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Dr. Jones: You just had a baby and you're feeling a little or a lot overwhelmed. Surely this is common, but is this postpartum depression?

Being overwhelmed with a new baby is common, whether this is baby number one or baby number three, but when does this feeling of being overwhelmed suggest that the problem is more serious for the new mom and the baby?

Today, we're going to talk about postpartum depression. And in the virtual Scope Studio is Jamie Hales. And Jamie is the board co-chair for Postpartum Support International, our Utah Chapter, and she's a clinical manager of the Huntsman Mental Health Institute. Thank you very much for joining us, Jamie.

First of all, let's just dive right in. Well, what is postpartum depression? Why is it something different than just, "Oh my god, I'm sleepless and I'm overwhelmed"?

Jamie: Well, you've hit it right on the head. I mean, those are completely normal things that can happen with pregnancy, right? You're sleepy, you're feeling like you're not quite yourself, but I think that there is a difference for sure between really struggling with postpartum depression versus having what we would typically kind of term as the baby blues.

When we're thinking about postpartum depression, it's really more stuff that doesn't just come and go, right? After a couple of weeks having your baby, if you are still just really not feeling like yourself, and not sleeping when your baby is able to sleep, and possibly more irritable or more depressed, having thoughts of hurting yourself, anything along those lines, it's probably more likely to be heading into the territory of perinatal depression or anxiety versus just kind of a normal adjustment to having a baby.

Dr. Jones: Right. So I think all of us, particularly as new moms, feel like we are imposters, meaning we feel like someone gave me this baby and I don't know what to do. For new moms, we're all amateurs, but it's that feeling overwhelmed with this and being inadequate. "I can't do this. I need to check out. Someone needs to help me." But often women don't reach out for help. How common is this?

Jamie: It is absolutely the most common complication of pregnancy, which is why we need to talk about it more often.

I mean, if you really think about it, as an OB-GYN, you screen women for gestational diabetes. You screen them for gestational hypertension, any of these things that could happen. But it's been relatively new in practice to make sure that we're actually screening for postpartum depression and anxiety.

It impacts 1 in 10 men, which a lot of people don't think about, but it also impacts probably closer to 1 in 4 women, even though the official statistic is 1 in 7.

Dr. Jones: Right.

Jamie: And that's just because it's under-reported, is really what it comes down to.

Dr. Jones: I think the old-fashioned and probably still prevalent practice is you see women, deliver them, you see them for a day for postpartum, and this is the doctor, and then you have them come back for their six-week visits. But by that time, they've sunk or swum.

So, in Europe and in England, there's a midwife who goes and does a mom check. And unless we check at two weeks or three weeks and say, "How are you doing? Do you need help?" by the time six weeks comes along . . .

And a lot of women don't even come to their postpartum visit. We don't pick up as much as we should. So we are counting on the woman or her family, and that's why we're doing this podcast, this topic. When women or their family members see this happen, they need to reach out. So what should they do?

Jamie: I think that absolutely is key. As providers, if we see people, we absolutely want to make sure that we are asking every one of our new moms, "How are you doing?" Not, "How's the baby? How are you healing physically?" We have to really talk about, "How are you doing emotionally?"

And you're right, we may not get women in for those two-week or six-week appointments because sometimes insurance has changed or they're just feeling so underwater already that making it in for one more thing is really, really difficult.

My advice always to family members and to women in general is to speak up. If you really truly feel like your motherhood experience is just not going the way that you would thought that it would, getting around that stigma and actually saying, "I'm struggling. I don't know that this is normal," is a really helpful thing to do.

I think that there are a lot of people out there who have resources, and have the ability to jump in, and try to help you feel better, and to start getting back more to what your baseline was before you had a kid. So I think that that's a big piece.

And then for family members, please, please, please ask and make sure that you are paying attention to the emotional needs of those new parents, because it is harder for people to speak up and say, "I'm having a hard time."

Dr. Jones: Yeah, and it's not necessarily . . . You could have flown through the first one, but maybe you're not flying through the second, or maybe you had postpartum depression the first time and you didn't have it the second. Although women who've struggled with mental health issues before are a little more likely to have postpartum depression. Do I have that right?

Jamie: Yes, that's accurate. You're absolutely right. You could cruise through four pregnancies and not have any real postpartum symptoms. And then with that last one, you do. Or you could have really, really rough postpartum depression the first time and then not have it with your subsequent ones.

So it's important to make sure we're checking in with people during all of these different points in their motherhood journey to see how they're feeling. Dr. Jones: So if a woman has come right out, what do you do? As a reproductive endocrinologist, I think this is potentially the biopsychosocial model, meaning the psychological makeup of the individual matters, the social environment may matter, but there's the biology of having a hormone crash, and some women are vulnerable to that.

So when you think of these three parts that make up any kind of illness we might have, how do we approach this in terms of treatment?

Jamie: I'm really glad that you brought that up, Kirtly. I couldn't agree more. I mean, you do have this major hormone change that happens once you give birth, just the lack of sleep and all of the social factors that can change.

I think for a lot of people, becoming a mother is great, and maybe it was something that they were really excited about. It also could be the opposite. And it can be really tricky, I think, for people to recognize that all of those experiences are valid. So we want to de-stigmatize this as much as humanly possible.

Then you add the other kind of psychosocial factors into it. I mean, if you're in a difficult home situation or you don't have financial resources the way somebody else might, these are all things that could put a woman more at risk for experiencing complications. So it's good to assess really, I think, the full person.

Dr. Jones: It's a thing about humans. We're the only mammal species, we're the only primate species that shares our baby. We are willing, as a social group, to let others keep an eye on our baby. So you can say, "I really need to go for a walk. I need some help. I would love to just have 10 minutes to myself."

But there are people who need an evaluation. And at least for those of us who are OBs, we always think they need to check their thyroid because low thyroid can be a player in this and it's not uncommon. But some women need medication. I would think that even group therapy would be ideal for this, to hear other women struggling. Is that something that's at all available?

Jamie: Oh, absolutely. There are a number of group therapy options out there for people. And I think what makes that so effective as an option is really that peer support. Being able to hear the stories of other women and just recognize that you're not alone in what you're experiencing really goes a long way toward helping them understand that it's not a normal complication, but it's definitely a common complication to experience these things. It goes a long way toward getting that stigma to not feel as acute.

Dr. Jones: So how long does it last? I mean, does it have its own natural course?

Jamie: So I think because of some of the biological factors, there is a course that comes along with it. I mean, we see a lot of people start to feel better again as they get toward the end of that first year, just because there are so many things that come up during that year, so many really positive milestones and also just lots of challenges that kind of come along with the experience of being a new parent.

When we really think about, "Is this postpartum versus something else? Is it pre-existing depression? Are there other complicating factors?" I always think about what was your emotional state and your experience like before you had this baby?

And really, if something changed with your pregnancy or in your postpartum experience and you're having struggles down the road, but you can still kind of pinpoint, "Yeah, that's when things really got to be a struggle," I think it's okay to still refer to that as being a perinatal mood and anxiety disorder.

I have worked with people who are several years out from their birth experiences and they're still sometimes coming in to talk about birth trauma or navigating being a parent, and they're years out.

Dr. Jones: I think all births are pretty traumatic.

Jamie: Yeah, that's fair.

Dr. Jones: This is just me. It's like, "Oh my God, how did that baby ever get out there?" But I think that there are women who come in with this hope for experience, and what happened wasn't really what they planned and they can't let go. They're healthy baby, healthy mom, but they have problems. And so that is a special subset of problems around birth.

Jamie: And I'm really glad that you bring that up, especially that last piece, because what we as providers may think of as, "Oh, that was a traumatic birth," there are some that you can look at and be like, "Yep, on paper, absolutely that was a terrible experience."

And then there are a lot of other people that maybe they don't have that exact presentation of what it could have looked like, but we're not there inside them experiencing it, or even for partners watching it. And it's always important to ask people about what their experience was like rather than assuming just because Mom is healthy and baby is healthy that everything is okay.

Dr. Jones: Exactly. I think it's getting back to asking the mom how she is. But when is this problem an emergency? A woman isn't feeling well, when does either the patient or . . . And sometimes a patient can't recognize it, but a family member say, "She needs help right now, today, this minute."

Jamie: Like with any other condition, mental health conditions can definitely come in varying degrees. I think there's always an argument to be made for if somebody is not doing well, jump on it and get them in and give them a safe place to be able to tell their story and potentially be able to get on medication. Sometimes that can take some time.

What I would say, all the way on the other end of the spectrum, is if you are working with somebody or you have a family member or your partner or somebody else who it seems like they've really lost touch with reality, and there could be some postpartum psychosis onboard, that is something that we absolutely consider to be emergent.

So there is a difference between having really kind of scary, intrusive thoughts. That can be something that can come along with just having postpartum anxiety or postpartum OCD. But if somebody is having all kinds of strange, outlandish thoughts about themselves or the baby, and it doesn't bother them, or it seems like it's something that really truly isn't connected to reality, I would make sure that you check in and get them some help pretty quickly. Same thing with suicide as well, suicidal thoughts.

Dr. Jones: Yeah. So if a woman is thinking of either harming herself for her baby . . . I mean, we do have mental health professionals in our emergency rooms . . .

Jamie: Yep, absolutely.

Dr. Jones: . . . who are aware and know what to do. So if that's what it takes, you just need to pack everybody up and come right in and get help right away.

Jamie: One of the things that I hear . . . and I'm sure you do as well. I've heard from plenty of parents, "I didn't want to say anything, because I don't want people to think I'm crazy," or, "I don't want them to put me in the hospital or pack my baby away to somebody else." The reality is that is not something that happens very often at all.

Dr. Jones: No. It's very uncommon.

Jamie: Yeah, it's a big fear people have, and I think it's a big barrier to having somebody come in sometimes to actually talk about these things. But that's so unlikely that something like that would ever happen. I mean, everyone's thought is trying to make sure that both you and your baby are being served and taken care of, and nobody likes separating you guys out.

Dr. Jones: Yeah. Well, as we wrap up, I think it's important to know that this is common. I know people want to be the ideal mother, but ideal mothers get depressed. And it's very important for your own mental health and for your baby's mental health, because your newborn is keyed into who you are.

So if you or a family member is depressed and struggling, that baby is struggling too. So all of us need to chip in. It takes a village to get a mom and a baby through their first year. And the more that we are attuned, the more we ask, the more likely we're going to have a healthy baby and a healthy mom make their way to Year 2. What fun.

Jamie: Yep, that is very true.

Dr. Jones: So, Jamie, thank you so much for joining us. And for all of you who are listening, thanks for joining us on The Scope.

This is your brain on hormones. This is your brain off hormones. This is your brain just right. Sounds like Goldilocks? There's a new treatment for postpartum depression that aims to make this better.

About one in seven women will suffer from postpartum depression. This isn't just a couple of days of feeling overwhelmed with the baby blues, something most of us felt in the weeks after a baby is born. This is overwhelming depression and inability to care for oneself and one's newborn. Neuroscientists have always been interested by the effect of sex steroids on the brain, estrogens, progestin, and testosterone. Those of us who practice reproductive endocrinology like me have a particular interest in progesterone and its metabolites, the molecules that the brain makes out of progesterone.

Progesterone and its brain metabolite allopregnanolone seem to make the brain less irritable. And falling progesterone at the end of the menstrual period may have a role in PMS in some vulnerable women. Progesterone is the most abundant hormone in pregnancy and some think that dramatic drop in progesterone after birth may have a role in postpartum depression.

For most women with postpartum depression, it seems to go away in weeks to months, but some women benefit from talk therapy or the usual antidepressants. But that can take weeks for a measurable difference. Until now, the therapies focused on postpartum depression have been based on the same principles and medication as depression that happens to men and women who haven't been recently pregnant. However, looking at the link of falling progesterone and its brain metabolite allopregnanolone, some researchers have wondered if administering allopregnanolone to women with severe postpartum depression who aren't benefiting from regular therapy might be an approach.

A pharmaceutical company has created allopregnanolone in the lab and call it Brexanolone. The research focused on women with severe postpartum depression who are randomized to a 60-hour infusion of Brexanolone or placebo. The women were within six months of giving birth and had experienced depression within a month after delivery. These women were very depressed. Starting out with an average score of 28 out of 30 on a standard depression scale, that's really depressed.

After the infusion, right after the infusion, not weeks later, women who received the Brexanolone had an average score of nine to 10. And women who received placebo had an average score 14. That meant that placebo works which we know from all studies of antidepressants but the Brexanolone worked better. Twice as many women who received the study drug had scores similar to non-depressed women than women who received placebo. The effect lasted for up to 30 days and maybe longer. And this might be enough for other therapies to take hold.

It has some drawbacks. One is that the infusion has to be done in a hospital setting as one in eight women had dizziness and several women temporarily lost consciousness, passed out. The drug itself has an average cost of $34,000 but there may be some ways that insurance or rebates from the drug company might help. And there is the cost of the infusion in the hospital-based monitoring.

The pharmaceutical company is currently studying an oral form of this hormone though they don't call it a hormone. It looks and acts like a naturally occurring hormone allopregnanolone and that's made in the brain, so I call it a hormone.

The most important aspect of those women who had this treatment is that it worked so quickly. We're all concerned that women with postpartum depression get diagnosed, get into treatment, get family support, and get the best therapy. The consequences for the new baby and for the family of a mom who's withdrawn and possibly suicidal is very significant.

So, this therapy isn't necessarily for all women with postpartum depression but for women for whom regular treatment isn't working and who are struggling to care for themselves or their baby. It's an innovative approach and it's good news for the women, their babies, and their families who are struggling at a pivotal time of their lives. So, take care of yourself and your baby. Get help if you need it. There's new stuff on the way. And thanks for joining us on The Scope.

Dr. Jones: Moms are most likely to experience depression in their mid-30s and 40s. Well, is that because it's the time of life, or is it because they're the moms of teens? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care, and this is The Scope.

Announcer: Covering all aspects of women's health, this is The Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: A recent study of over 2,000 mothers with children from newborns to early adulthood looked at levels of anxiety and depression in these mothers. We all know that post-partum depression is common, affecting about 12% of women who just had a baby. That feeling of being overwhelmed, being inadequate to the job of being a mom. Depression and anxiety is well-described, and clinicians are ever more focused on identifying moms with postpartum depression and helping them get better.

However, what this new study published in the Journal of Developmental Psychology suggests is that moms are more likely to be overwhelmed and depressed when their kids are early teens than when they're newborns. What's going on here and what shall we do about it?

Firstly, being the mom of teens is much harder than being the mom of a healthy newborn, even if it's your first baby. Babies are moderately predictable. Yes, you get sleepless, but usually you have the tools to figure out what the baby needs and get the job done. There is a very significant hormonal shift after giving birth that can upset the emotional applecart for women.

They're vulnerable, but for most women, the combination of increased awareness, social and psychological help and occasionally, some medicine, gets most women over the hump of postpartum blues in about a year. The baby starts to smile and giggle, you feel more comfortable in your role, and things are still pretty well-defined.

But being the mom of a teen is really hard for many women, and at least a baby will give you a full-on genuine smile once a day. There's no guarantee that an early teen will give you a smile once a month, one that isn't a little twisted with a "Gotcha." They're pushing the boundaries of their bonds with their mom, and it isn't very pretty and it isn't very predictable.

The solutions to their own unhappiness isn't found in a simple checklist. Are they doing drugs? Check. Are they having sex? Check. Are they really going evil places in the Internet? Check. Are they being bullied? Check. Will they even talk to you? Check. Mothers with kids this age have the highest level of stress and loneliness of moms of kids at all ages, and the lowest levels of life satisfaction and fulfillment.

The second possibility is that some of the same hormonal re-wiring of the kids' brain is happening in the moms' brains. The study looked at "well-educated" women who probably didn't have their kids when they were 15 and now they're just 30. More likely, first kid at 25 and now they're about 40. And if they're moms of several teens, they're probably in their mid-40s. Their own hormones are less predictable.

Symptoms of women with PMS are often most prevalent and the most severe in women in their late-30s and early-40s. Our own health may be changing and our relationships may be changing. This is a time of significant stress in marital relationships, and that can add to the loneliness. It's totally unfair that our children are going through very significant mental, physical and social changes at the very time that we're going through our own. In fact, for mothers, "the mid-life crisis" is most likely when their kids are in their early teens.

The third possibility is that this is just part of the biopsychosocial phenomenon called the U-shaped curve of happiness. Studies done all over the world, men and women, rich and poor, highly educated and less educated, millions of people studied show that the levels of happiness are relatively high in the late teens and early 20s, lowest in the 40s, and starting to rise up again about 50, and are the highest in the late 60s to 70s.

Is the U-shaped curved with the bottom of the U of happiness coinciding with the time that most of us have early teens? There are many reasons proposed for this, combined with crazy teens, tough marriage, aging parents, perception there is more good years behind us than ahead of us, and physical aging. The U-shaped curve of happiness is the same for men and women, so it can't be blamed on menopause or pre-menopause.

So what's to do? There are lots of blogs, hotlines for new moms. There are movies and pop stars coming out to talk about their postpartum depression, and it's all the rage. But mid-life moms are on their own, and they don't need to be. The answer of mid-life moms who are tweens who struggle, they share the same similarities with those other new moms. Let's get someone to talk to, someone who's there or has been there. Maybe your mom or sister, or maybe not. Be assured that your friends with the kids of the same age are going through the same things.

Get a group, go out to dinner with your tweenie-mom friends. Giggle a little, reach out to them. You know the kids who are in trouble, more trouble than your own. Reach out and help someone else. Get out of your own head and share with others. Just get out, go for a walk, take an exercise class. Best of all, go for a walk with other tweenie-moms. Many moms had a support group called a playgroup when their kids were little. Now, you should invent a tweenie-moms playgroup for moms to go get out and play.

But sometimes, this won't be enough. If you need more help, and there's no shame in asking for it, healthcare professionals know about this mid-life slump and can help. Women in trouble can get better with therapy, and sometimes a medication can help. It is often a hard time for the kids, the partners, the entire family, but remember, in the event of a sudden loss of cabin pressure, put on your own mask first.

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Interviewer: If you're feeling a little bit overwhelmed with your newborn, it's totally natural because it's hard having a newborn. We're going to find out exactly what that means, and hopefully reassure you coming up next on The Scope.

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Interviewer: Dr. Sonia Van Hala is with University of Utah Health Care and one of things she likes to reassure her patients about is when you have a newborn, it's hard. It's difficult. And you find that your patients come in and they think that they are inadequate in some way because it is hard. Tell me a little bit about that.

Dr. Van Hala: Babies are remarkable in so many ways, and especially remarkable in how they really turn your world upside down and you're trying to figure out, how do I right things? The biggest thing that parents are challenged with is when things aren't going according to their expectations. We talk a lot about this as we're approaching the delivery date. I deliver babies as well. Just in being flexible and thinking about what's reality going to look like.

The arenas that I see the big challenges happening are in breastfeeding. When breastfeeding is hard either because of too little milk, too much milk, difficulty with the latch. Just having to work really hard at it, so breastfeeding is a common concern.

Also sleep deprivation. Trying to figure out how to manage with not a full nights worth of sleep. I think one of the big things with that is, just trying to not do too much because if you expect to carry on with your regular life while you're figuring out how to have a newborn, well that's a bit too much at that time. You can postpone those other things until a later time. Focus on your newborn first.

Interviewer: Take it easy on yourself.

Dr. Van Hala: Take it easy on yourself. Then, the third issue would be the fussy baby. There are a lot of really unfussy babies out there. When you see them you think "Oh, that's just lovely" and that's really hard when your baby is not one of them. I know because I had two fussy babies myself. So I really have a lot of heartfelt empathy for those parents who come in concerned about the baby that just cries a lot.

For those parents I say bring your child in as many times as you need, if you are worried about something medical going on. So that your doctor can check your child to make sure your child is well and there is nothing that's being missed.

Also know that babies do cry. The range of temperaments between babies is quite broad and it's very normal. The other really important piece is, it's temporary. So your baby will eventually stop crying and you will eventually have a good relationship with your child.

Interviewer: You said early on that parents come in with expectations about what's it's going to be like having a newborn. What are some of the expectations that they have that aren't quite in tune with reality and I think these answers should be something like, when a parent hears it they're like, "Oh, that's me. I'm expecting too much, maybe I should be more over here."

Dr. Van Hala: I think it falls into some of the arenas I just mentioned regarding feeding, temperament, sleep. Also, your emotional response to that. It's pretty common for parents to, especially moms, who are tired, who are trying to breastfeed, and do all this new stuff, to feel overwhelmed, to maybe not feel so delighted to be with their child all the time and then have guilt surrounding that.

Interviewer: Because what good mother would not want to be around their child all the time? Right? Isn't that the expectation?

Dr. Van Hala: Right, right and then they judge themselves and get down on themselves. You know what? That is totally normal, but I really encourage my moms to just be easy on themselves. Recognize this is a hard job and they will make it through it and they will have a good relationship with their child when they get through it. Sometimes people are worried about the quality of time that they're spending with their child when they are not feeling as positive as they had hoped they would be.

Interviewer: But that time is just the same to the child.

Dr. Van Hala: It is.

Interviewer: All that other stuff is our internal thing.

Dr. Van Hala: Yes, that's exactly right.

Interviewer: What about parents that see other parents on Facebook and think "Their life's is so perfect."

Dr. Van Hala: Yeah, Facebook.

Interviewer: Just judging yourself against other parents and how other parents experience are going and not knowing the whole story. Does that happen a lot?

Dr. Van Hala: Absolutely. Well I think it's common and popular to post the good and fun things in our life. We don't want to be posting all the stuff that's sort of a downer. That can be a disservice to parents with a newborn. If all they're seeing is these positive images, and then they're looking at themselves and saying "That's not me, what's wrong?" When really, there's nothing is wrong. Their experience is normal. It's also temporary

Interviewer: What's that last piece of advice you'd have for a parent that is struggling with these things. Just be sweet to yourselves?

Dr. Van Hala: Yes, absolutely. Be kind to yourself. Gentle, loving, kindness. Right? Also seek a support network, people who can help you out and reach out to them and do ask for help. A lot of people just don't feel comfortable asking for help, do. People want to help and they're not going to know your needs unless you speak up.

Also, important to mention, if you're feeling really down and low, you're just feeling like can't pull out it and you're not having the happiness, do check in with your doctor. Make sure you're not dealing with having postpartum depression. That's a real entity and it does affect your health, and the health of your child, and the health of your relationships. Seek support from your friends your family and also your physician.

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Dr. Jones: Your baby smiles and her whole little face lights up, but you can't smile back. What's wrong? Is it the baby blues or something more serious? This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care and we're talking about postpartum depression today on The Scope.

Announcer: Covering all aspects of women's health. This is the Seven Domains of Women's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: The birth of a child rewires a woman's brain for maternal behavior. There are huge shifts in the hormonal environment from pregnancy to the postpartum state, breastfeeding turns on the bonding hormone, oxytocin, and adds some sleep deprivation in a world turned upside down and it's no wonder that women can experience a roller coaster of emotions. What are the baby blues and what is postpartum depression, and what can a woman do, and her family do to get help?

Well, let's start with the baby blues. Seventy-five to 80% of new moms experience some emotional upheavals in the first couple of weeks after the birth of a child. It's common. It's hard to do research on new moms. No prospective randomized trials, and we don't have any great animal models for the baby blues, rats. But we do know that a big change in pregnancy hormones and a drop in the levels of endorphins that got a woman through her labor and delivery might be part of the reason that women experience the following: weeping and bursting into tears, sudden mood swings, anxiousness and hypersensitivity to criticism . . . who would criticize a new mom, anyway? Low sprits and irritability, poor concentration, and indecisiveness, feeling unbonded with the baby.

I remember wondering when my new baby's mother was going to show up, myself. The baby blues happened in the first couple of weeks after delivery and don't last more than a couple of weeks, often just a few days. This is the time where family should be around helping the new mom get settled and get as much rest as possible with the new baby. Women without family or partner support may struggle and good news is that it happens to most women and it gets better in about a week or so.

When is the time that baby blues is possibly postpartum depression? If the anxiety and sadness continue the first couple of weeks and gets worse, this is more likely postpartum depression. Postpartum depression affects 8 to 15% of women, about one in eight. The symptoms are similar to depression, in general, overwhelming fatigue or loss of energy, severe mood swings, withdrawing from family and friends, reduced interest in activities you used to enjoy, feelings of worthlessness, shame, guilt or inadequacy. This list makes me sad just to say it out loud.

Where baby blues are common and short-lived, postpartum could go on for months and it should be recognized and treated for the sake of the mom and the baby. The women who experience postpartum depression may not even know what's happening. Families and partners need to be aware that the new mom's in trouble. Treatment is very helpful and can include talk therapy with a psychological therapist and medication can be important. Women who realize they don't feel well emotionally should call their doctors or midwives, or pediatricians and they can be referred appropriately.

There's one other postpartum psychological problem that is a medical emergency. Postpartum psychosis is very rare but serious disease that can develop within the early weeks after childbirth that's marked by a loss of contact with reality. Women may have hallucinations, hearing or seeing things that aren't real that say bad things about them or their baby, they may have delusions about themselves or their babies that are paranoid or irrational, they may show extreme agitation or anxiety, they may have thoughts of harming themselves or their babies.

This is a devastating condition for the new mom and the family and needs immediate medical care. New mom showing these problems should be brought to the medical care right away and often need to be hospitalized to protect themselves and their babies. The good news is that we're better at recognizing and treating women with postpartum mood disorders. We need to get the word out so that women and their families, that it's okay to ask for help, and they can feel better. So let's all go smile and talk to that little baby and thanks for joining us on The Scope.

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