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Depression After Pregnancy

Which Women Are At Greater Risk?

Wednesday, March 21, 2012 - 15:55

Contributing Author: Guy Slowik FRCS

A woman's risk for depression after pregnancy cannot be accurately predicted based on her hormone levels. But some women may be at higher risk for postpartum depression. These include women who:

  • Have had a previous postpartum episode. Women who have experienced postpartum depression after the birth of a child may have a greater chance of having the same problem again.
  • Had a traumatic birth experience. Women who have had a difficult labor and delivery may be more prone to depression after pregnancy.
  • Experienced prebirth (antepartum) depression. Women who have experienced depression, mood swings, and panic attacks while pregnant may be at greater risk for experiencing those feelings after delivery.
  • Have experienced depression unrelated to pregnancy. Women who have had a previous mood disorder may have a greater chance of experiencing postpartum depression.
  • Have a mother or sister who suffered from postpartum depression. The condition seems to run in families.
  • Have had a recent stressful life event or major life change. Losing a job or home, marital difficulties, the death of someone close to you, or other stressful life events may worsen the effects of a drop in hormone levels after delivery.
  • Have a history of extreme premenstrual syndrome (PMS). Women who suffer from severe PMS may be more susceptible to hormonal imbalances after birth.

How-To Information:

Having a Baby, and a Life, Too

You knew your life would change after you had a baby. You just didn't realize the range of emotions you would feel. Having a baby challenges your sense of control, and this may leave you depleted and overwhelmed. Sometimes you may even feel resentful, wishing you could return to your pre-baby life. The following exercise will help you identify what is missing and may help you to identify some changes you can make to regain a sense of control:

  • Make a list of the old parts of your life that you miss, such as going shopping when you want or having a night out with girlfriends. Write down everything you can think of, no matter how small, without editing or passing judgment.
  • Review your list with your partner or other family members. Talk over each item on the list, discussing the advantages and disadvantages of the things you feel you can no longer do. For example, you may have more time with your new family if you don't go out with your friends every Thursday night, but you may also miss spending time with your friends and feel sad and isolated without them. Be honest about the items you have listed.
  • Next, choose one or two items from the list that you may be able to add back into your life. For example, if you miss going out to dinner with your partner or friends, maybe other friends or family members could watch the baby for an hour or two while you go to your favorite restaurant.

Choosing a few specific activities to restore to your life can help you to regain a sense of balance in your life, and it may help you shake those baby blues.

What Should You Do If You're At Risk?

To reduce your risk of depression after pregnancy, learn as much as you can about the responsibilities of parenthood before the baby arrives. Read parenting books and magazines and interact with other couples who are experienced parents. If you are at high risk for postpartum depression, it may be wise to identify a therapist during your pregnancy.

How-To Information:

Before you give birth, develop a good postpartum plan. A good postpartum plan can also help to reduce the emotional upheaval many women experience following childbirth. The plan should include specific ways to:

  • Take care of yourself. Nurture and pamper yourself. Take breaks when you can. Sleep when baby sleeps.
  • Accept help from others. Ask for help when you feel exhausted or overwhelmed.
  • Avoid major life changes. Ideally, make changes such as moving or changing jobs before you become pregnant. Next best is making such changes while pregnant.
  • Arrange for at-home help. Try to have a friend or family member stay with you for the first week to assume household chores and help with older children.
  • Limit visitors. Showing off baby is fun, but a constant stream of visitors can be taxing. However, visits from family members are inevitable, and if you have a large family, this could be stressful. Sometimes staying in your robe or pajamas for the first week will at least remind your family that you are still recovering from childbirth.
  • Make a "To Do" list.¬†When friends and family call and ask how they can help, you can simply read from the list. Most people genuinely like to feel helpful.
  • Prepare meals ahead of time. During the last weeks of pregnancy, freeze several meals and mini-meals that can easily be heated up during those first weeks at home with baby.
  • Eat balanced meals through the day. Some new mothers have found eating small portions every three hours helpful. Limit alcohol, nicotine, and caffeine.
  • Avoid rigid schedules. Go with the flow. Try to be flexible, adjusting schedules to baby's needs rather than trying to follow fixed schedules suggested in books or by friends.
  • Get enough rest. Avoid overexertion. Rest, meditate, and sleep when baby sleeps. Baby's naps are not the time to catch up on household chores or phone calls.
  • Express bothersome feelings. Find people-spouse, friends, family, or a support group-with whom you can share.
  • Exercise every day. If weather permits, take your new family member outside. A brisk walk on a beautiful day can lift your spirits. Check with your doctor before starting any exercise program.

Need To Know:

What if it's too late for a postpartum plan and you're in the throes of depression? Find a quiet half-hour with a spouse, friend, or family member to identify stress factors and brainstorm solutions. You can't solve everything all at once, but you can take positive steps toward feeling better if you simply slow down and work things through. Having someone do this exercise with you will help you remain more objective even though you are feeling overwhelmed and trapped.

How-To Information:

Tips to Relax

A few minutes of quiet time each day can help to reduce your risk of depression after pregnancy, or to restore equilibrium to your life if you are feeling blue. Here are some simple exercises you can do:

  • Sit in a comfortable chair, close your eyes, and breathe deeply. You can even practice childbirth breathing techniques. Breathe in and out slowly, concentrating on your breathing. (3 minutes)
  • Sit quietly and pay attention to noises, smells, and feelings. Think about the details of these stimuli. What do you hear? Smell? Feel? If your mind wanders, gently return to the smells and noises around you. (5 minutes)
  • Sit down where you are and notice the environment around you. Notice the dirty dishes, unfolded laundry, unopened pile of mail. Try to notice these things without passing judgment and without using the words, "should," "ought," or "must." This form of "detachment" is a particularly helpful technique in keeping your expectations of yourself in perspective. (3 minutes)
  • Step outside. Notice nature-trees, clouds, sun, flowers, birds. Take a few moments to water the flowers or repot a favorite plant. (5 to 10 minutes)
  • Keep a journal. Write down the things you accomplished each day. It may be eating a healthy lunch, or spending a half-hour rocking baby or reading a story to an older child. Give yourself credit for the things you do, not criticism for the things that you don't do. If you find yourself thinking about all the things that didn't get done, gently bring your mind back to your accomplishment list. (5 to 10 minutes)
  • Indulge yourself. Use a rich hand lotion. Give yourself a quick manicure or pedicure. Apply a favorite perfume. (5 minutes)
  • Listen to soothing music or uplifting motivational tapes. (15 to 30 minutes)

Depression After Pregnancy