Postpartum-Blues




 

Although delivering a baby is typically a happy event, many postpartum women develop depressive symptoms. These symptoms may manifest as the postpartum blues, which consist of mild depressive symptoms that are generally self-limited, but may be a risk factor for more severe syndromes of major depression. Up to 85% of new mothers are affected by postpartum blues, with symptoms starting within a few days after childbirth and lasting up to two weeks in duration.

Presentation - Symptoms of postpartum blues can vary significantly from one individual to another, and from one pregnancy to the next. Many symptoms of postpartum blues overlap both with normal symptoms experienced by new parents and with postpartum depression. Individuals with postpartum blues have symptoms that are milder and less disruptive to their daily functioning compared to those with postpartum depression. Symptoms of postpartum blues include, but are not limited to:
  • Tearfulness or crying "for no reason"
  • Mood swings
  • Irritability
  • Anxiety
  • Questioning one's ability to care for the baby
  • Difficulty making choices
  • Loss of appetite
  • Fatigue
  • Difficulty sleeping
  • Difficulty concentrating
  • Negative mood symptoms interspersed with positive symptoms

Causes:
Pregnancy and postpartum are significant life events that increase a woman's vulnerability for postpartum blues. Even with a planned pregnancy, it is normal to have feelings of doubt or regret, and it takes time to adjust to having a newborn. Feelings commonly reported by new parents and lifestyle changes that may contribute to developing early postpartum mood symptoms include:
  • Fatigue after labor and delivery
  • Caring for a newborn that requires 24/7 attention
  • Sleep deprivation
  • Lack of support from family and friends
  • Marital or relationship strain
  • Changes in home and work routines
  • Financial stress
  • Unrealistic expectations of self
  • Societal or cultural pressure to "bounce back" quickly after pregnancy and childbirth
  • Overwhelmed and questioning ability to care for baby
  • Anger, loss, or guilt, especially for parents of premature or sick infants
Risk factors:
Most risk factors studied have not clearly and consistently demonstrated an association with postpartum blues. These include sociodemographic factors, such as age and marital status, obstetric factors, such as delivery complications or low birth weight.
Factors most consistently shown to be predictive of postpartum blues are personal and family history of depression.

Treatment is supportive, including ensuring adequate sleep and emotional support. Prevention can be tried by educating women during pregnancy about postpartum blues may help to prepare them for these symptoms that are often unexpected and concerning in the setting of excitement and anticipation of a new baby. Mothers who develop postpartum blues often have significant shame or guilt for feelings of anxiety or depression during a time is expected to be joyful. It is important to reassure new parents that low mood symptoms after childbirth are common and transient.

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