Postpartum Depression: More Than Just the Baby Blues
by James Windell

Kathy had what she described as a wonderful pregnancy. Having her first baby was exciting and she enjoyed everything about being pregnant from growing a belly to shopping for maternity clothes.

Although she had planned to work until a week before her expected delivery date, she became so emotionally and physically fatigued she stopped going to her office in her seventh month. During the final weeks of her pregnancy, she was feeling frightened about both the delivery and being responsible for another human being.

"I kept thinking it was nervousness about the health of my baby and becoming a mother," Kathy recalls, "but I thought once the baby was here, I’d be all right." The day she gave birth, Kathy was amazingly calm, even a bit detached. "I actually felt indifferent when my husband was holding our baby for the first time," Kathy says, "like the baby didn’t really belong to me." Once she was home, Kathy crawled into bed and withdrew from her baby, her husband and her friends. Within a few days, Kathy said to her husband, "I want to give our daughter away so I can have my life back the way it was before." From that point on, Kathy cried continuously and felt like she had ruined everyone’s life by bringing a baby into the world. In contrast to the 75 percent of all new mothers who experience a temporary feeling of being blue right after the birth of a baby, Kathy’s experience wasn’t temporary; she was experiencing postpartum depression.

Postpartum depression is a serious disorder that occurs in 10 to 17 percent of all mothers. It’s a disorder that presents itself as a unique combination or mixture of symptoms from more than one traditional disorder. But postpartum depression is different from all the other mood disorders (such as bipolar depression, anxiety, obsessive compulsive disorder and posttraumatic stress disorder) in that it’s the only one that is caused by hormonal and neurotransmitter imbalances.

The effects of this disorder vary in severity. When women with postpartum depression look back at their pregnancies, many of them see that they had depressive symptoms during their pregnancy but didn’t notice them. When they delivered, their symptoms worsened and it was increasingly difficult to ignore how they felt. One of the most important differences between the baby blues and postpartum depression is that the baby blues tend to go away on their own within about two weeks. Postpartum depression lingers and women frequently hide what they’re going through while at the same time feeling devastated and ashamed. Some feel like they did something wrong to cause their depression, and others have a strong feeling that they "should" be able to control their symptoms. Far too many women with postpartum depression consistently feel depressed, but don’t ask for help until someone usually a family member, insists they get help.

While postpartum depression has always been around, interest in the disorder was generated by two events. One was the release of Marie Osmond’s book ("Behind the Smile: My Journey Out of Postpartum Depression") and the Andrea Yates case both in 2001. Prior to that year, postpartum depression was considered a shameful condition that was talked about, if at all, in hushed tones.

The spectrum of this mood disorder, which begins with a dip in the hormone levels, can range from an acute period of depression to a more prolonged major depression that can be totally debilitating. Your mood may be very low all the time, or it may swing dramatically from the depths of despair to a feeling of elation in a short period of time.

Typical features of postpartum depression include a depressed mood that you just can’t shake that keeps you from experiencing life and your baby in the way you expected. For some women, there is a component of anxiety that ranges from feelings of excessive worry, to racing thoughts to panic and obsessive behaviors.

If you are feeling depressed or anxious during your pregnancy or even as late as 12 months or more following childbirth, it’s possible that you may have postpartum depression. It often masquerades as marital conflict, sexual disorders, a fear of caring for your baby, or even doubts about whether or not you’ve made a mistake by having a baby.

If you are frightened and distressed by the thoughts and feelings you have, either during pregnancy or after giving birth, you should contact an expert in postpartum depression. The good news is that the disorder is treatable. Many women, once treatment begins, can begin to experience a lifting of their depression within a relatively short period of time.

James Windell is a family therapist in Bloomfield Hills, Michigan and the author of several parenting books. His latest book, co-authored with Ronald Rosenberg, M.D. and Deborah Greening, Ph.D., is "Conquering Postpartum Depression" (Perseus Publishing, 2003), available at book stores everywhere.