Postpartum Depression (PPD)

Updated May 11, 2013.

Postpartum depression (PPD) is a common illness that affects about 10% - 15% of all moms. PPD affects the health of the mother, parenting, and can have lasting effects on the growing child, leading to developmental delays and social troubles. It can be treated with medication or with different types of counseling.

Postpartum Depression in the NICU

Having a premature baby in the NICU is stressful for a family, and can easily become overwhelming.

Moms of preemies have a huge emotional job. They must simultaneously heal from childbirth and mourn the loss of the end of their pregnancy and idealistic birth expectations. They are trying to bond with a baby who may be too small or sick to even touch. While they are falling in love with their baby, they balance hope for a healthy future with the knowledge that many preemies have long-term effects of prematurity.

Because having a premature baby is so emotionally difficult, it's not surprising that moms of preemies are two to three times more likely to suffer from postpartum depression than other moms. Moms of babies who were born very premature seem even more likely to have PPD than moms of babies who were only moderately early. If your baby was born early, then learning the symptoms of postpartum depression and where to go for help can help you to get treatment early and to minimize the lasting effects of PPD.

Symptoms of Postpartum Depression

Most women have some type of "baby blues" in the days or weeks after having a baby.

Mood swings, crying or feeling sad, loss of appetite, and trouble sleeping are all normal. Baby blues usually lasts 2 weeks or less, and may be caused by the hormonal changes a woman's body goes through after having a baby.

Postpartum depression is longer lasting and more serious than baby blues. If the blues lasts more than 2 weeks or if you have any more serious symptoms, then you may have PPD. Symptoms of postpartum depression include:

Crying spells or profound sadness
Trouble concentrating
Difficulty making decisions
Feelings of failure
Lack of interest in the baby
Thoughts of hurting yourself or the baby
Thoughts of suicide

Who Can You Talk To About PPD?

If you have symptoms of postpartum depression, it's important for you to get help immediately. PPD is a serious illness that can have lasting consequences for you, your child, and your family.

There are many different places you can turn to for help if you think you may have PPD. Your obstetrician or midwife is a good place to start. You can also ask to talk to the social worker in your baby's NICU, or search for a local psychiatrist.

How is Postpartum Depression Treated?

Many different treatment options have been studied for postpartum depression. Work with your doctor or mental health professional to find the option that works best for you. Some of the available treatments include:

Medication: There are many antidepressant medications that have been found effective at treating postpartum depression. Zoloft (sertraline) and Paxil (paroxetine) are two that are considered relatively safe while breastfeeding.
Psychotherapy:Psychotherapy or talk therapy is designed to help patients with emotional problems. Psychiatrists, psychologists, and some social workers, counselors, and advanced practice nurses can perform psychotherapy. Psychotherapy can be used alone in treating milder forms of depression, and may be used in conjunction with medication or other biological treatments for more severe depressions. Psychotherapy can be done one-on-one or in a group setting.
Cognitive behavior therapy (CBT):Cognitive behavior therapy is a model of psychotherapy that helps people understand how thoughts influence feelings and behavior and is often used in the treatment of depression and anxiety disorders.
Group therapy:Group therapy is a type of therapy where therapists work with multiple people at the same time. Group therapy for post partum depression may have certain advantages including peer support and education around parenting and postpartum issues.

Taking care of yourself physically, mentally, and emotionally is one of the most important things you can do for your baby and your family. Remember that you're not alone, and there are plenty of ways to find help if you have postpartum depression.

_Resources:

_{Bledsoe, S. & Grote, N. "Treating Depression During Pregnancy and the Postpartum: A Preliminary Meta-Analysis." Research on Social Work Practice. March 2006: 16, 109-120.}

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Vigod, S., Villegas, L., Dennis, C-L, and Ross, L. "Prevalence and Risk Factors for Postpartum Depression Among Women With Preterm and Low-Birth-Weight Infants: A Systematic Review." British Journal of Obstetrics and Gynaecology. January, 2010: 540-551
_{Lefkowitz, D., Baxt, C., and Evans, J. "Prevalence and Correlates of Posttraumatic Stress and Postpartum Depression in Parents of Infants in the Neonatal Intensive Care Unit (NICU)." Journal of Clinical Psychology Med Settings. July 2010; 17, 230-239.}

_{Womenshealth.gov. "Depression During and After Pregnancy Fact Sheet." Accessed from http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.cfm}