Perinatal Depression

Having a baby can be one of the biggest and happiest events in a woman's life. While life with a new baby can be thrilling and rewarding, it can also be difficult and stressful at times. Many physical and emotional changes can happen to a woman when she is pregnant and after she gives birth. These changes can leave new mothers feeling sad, anxious, overwhelmed or confused. For many women, these feelings go away quickly. But when these feelings persist or get worse, professional help is needed.

The term perinatal depression encompasses a wide range of mood disorders that can affect a woman during pregnancy and after the birth of her child. It includes prenatal depression, the "baby blues," postpartum depression and postpartum psychosis. Between 15 and 20 percent of all women experience some form of pregnancy related depression or anxiety. Prenatal (during pregnancy) depression affects between 10 and 20 percent of women. Symptoms of prenatal depression include:

  • Crying
  • Sleep problems (not due to frequent urination)
  • Fatigue
  • Appetite disturbance
  • Loss of enjoyment of activities
  • Anxiety
  • Poor fetal attachment

The "baby blues" (which occurs after the baby is born) affects as many as 80 percent of new mothers. "Baby blues" symptoms are usually resolved within two weeks of delivery. These symptoms can include:

  • Feeling overwhelmed
  • Irritability
  • Frustration
  • Anxiety
  • Mood changes - mom is elated one minute, and crying the next
  • Feeling weepy and crying
  • Exhaustion
  • Trouble falling or staying asleep

"Postpartum depression" affects 10 to 20 percent of new mothers, with the following symptoms continuing more than 14 days:

  • Frequent episodes of crying or weepiness
  • Persistent sadness
  • Fatigue
  • Feelings of inadequacy or guilt
  • Sleep and/or appetite disturbances
  • Irritability/mood changes
  • Overly intense worries about the baby
  • Difficulty concentrating, making decisions or remembering things
  • Lack of interest in the baby, family or activities
  • Anxiety is a prominent symptom and may manifest as bizarre thoughts and fears, such as obsessive thoughts of harm to the infant
  • Feeling overwhelmed
  • Headaches, chest pains, heart palpitations, numbness and hyperventilation

Postpartum psychosis is a very rare condition that usually includes auditory hallucinations and delusions and, less frequently, visual hallucinations. Affecting only one or two women per thousand, this is an emergency requiring hospitalization.

Postpartum psychosis usually appears within the first few days to a month after delivery, but can occur any time during the first year. Symptoms may appear abruptly. This disorder has a five percent suicide rate and a four percent infanticide rate. Postpartum psychosis is a severe but treatable emergency, requiring immediate admission to a psychiatric facility. If you suspect a woman might be experiencing postpartum psychosis, she must be separated from her infant and provided with immediate assistance.

A woman who recognizes that she has symptoms of depression may be inhibited by denial, shame, fear, and/or lack of energy from discussing her symptoms with her provider. Women should be encouraged to be open about their feelings, to seek help, and to feel that depression is not shameful and does not make her a bad mother.

The two most common forms of treatment for depression are psychotherapy and medication. The type of treatment will depend on the severity of the depression. Treatment has an 80 to 90 percent success rate in patients. The earlier treatment is initiated, the better the prognosis.

For more information on perinatal depression contact your Local County Health Department or your Local County Office of Mental Health.