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Postpartum Depression

Is it any wonder that after 9 months of pregnancy, several hours (or days!) of labor and childbirth, sleep deprivation, nursing, and numerous life changes that maternity or "baby blues" affect nearly 7 in 10 new mothers? The good news is that this is generally a mild, transient disorder that resolves without intervention. Of greater concern, however, are the 10% of women who will develop postpartum depression. Dr. Donnica discusses the different types of mood disorders that affect women after childbirth from just plain cranky to postpartum psychosis. She also discusses these conditions, how to identify them in yourself or in others, and what can be done to treat them.

Mood changes are expected after mom delivers a baby, but how do you know what's "normal"? If a new mom's psychologic changes are not normal, there are several possibilities to consider: sleep deprivation (which can be overwhelming), physical illness, "baby blues", postpartum depression, anxiety, obsessive-compulsive disorders, and postpartum psychosis. It is estimated that the "baby blues" affect anywhere from five to seven out of every ten new moms. It is a mild, benign, and transient mood change that usually begins within three to four days after delivery and peaks on the fourth to fifth day. The most common symptom is unprovoked weeping; spikes of elation may also, but less typically, occur. Other symptoms include irritability, anger and hostility, headaches, feelings of unreality, exhaustion, and restlessness. Sleep disturbances are classically listed as a symptom for all of these disorders, however I have yet to meet a postpartum woman who did not have sleep disturbances!

The baby blues generally resolve without medical intervention within two weeks; if the symptoms persist longer, another diagnosis must be identified. Social intervention such as a relative babysitting for a few hours so that mom can get some sleep or assistance with household chores or providing instruction on newborn care can often help significantly. Women who have this condition are likely to have it recur with subsequent pregnancies.

Women who suffer from "the blues" for longer than two weeks are at greatly increased risk for postpartum depression (PPD). Estimates are that this disorder affects anywhere from 8% to 15% of all new moms, yet in one 1999 study, only about 3% were correctly diagnosed. PPD can begin anytime within months of delivery. Characteristic symptoms include: crying jags, sadness, emotional lability, guilt, loss of appetite or anorexia, profound sleep disturbances, poor concentration and memory (most likely a consequence of the sleep disturbances), irritability, and feelings of inadequacy to care for the newborn or other children.

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 Alternative therapies are techniques and modalities which have yet to be proven to work in people in general by scientifically controlled clinical research trials, but which many people have testified work for them. 

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