After having a baby, many women have mood swings. One minute they feel happy, the next minute they start to cry. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can't sleep well even when the baby is asleep. These symptoms usually start about 2 to 4 days after delivery and may last for several days.
If you are a new mother and have any of these symptoms, or have had them in the past, you are amongst the 70-80% of women who get what is called the "baby blues". The "blues" are considered a normal part of early motherhood and usually go away within 10 days of the delivery. However, some women have worse symptoms or symptoms that last longer. This is called postpartum depression.
Instead of the normal and relatively mild sadness and anxiety, about 10% of new mothers develop a more troubling condition called postpartum depression. Postpartum depression lasts longer, is more intense, and often requires counseling and treatment. Postpartum depression can occur after any birth, not just the first.
Feeling depressed doesn't mean that you're a bad person, or that you did something wrong or that you brought this on yourself.
Although many women get depressed right after childbirth, some women don't feel "down" until several weeks or months later. Depression that occurs within 6 months of childbirth may be postpartum depression.
There are many causes. Hormone levels change during pregnancy and right after childbirth. Those hormone changes may produce chemical changes in the brain that play a part in causing depression.
Low thyroid functioning is very common in women after childbirth. The baby's thyroid can produce antibodies against the mother's thyroid and causes it to under-function. This may be one of the chief causes of postpartum depression and weight gain.
Long chain polyunsaturated omega-3 fatty acid deficiency may contribute to depressive symptoms in alcoholism, multiple sclerosis and postpartum depression. Adequate long chain polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), may reduce the incidence of depression just as omega-3 fatty acids may reduce the incidence of coronary heart disease.
In studying 20 healthy primiparous women (women bearing their first child) without significant health or psychiatric problems, a significant connection between reduced serum cholesterol levels and depressive symptoms postpartum was found.
Postpartum depression is more likely if you had any of the following:
Here are some symptoms of postpartum depression:
Postpartum depression is treated much like any other depression. Support, counseling ("talk therapy") and medicines can help. If you take an antidepressant medicine, it will go into your breast milk. Talk to your doctor about the risks of taking an antidepressant while breast-feeding. Your doctor can decide which medicine you can use while nursing your baby.
Tryptophan at 1-3gm per day can be used to treat a variety of depression syndromes. It is especially effective when treating depression which is accompanied by insomnia. Depression associated with menstrual cycles and postpartum depression sometimes responds very well to tryptophan supplementation. Postpartum women usually have high estrogen levels and it has been found that high estrogens increase the conversion of tryptophan to niacin. Progesterone and hydrocortisone decrease its conversion. Women on birth control pills, when given vitamin B-6 and tryptophan, generally tend to metabolize tryptophan more normally.
If you have given birth recently and are feeling sad, blue, anxious, irritable, tired or have any of the other symptoms mentioned here, remember that many other women have had the same experience. You're not "losing your mind" or "going crazy" and you shouldn't feel that you just have to suffer. Here are some things you can do that other mothers with postpartum depression have found helpful:
How long does postpartum depression last? It's hard to say. Some women feel better within a few weeks, but others feel depressed or "not themselves" for many months. Women who have more severe symptoms of depression or who have had depression in the past may take longer to get well. Just remember that help is available and that you can get better.
(1) "Dietary Polyunsaturated Fatty Acids and Depression: When Cholesterol Does Not Satisfy", Hibbeln, Joseph R. and Salem, Norman, Jr., American Journal of Clinical Nutrition, 1995;62: pp.1-9.
(2) "Rapid Decrease of Serum Cholesterol Concentration and Postpartum Depression," Ploeckinger, Barbara, et al, British Medical Journal, September 14, 1996;313: p.664.
Depression associated with menstrual cycles and postpartum depression sometimes respond very well to tryptophan supplementation. Postpartum women usually have high estrogen levels and it has been found that high estrogens increase the conversion of tryptophan to niacin. Progesterone and hydrocortisone decrease its conversion. Women on birth control pills, when given vitamin B-6 and tryptophan, generally tend to metabolize tryptophan more normally.
On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women.
US scientists found low levels of omega-3 fatty acids, especially DHA, in mother's milk and in the red blood cells of women with postpartum depression. The difference was significant compared to those without depression. The reason for this finding was related to low intake of fatty fish such as salmon and herring containing large amounts of DHA. [Hibbeln JR., Seafood consumption, the DHA content of mother's milk and prevalence rates of postpartum depression: J Affective Disorders 2001]
Breast milk remains the primary source of DHA for the baby and a mother's brain the primary source of DHA for the milk. Researchers found significant variations in breast-milk DHA levels around the world. The lowest concentrations were found in vegan and American mothers, and the highest in mothers who ate fish regularly. [NOAA technical memorandum, NMFS-SEFSC-367, NIH meeting on omega-3 fatty acid research, May 12, 1994]
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