Post-natal depression or the blues?

The statistics on incidence vary depending upon the definition used. It is generally thought that depressive conditions, which begin during the first two to three months after birth, occur in about eight to 20% of post-partum women.

Post-partum blues, on the other hand, occur within a few days to a month after the birth. At first new mothers are excited, but, following their discharge from hospital and the first few days at home, the mother can experience a letdown, a sense of vulnerability and even loss. She may feel an incredible responsibility and can mourn the loss of freedom. She may feel unloved and unloveable. Fatigue and sleep deprivation play a major role in these sensations. She may feel sore and weak, and if there have been complications with her own health or that of the baby the sense of sadness can become overwhelming.

Sometimes women experience the blues when their support systems — such as their own mother, husband or friend — become less available after the first few days or weeks. The new mother, especially a single mother or one who has had a caesarean, can feel that she has no time to care for her own physical and emotional needs.

Some mothers feel at a loss as to how they are going to get everything done, and often ask themselves if they can protect and care for such a vulnerable little creature. They become frightened at the strong contradictory emotions they feel. They may love the baby to the point of tears one minute and become angry and upset the next when the baby seems inconsolable.

Support and assistance from the partner, family or friends is vital at this time. It can sometimes mean the difference between significant improvement and sliding deeper into true depression. Usually ‘the blues’ last a few days to a few weeks, but may recur during the year following the birth owing to such factors as stress or loss of sleep.

The criterion for post-natal depression is different from that of post-partum blues. It is very similar to the types of minor and major depression that may occur at any time of life in both men and women. If it begins within the first three to six months after childbirth, it is considered post-natal depression. Some experts agree that this can be extended to one year after the birth.

Criteria for this type of depression include ‘depressed moods or loss of interest or pleasure in life nearly every day.’ This must be present with at least five of the following signs:

• Markedly diminished interest or pleasure in all or almost all activities
• Significant weight loss or weight gain when not dieting, or a decrease or increase in appetite
• Insomnia or excessive sleepiness most of the day
• Agitation or slowness when handling daily activities
• Fatigue or loss of energy
• Feelings of worthlessness, or excessive or inappropriate guilt
• Diminished ability to think or concentrate
• Suicide attempt or recurrent thoughts of death.

Some women have a higher risk than others of developing post-natal depression, such as women who have a previous history of any type of depression, women with a family history of depression, adolescents, single mothers and mothers with little or no emotional or physical support.

When you feel the blues setting in, remember the three keys to prevention and treatment: rest, exercise and nutrition. I would add that obtaining a good support system is also essential.

Women who engage in a regular programme of activity every day, eat a healthy diet and rest when their baby is resting have a reduced incidence of the post-partum blues. Family or partner support is crucial to giving the mother time and opportunity to do this.

Share support & ideas with other new mums suffering from post-natal depression.

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