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Postpartum Depression

Postpartum Depression: Patient Information Sheet
What does postpartum depression feel like?
• "It feels scary."
• "It feels out of control."
• "It feels like I'm never going to feel like myself again."
• "It feels like each day is a hundred hours long."
• "It feels like no one understands."
• "It feels like my marriage cannot survive this."
• "It feels like I'm a bad mother."
• "It feels like I should never have had this baby."
• "It feels like if I could only get a good nights sleep, everything would be better."
• "It feels like I have no patience for anything anymore."
• "It feels like I'm going crazy."
• "It feels like I will always feel like this."

Why did this happen to me?
There is no single cause or reason. PPD is a condition that results from a combination of biologic, hormonal, environmental and psychological factors. It is most often influenced by a number of risk factors, some of which may include: dramatic hormonal changes, unexpected childbirth experience, chronic sleep deprivation, your family's medical history, your previous experience with depression, (particularly PPD), recent losses, lack of social support, environmental stressors, high-needs infant, perceived loss of control, unsupportive partner, history of abuse. It's important to note that PPD can strike women with no risk factors, too. It is not fully understood why it happens to some women and not to others, but we do know exactly what to do to treat it. For each woman with PPD, the combination of factors that cause it are unique.

Will this ever go away?
Yes. Postpartum illness is more common than you might think. It is a real medical condition that affects 20% of new mothers. It is not your fault. It did not happen because you are weak, or thinking the wrong things, or because you are not a good mother. PPD is a mood disorder characterized by a cluster of symptoms (which are present most of the time during a period of at least two weeks) which can include: weepiness, irritability, anxiety, sleeplessness, loss of appetite, excessive guilt, difficulty concentrating, obsessive thoughts, panic, feelings of sadness, hopelessness, thoughts about death, general fatigue. These feelings and thoughts - which can make you feel like you are doing something wrong or simply not handling motherhood very well - are symptoms which respond well to treatment.

How do I know if I have postpartum depression or if what I'm feeling is normal?
Trust your instincts. If you think something is wrong, it probably is. That doesn't mean anything terrible is happening. It may mean you are overwhelmed and overloaded and need some down time so you can get things back on track. It is possible for you to be experiencing what we call Postpartum Stress Syndrome, which is not a clinical depression, but rather an adjustment disorder that is self-limited and responds well to supportive intervention. Baby blues, which is marked by feelings of sadness, fatigue, anxiety, occurs shortly after birth and lasts for a few days to a couple of weeks. Postpartum Stress Syndrome and Postpartum Depression can emerge any time during the first postpartum year. If you notice that you are feeling worse as time goes on, it's important for you to let someone know how you are feeling. Do not let feelings of guilt or shame or embarrassment get in the way of you doing what you need to do to feel better.

What can I do about it?
First, focus on self-help measures, such as eating nutritiously, even if you're not hungry; resting as much as you can, even if you can't sleep; getting out of the house for a walk, even if you don't feel like moving. Avoid caffeine, alcohol, high fat and sugar foods. Talk to someone you trust about the way you are feeling. Let your doctor know. Let your partner know. Find supportive people who can help you and accept their help. Do not delay getting proper treatment. The longer you wait, the harder it is to treat.

What if I still don't feel better?
Sometimes, self-help measures are not enough. If symptoms persist for more than two weeks, you should consider seeking professional support. Ask your doctor for the name of a good therapist who specializes in the treatment of women and depression. Often, the combination of therapy and anti-depressant medication is the most efficient, effective treatment for PPD.

What can my husband do to help?
• He can encourage you to rest as much as possible.
• He can take you seriously and listen to your concerns.
• He can go to the doctor or therapist with you to get more information and support for himself.
• He can help you set limits.
• He can sit with your when you're feeling bad.
• He can tell you he loves you and remind you that you won't always feel this way.
• He can reassure you that he's not going anywhere and he can wait this out as long as it takes.
• He can give you permission to do what you need to do to take care of yourself during this vulnerable time.
• He can continue to take care of himself so he remains strong and supportive.

Is there anything else I can do to help myself feel better?
• You can stop blaming yourself.
• You can stop feeling guilty.
• You can begin to accept that you have an illness that is treatable and take the steps necessary for recovery.
• You can put yourself on top of your list of things to take care of.
• You can ask for help and accept it when it is offered.
• You can try to make time for yourself and do your best not to overload yourself.
• You can give yourself permission to rest, to exercise, to surround yourself with things that feel good.
• You can avoid people and things that make you feel bad.
• You can stay close to those who love you unconditionally.
• You can thank them for their continued support.
• You can accept your feelings, good and bad.
• You can take one day at a time, allow yourself the freedom to make mistakes and you can remind yourself that you will not always feel this way.
• You can understand that the healing process is a slow one and may not move as quickly as you would like.
• You can believe that you will feel better again.

Please inform your doctor if you do not like the way you are feeling.

2001 The Postpartum Stress Center

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