/chat.
In 2019 the U.S. Food and Drug Administration (FDA) approved the first drug designed specifically for treating postpartum depression. Zulresso (brexanolone) is given intravenously (IV) over a period of 60 hours. Patients must be hospitalized for this medication to be administered. In two studies, one looking at patients with severe depression and one looking at patients with moderate depression, brexanolone patients improved more than placebo patients. Their improved mood lasted at least 30 days, when they were seen for follow-up.
Other antidepressants, used for major depressive disorder, have also been used successfully. The following is a list of serotonin reuptake inhibitors (SSRIs). They work by increasing the molecule serotonin in the space between cells in the brain. This enables brain cells to communicate. Examples of antidepressants are:
- Prozac (fluoxetine) 10 to 60mg/day, by mouth
- Zoloft (sertraline) 50 to 200mg/day, by mouth
- Paxil (paroxetine) 20 to 60mg/day, by mouth
- Celexa (citalopram) 20 to 60mg/day, by mouth
- Lexapro (escitalopram) 10 to 20mg/day, by mouth