Chapel Hill NC and Cary NC

New Baby Blues: Depression after Childbirth (*)

Six months after the birth of her first child, Carrie still cried at the drop of a hat. Even though the baby was sleeping through the night, Carrie found herself schlogging through the day, exhausted and irritable. The simplest tasks seemed to take herculean effort. Carrie started blaming herself, thinking maybe she didn't love her baby.

Carrie does love her baby. She just happens to be one of countless American women who suffer an episode of depression in the weeks or months after the birth of a child.

Postpartum depression is often overlooked and probably under-diagnosed. After all, the birth of a child is a time in our lives when everything in our social and cultural scripting says we should be joyful.

When instead of pure joy we feel joy mixed with all these other negative emotions, it contradicts our most fondly held myths about motherhood. But most of life is mixed, and so is motherhood. Unreasonable expectations abound in a society where women expect to be back in shape and back at work in the blink of an eye.

The term postpartum depression has been used to describe a variety of symptoms of emotional distress that occur after the birth of a child.

Some of what gets labeled "new baby blues" is probably hormonal. Some is probably not much different from the feeling of emptiness that one gets on certain holiday mornings after all the packages have been opened. Nine months is a long time to sustain excitement and anticipation without some letdown. This package coos and gurgles, but it also wails. Sleep deprivation is not for the faint hearted.

This kind of postpartum depression, which lasts only a few weeks and is self-limiting, is estimated to affect between 50-80% of women who give birth in the U.S.

When the "new baby blues" last more than a few weeks, or when the blues blacken into depeer shades of depression, a woman should get help. Clinical depession is thought to occur in 10-20% of women and can last for months.

It is important to seek professional help for clinical depression because it can be a serious condition. Untreated, depression can worsen, can have a negative impact on the baby, and can strain even the best marriage.

Depression is an emotional disorder that can manifest in various ways. It usually involves a sad mood that is hard to shake, but sometimes can involve irritability or worry. Some people complain about not being able to enjoy much of anything anymore.

Sometimes a dramatic weight gain or weight loss will accompany depression. Sleep disturbances - either not being able to get to sleep or sleeping too much, can also be symptoms of depression.

Being noticeably keyed up or slowed down, feeling fatigued, feeling worthless, or feeling guilt out of proportion to any real fault, and being less able to think or concentrate are all symptoms that could point to a clinical depression.

Adam and Marcie are a fairly typical middle class American couple. When baby Ashley was born, Marcie adjusted pretty well. She started exercising right away, and the weight she had gained during pregnancy came off quickly.

Ashley was an active baby, and Marcie loved being a mom. Six weeks of maternity leave went by in a flash, and Marcie was back at work juggling executive meetings and day care. But Adam wondered where his wife had disappeared to.

He missed their long walks, and the way they would talk about everything. Whenever he tried to be romantic, Marcie seemed far away. Truth of the matter was she always had an ear out for the baby. She lived poised to jump at the slightest whimper.

Adam started staying at work later. When he came home, he was either online or reaching for a beer. It wasn't until he realized that he was drinking just so he could get to sleep nights that he decided he'd better get some professional help.

Adam was clinically depressed. Marcie was running as fast as she could to live up to the supermom role she had set for herself, and doing a very creditable job. But the marriage was miserable.

The latest researchfrom a national longitudinal study, called the Early Childhood Longitudinal study being conducted jointly by scientists at Eastern Virginia Medical School and The University of Colorado at Denver, confirms that 14% of new mothers experience clinically significant levels of postpartum depression and 10% of new dads experience the same. Clearly, hormones are not the whole picture. Hormones are life’s amplifiers but they don’t cause depression all by themselves. Even the studies that were able to induce depression in women by artificially replicating the drops in hormones that happen after pregnancy and delivery, were only able to do so in women who had already experienced at least one episode of clinical depression. But expectancy effects, the ways that paying attention to slight changes in our bodies can influence our moods and emotional states, were not controlled for in this experiment. A great deal of research exists showing the importance of expectancy effects. In fact, the power of expectations to cause real physiological changes is what the placebo effect is all about. And the FDA requires that any drug put on the market must show that it is better than placebo—in other words, better than 35% effectiveness.

The birth of a child is a major life change that affects both men and women. Each has a new role as parent, but each also has a new role in their relationship to each other. Suddenly, a couple becomes a family, and that means the marriage has to be redefined.

The pressures of careers and budgets can make finding time together a challenge. And yet finding ways to nurture the marriage is crucial.

Get professional treatment if you feel trapped with nowhere to turn, if you can't seem to get away from worry or from feeling guilty. Get professional help if the way you feel is affecting your sleep, your eating habits, your job, your relationships, or your everyday life. Get help if you've tried to pull yourself together, but it just isn't getting any better.

Get help if you need it. And take care to protect your relationship. Make it a priority to spend time alone together. And don't forget to open your eyes, and see, really see, your mate.