It takes time, reading baby-care books, talks with the pediatrician, support groups with other mothers, and experience to know how to care for a child. And the maternally bonding feelings sometimes take weeks or months to develop.
Perfect Baby. The fantasy that your baby will be beautiful in every way, sleep through the night, and never cry is exactly that -- a fantasy. And the thoughts that all your friends new babies are perfect and yours isn't is also a fantasy. In 99 cases out of 100 that won't happen. But these thoughts can contribute to PPD.
Perfect Mother. Being the perfect mom will never happen -- either for you or your friends whom you perceive as perfect. You think you are not living up to the ideally perfect mother because you have trouble sometimes balancing the baby, other children, housework, a job, a spouse, and a myriad of other tasks. These feelings are normal even with a significant amount of support (ACOG, 2009).
A birth mother is at risk for PPD following the delivery of any number of children, not just the first one. and, the risk of PPD is significant in the first four weeks after birth. As time goes on with a new baby, the chances of becoming depressed decrease. A mother under the age of 20 is usually more at risk, due to maturity levels in dealing with stress. Alcohol abuse, intake of illegal substances or smoking add to the risk -- as well as seriously risking the baby's health. If the mother did not want or did not plan the baby, the lack of preparedness and mental state affect the risk of PPD. A close family member who has had depression or anxiety, especially if recent, can affect the birth mom's risk of PPD. A poor relationship with the spouse or partner causes increased risk. and, finally, previously attempted suicide will increase risk. There are several other risk factors that we have covered in other areas of this paper.
First of all, it is important that the birth mother admits that she is experiencing the blues, sadness, or depression as soon as possible. Many feel embarrassed because they think they shouldn't feel the way they do, which, by itself, is a symptom, as we have discussed earlier.
Immediate attention is important for the mother and for any potential risk of harm to the baby should psychosis develop. If the feelings are interfering with daily tasks, that is a sure sign that help is needed (Mayo Clinic Staff, 2009).
Besides the mother's own physician, there are support networks and websites such as Postpartum Support International that can offer assistance and the locations of groups in the local area that can offer a network that may not exist otherwise (PSI, 2010).
Most experts will agree that, for the most part, there is no reason to assume that postpartum depression should be treated unlike other types of depression or that it would respond in a different manner. Early identification and treatment are always necessary with any form of depression.
PPD is successfully treated with medications, psychotherapy or a combination. Treatment using drugs is the preferred method in persons with more severe symptoms, prior bouts with depression, or with family histories. Anti-depressants usually work best, but some may affect the mother's breast milk, so care in choosing a specific medication is important. Medications are usually less costly than psychotherapy as well, and they take less time to apply. With severe depression, postpartum psychosis, or poor response to medication, it is essential, in most cases, to add psychotherapy to the treatment (Leopold & Zoschnick, n.d.).
Hormone therapy may be indicated in some instances. The replacement of estrogen could ease the signs of PPD. However, research and studies on the affectivity of hormone therapies is minimal. The potential risks of this treatment vs. normal anti-depressant treatments should be thoroughly discussed with and explained by a physician competent in this area.
With proper attention and treatment, PPD should disappear within a matter of months. What is most important is not to stop treatment when the birth mother is beginning to feel better or there can be a regression back into PPD. Any medications or other treatments being used should be continued until a physician recommends stoppage.
PPD Effects on the Infant
The negative impact on the birth mother from PPD could, in turn, have negative effects on the newborn, because the mother is the baby's primary source of emotional, social, and cognitive stimulation especially during the first months of life (WebMD, 2003).
There have been approximately 15-20 studies of the negative impact of PPD on the infant. A consolidation of those findings indicate that PPD has a significant -- moderate to large -- effect in relation to the reaction between moms and newborns during the first year (WebMD, 2003).
The comparison between those mothers unaffected by PPD and those with PPD resulted in the following findings concerning those with the disorder: (WebMD, 2003)
They exhibited less affectionate behavior
They were less responsive to infant feedback
They were withdrawn and were hostile and intrusive with the baby
The infants were fussier, more discontent, and avoidant of social interaction. They also had less positive facial expression and vocalization. The infants had more sleep problems. Finally, results indicate that negative effects on the child could last five years or longer in some cases.
ACOG. (2009, January). Postpartum depression. Retrieved February 27, 2010, from the American Congress of Obstetricians and Gynecologists (ACOG): http://www.acog.org/publications/patient_education/bp091.cfm familydoctor.org staff. (2008, February). Postpartum depression and the baby blues. Retrieved February 28, 2010, from familydoctor.org: http://familydoctor.org/online/famdocen/home/women/pregnancy/ppd/general/379.html
Lane, B. (2007, January 21). Causes of postpartum depression. Retrieved February 28, 2010, from suite101.com: http://pregnancychildbirth.suite101.com/article.cfm/causes_of_postpartum_depression
Leopold, K., & Zoschnick, L. (n.d.). Postpartum depression. Retrieved March 1, 2010, from obgyn.net: http://www.obgyn.net/femalepatient/femalepatient.asp?page=leopold
Mayo Clinic Staff. (2009). Postpartum Depression. Retrieved February 27, 2010, from Mayoclinic.com: http://www.mayoclinic.com/health/postpartum-depression/DS00546
Office on Women's Health. (2009, March 6). Depression during and after pregnancy. Retrieved March 1, 2010, from womenshealth.gov: http://www.womenshealth.gov/faq/depression-pregnancy.cfm
PSI. (2010). Get help. Retrieved March 1, 2010, from postpartum.net (PSI): http://postpartum.net.gravitatehosting.com/Get-Help/Support-Resources-Map-Area-Coordinators.aspx
Rogge, T.A. (2008, August 24). Postpartum depression. Retrieved February 27, 2010, from National Institutes of Health: http://www.nlm.nih.gov/medlineplus/ency/article/007215.htm
WebMD. (2010). Postpartum depression. Retrieved February 27, 2010, from emedicinehealth.com: http://www.emedicinehealth.com/postpartum_depression/article_em.htm
WebMD. (2003). The effect of PPD on infants and children. Retrieved March 1, 2010, from Medscape.com: http://www.medscape.com/viewarticle/450938_6