Cindy-Lee Dennis On Signs of Postpartum Depression

Cindy-Lee Dennis, PhD, is associate professor of nursing and psychiatry at the University of Toronto and holds a Canada Research Chair in Perinatal Community Health.

Q: I have never suffered from depression. What are the odds I might develop PPD?

A: About 13% of new moms experience postpartum depression. However, the recurrence rate for mothers who have experienced a previous depressive episode in their life can range from 24% to 63%.

Q: Are there any warning signs during my pregnancy that I am at increased risk for PPD?

A: Yes, and they are easy to spot: If a mom is feeling at all depressed or anxious for two weeks or more during her pregnancy, chances are good it may continue into the postpartum period. This is why it's important that you get treatment for that original depression.

Q: How do I know whether I am experiencing the "baby blues" or PPD?

A: "Baby blues" occur in the first couple of weeks after delivery in approximately 50% to 80% of mothers; for most of them the tearful episodes go away on their own. However, if you start not enjoying once pleasurable things, sleeping too little or too much, or having changes in appetite and sudden mood swings, then you might be developing postpartum depression. Often women begin to believe that they are not very good mothers. If these symptoms and feelings come every day and last more than two weeks, then you should seek help from a health professional such as a family physician or a public health nurse. These professionals can refer you to a mental health specialist such as a psychiatrist or psychologist if necessary.

Q: I am a 30-year-old woman who suffered PPD with my first child. I want to have another but fear it could happen again. Is there anything I can do?

A: Above all, you need to have a support system in place, usually made up of family and close friends. This support will help you develop coping skills that will be of great benefit both in warding off postpartum depression or dealing with it if it returns. Having a supportive marital situation is very important. It is also important to develop realistic expectations with your partner about the challenges and stresses that you will both face in the postpartum period and how you will deal with these stresses. You will also want to meet other women in the community who have young children. These women can provide excellent support and validate the challenges of motherhood. Furthermore you should plan events to get out of the house on a regular basis so you do not become isolated. And think about what type of help you can arrange in relation to child care and household responsibilities so that you can get sufficient rest and take a break. Remember that your fears are genuine, and you have to be prepared.

Q: If I develop PPD, should I consult a doctor for medication and a therapist, or first see how it goes with the drugs?

A: If your symptoms are mild, you might first contact a health professional like your family physician. Sometimes talking with close friends or family members can help, and you can always participate in a mothers support group or various activities that get you out of the house.

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If the symptoms are moderate to severe, this is where antidepressants come into play. It's hard to go to therapy or supportive activities without first getting some relief. I am referring to severe symptoms which can decrease your ability to function in regular day-to-day activities. But keep in mind that antidepressants only control the symptoms of postpartum depression. They will not make your marriage better if that is the cause of your depression. Combining antidepressant medication and couples counseling may be the best treatment option in this case.

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Last Updated: April 26, 2008

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