The high concentration of estrogen that prevails during pregnancy generally produces feelings of well-being. After delivery, however, estrogen levels drop and thyroid hormone levels may fluctuate for several weeks, which can cause symptoms of depression.
A new normal
Labor and delivery themselves are stressful and deplete a woman’s energy. Then there is the care of a new infant, whose feeding and diaper-changing schedules often do not conform to the usual routines of days and nights. Some mothers also experience difficulty breastfeeding at first.
For most mothers, improvement can be felt as early as the second week of a newborn’s life. New routines are established, husbands and other helpers adjust to their responsibilities, and physical strength begins to return.
However, in about 10 percent of mothers, symptoms of depression ensue. These women experience an array of emotions and problems that include anger, doubt, guilt, helplessness, difficulty concentrating, disruption of sleep and appetite, uncontrollable crying, mood swings, confusion and unrelenting fatigue.
In severe cases, mothers lose interest in the baby and suffer through thoughts of wanting to hurt their child, which brings on a renewed cycle of guilt. Symptoms often appear within a couple of days after delivery or may begin six to 12 months later. Fortunately, help is available.
What is actually happening
Postpartum depression is believed to arise from a combination of physical, emotional and environmental factors. Women with severe PMS or a history of depression are at greater risk of developing postpartum depression. Emotional and environmental factors can include marital difficulties, doubt about parenting skills, financial worries, fears about the child’s future and lack of social support.
Frequently medications are needed and counseling is beneficial. Additional support from spouse, family and friends is crucial. The new mother needs not only reassurance and companionship but help with infant care so she can rest. Some mothers with exceptionally severe postpartum depression have benefited from a few days to weeks in the hospital.
Reginald Finger, MD, MPH wrote this article while on staff with Focus on the Family. He currently is on the faculty of Indiana Wesleyan University.
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