Search for tag: "postpartum"

Interviewer: You've likely heard of postpartum depression in regards to the mother of a new baby. But did you know as many as 10% of fathers face their own sort of postpartum depression? And it can happen before or after their child is born. But unfortunately, men are unlikely to discuss it or get support. And untreated, it can impact the emotional health of the father and his ability to be available for his baby and the mother.

Jamie Lea Hales is a licensed clinical social worker, and she specializes in helping couples with their mental health during and after pregnancy. I didn't know postpartum depression was a thing that men could have. Does it have a particular name when men have it, or is it just male postpartum depression?

Jamie: Actually, it really doesn't have its own special name. You would think that it might, but the reality is we just refer to it as perinatal mood and anxiety disorders because it can hit moms, dads, partners, grandparents, and caregivers really just in general. So it's much more broad than I think we initially realized.

Interviewer: And what causes it?

Jamie: I think it comes from a combination of life stressors, changes, loss of identity, and also the fact that your brain can change as you become a parent.

Interviewer: Wow, that's really interesting. So is it all in the brain? Is it all chemical related or are there other factors that can contribute to male postpartum depression?

Jamie: Outside of the changes to the brain, realistically when you have a new baby enter your life, whether it's your first or your fifth, there are going to be some compounding psychosocial stressors that come along with that. It is one of the biggest changes that you can go through.

Interviewer: And what kind of stressors are the most common to contributing to perinatal mood disorders or postpartum depression in men?

Jamie: First and foremost, lack of sleep. I cannot hit that one enough because it is the thing that I see over and over again. If you are not taking care of yourself, if you're not getting enough rest . . . And when I mean enough rest, I mean four- to five-hour chunks at a time. For both parents, this is probably the key to keeping yourself well.

Interviewer: Are there other types of stress guys talk about that can lead to male postpartum depression?

Jamie: When we look at some of our male patients, the pressure to provide financially can actually increase stress quite a bit because there are dueling priorities between being home, helping out, and being more involved, which we are seeing a lot more men being more actively involved in their child's caregiving, but also the dual pressure of having to be at work as well.

I mean, I don't want to completely gender that because that can 100% be the reverse as well. But it's just a lot.

Interviewer: And I've heard another major form of stress for men can be these expectations about what it's like to be a father or the kind of father they want to be. Can you tell me more about that?

Jamie: We all have this idea maybe in our heads of what parenting is supposed to be or should be. And when you actually get into the thick of it, a lot of the time, it doesn't line up with exactly what you thought it would be. And so there can be kind of an interesting grief reaction.

If you had a difficult relationship with your parent, you may have a lot of pressure on yourself to do better than they did. Or if you feel like you had the ideal parenting situation and it's not . . . And some people do. I mean, some people really do feel like, "My dad was the best. He was the best that I could possibly hope for." And then when they feel like they're not living up to what those expectations might be, that can be really, really difficult for people to accept.

And it takes some time I think, especially if you're not going to therapy or talking with somebody openly about this, to be able to resolve and say, "Okay, but I get to decide what type of parent I am going to be," and whatever that is, is okay.

Interviewer: Right. It doesn't have to be what you see on TV or in the magazines or what the guy down the street is doing.

Jamie: Absolutely.

Interviewer: We create those own realities ourselves.

How do most men experience this when they describe to you how they're feeling? What are the words they use?

Jamie: A lot of the time, it's just "I'm not feeling like myself." There's a loss of identity, I think, coming into being a parent.

And some of the symptoms that we see more frequently with men is irritability. Lots of "I've been really snappy with my partner a little bit more, just quick to anger in general."

We also see an uptick in use of substances. So more frequent use of whether it's prescribed to things that they've been given to help with sleep or anxiety, or even just increase in alcohol use because there is that stress and trying to figure out how to kind of mellow out. That's something that we see pretty frequently.

Interviewer: Are some fathers more likely to be impacted by male postpartum depression than others? Are there some things we know?

Jamie: Definite risk factors are preexisting mental health conditions. You are far more at risk for experiencing a PMAD if you are already struggling with mental health conditions.

Now, that being said, it does not mean that it will necessarily get worse. It's just something to be very much aware of, which is why we talk about a lot of this from a preventative standpoint.

Also, if you are somebody that has struggled with depression or anxiety prior to having kids, staying on your medication and continuing to work with that is going to be pretty key.

Another risk factor that I would definitely want to touch on is when a pregnancy is unplanned or unwanted and you haven't had adequate time to truly process through that and kind of wrap your head around it, that can be a risk factor as well.

So I highly encourage people who are in maybe a situation that they're not 100% sure about to talk with their partners about it well in advance during the pregnancy so that you can work on communication and really just work on trying to set yourselves up for a healthy plan for self-care once baby actually gets here. It's important for both people, and I always like to include both partners as much as I can in our process.

Interviewer: At what point, if a guy recognizes some of the symptoms you talked about, should he be concerned and seek some additional help to get some tools to help get through this time?

Jamie: If you notice it at all, if it's really impacting your day-to-day life, it's impacting your relationships, impacting your work, that's a great time to reach out and get some help. I think that there is benefit potentially to getting on the internet and looking at some just online resources, just trying to understand it better and get some education.

Interviewer: And of course, make sure that the resources you're reading are reputable from medical institutions, that sort of thing. Are there other resources online you like?

Jamie: The online resources I do really enjoy because I think it's a good way for dads to find a community of people who are struggling with the same things and are being open about it without having to search too hard or run the risk of feeling like the person in their life is just going to say, "Well, suck it up."

If it looks like it is getting worse or you just don't quite know how to wrap your head around it, I think that speaking with somebody who is in the mental health field could be very warranted.

This is a really common thing. We see this. Statistically, it could be 10%, but I think it's much higher than that. So please reach out for help if that's something that you feel like you could be struggling with or even if you're just unsure. There is no shame in that.

Interviewer: For men that aren't quite to the point where they feel they need to see a professional, you've talked about an acronym called SUNSHINE that can help with postpartum depression. Does this apply to both women and men?

Jamie: Absolutely.

Interviewer: All right. Let's go through this, because this is a tool right now that our listeners could take away and start implementing right now and see if it helps. So let's talk about SUNSHINE.

Jamie: One of the wellness acronyms that we use quite frequently in our work is actually SUNSHINE. So what it is, is a series of different things that you should be thinking about when it comes to your mental and physical well-being during pregnancy and the postpartum period.

So it stands for sleep, understanding, nutrition, support, humor, information, nurture, and exercise. So those are all points that I think would be helpful in the preparation phase for having a kid, to think about, "How am I going to still try to get some of these things?"

And it's going to vary depending on where you are in that process. During the early stages, your focus may be on one of those things. And throughout the process, it might be able to expand into something else.

So I always advise my patients not to think about it as if you're not doing each and every one of these things, you're failing at your postpartum experience or you're failing at therapy. But just make sure that you are keeping them somewhere in the back of your mind because you are still an important person and your relationships are still important, whether you've got a baby in the picture or not.

Interviewer: So just give us one sentence for each one of the items in SUNSHINE. So sleep.

Jamie: Four to five hours as often as possible. Uninterrupted.

Interviewer: Uninterrupted. And try to get the standard eight to nine, otherwise?

Jamie: Absolutely, if you're able to. What that will likely look like, however, is especially in the early days taking turns potentially with your spouse, because they also need that time.

Interviewer: What about understanding? Expand on what that means.

Jamie: Understanding can mean a couple of things. You could again reach out and try to get a better idea of what other people's experiences have been like. Or you could also just get some education around what perinatal mood and anxiety disorders actually are.

Interviewer: And then what about nutrition?

Jamie: Nutrition, that's a tricky one. So this is not a great time to start a brand new diet plan. It's probably not going to be the top of your list of things. What we do want to make sure is that you are making sure you're actually eating and fueling your body. It's really, really easy to put your focus all on everybody else and sort of forget that you have needs also.

Interviewer: All right. So make sure you're eating and try to get as much nutrition as possible, knowing that maybe you might have to use some convenience foods.

Jamie: Absolutely. And preparation going into this can be really helpful for that, making sure that you do have some healthy things around the house. But I'm certainly not going to judge you if the thing you ate for lunch was a bag of M&Ms. Just get something in your system if you can.

Interviewer: Support.

Jamie: Support is something that we should start generating right from the get go, whether it's our family, improving our communication with our spouse, whatever that looks like. It's good to try and bring your support system in as long as that's a safe thing for you to do.

Interviewer: All right. And humor. Crack lots of jokes?

Jamie: Definitely. Hey, dads are known for their dad jokes, right? That's a thing for a reason. But being able to laugh at the situation sometimes really can help. Not only does it increase your endorphins and just make you feel better in general, but sometimes being able to find humor in the absurdity that can come along with parenting is not a bad thing to do.

Interviewer: Good tension release a lot of the times, yeah. Information.

Jamie: Information. Get good information about these things. Get good information about your mental health. When I say go to online resources, I think finding ones that are specific to dads' mental health through Postpartum Support International are great. I would suggest don't go down the social media rabbit hole of things that will probably make you feel worse about your parenting.

Interviewer: Does information also include just learning more about what it is to raise a child?

Jamie: Absolutely.

Interviewer: Because to me, that would be a major stress point. I have a friend that I don't know how many books he read before his child arrived, and he said it just made him feel so much better.

Jamie: Yeah, I think it can be a real help to people just having a better idea of what that could look like. The caution I will put on that is that there is a perspective for pretty much anything you can find out there. So maybe get some guidance from your pediatrician before you just delve into something.

Interviewer: Yeah, make sure you're getting some of the good books. Nurture.

Jamie: Nurture comes back to the self-nurturing piece of this. It is okay to talk about how you are feeling.

Interviewer: And feel. It's okay to feel. A lot of guys struggle with just even doing that or identifying what the emotion is.

Jamie: Yeah, absolutely. Or feeling like a dad in general. It's a big shift and we want to make sure you're taking care of yourself.

Interviewer: And it's okay to say, "Hey, I'm doing okay. I'm an okay dad." I mean, if you can't say, "I'm a great dad," go with, "I'm an okay dad," I suppose.

Jamie: Being a good enough dad is good enough. It's different for everybody. And people always balk a little bit about that idea, but there is a whole theory around the good enough mother, and so we do actually talk about that quite a bit. Dads fall into that category too.

Interviewer: And finally, in SUNSHINE, you have exercise.

Jamie: Again, I'm not saying go out and start a whole brand new plan and get a gym membership and do all the things that you've been trying to accomplish, but get some movement. That movement can just be going out for a walk once a day just to get some vitamin D and stretch your legs.

Interviewer: It's good for the body and the mind.

Jamie: It is.

Interviewer: Exercise, like you said, releases all those endorphins and makes you feel good, helps reduce that stress.

If those things aren't working, what's the next step that you would recommend a man take?

Jamie: I would recommend reaching out to even if it's just your primary care physician to say, "I'm struggling with this. This is hard." If you are actively involved in child's doctor's appointments, you could even talk to your kid's pediatrician about how you're feeling. They have a lot of really great resources.

Interviewer: Jamie, this has been a very informative, great conversation. I know it's going to help a lot of dads-to-be. Any kind of final thoughts as we wrap up this conversation that you would really want somebody to take away after listening?

Jamie: There are times when you're in the early stages where it just feels like everything is falling apart, but you're definitely not by yourself. You're not the only one that has struggled with becoming a parent or feeling like it's going to be like this forever. It's truly not. Get some support, and at the end of the day, it will get better and you're not by yourself.

Dr. Jones: Today, in The Scope studio, we're talking with Dr. Audra Jo Hill. Dr. Hill is a urogynecologist, who specializes in problems with the pelvic floor, the down there that isn't always the same after childbirth. She started a new clinic for postpartum pelvic floor problems. Welcome to The Scope, Dr. Hill. So help us understand a little about this specialty clinic. What made you decide to start this clinic?

Dr. Hill: I think I was going through training and treating patients, I started to recognize unvalidated problem, an unspoken problem that a lot of women experience following childbirth. There's small specialty clinics across the country that really focus on postpartum pelvic floor disorders, but we didn't have anything here in the state of Utah, and helping fix some other problems following deliveries has really motivated me to start the clinic. I find ways to help these women who previously had gone untreated.

Dr. Jones: And they've come to you. They probably came to you even before you formally started this clinic. Is there a story? Is there . . . Not without using anybody's name, but someone who's come, who's had a baby, is overwhelmed, and she can't talk about the fact that either it hurts or she leaks or . . . And it's kind of overwhelming. She's just trying to be a happy mom, but she's not so happy. Is there something that's common?

Dr. Hill: Yes. So following delivery, some women can experience different levels of vaginal tears that can occur. And one story that really sticks out in my mind was a woman who sustained a fourth-degree laceration.

Dr. Jones: That's where the tear went all the way through the muscles around the rectum and into the rectum.

Dr. Hill: Correct. And she was repaired appropriately at the time of her delivery. But about one week later, she called in complaining of increased pain and symptoms of discharge and starting to leak stool through her vagina. And so she presented to my clinic as a new time mom, trying to handle breastfeeding, juggling life, new baby, lack of sleep, but also these problems that were not exactly on her list of following delivery.

Dr. Jones: No.

Dr. Hill: And so we were successfully able to, based on her tissue quality and her examination, to take her back to the operating room on Christmas Eve, and we repaired her vaginal tissues and her rectal tissue so that she was able to be continent. And she now is successfully able to ride her horses, and take care of her baby, and is very pleased that she doesn't have to deal with this as part of her postpartum adventures in motherhood.

Dr. Jones: Wow. You gave her a new year, a brand-new year. We've heard all over the world about the trauma of childbirth that goes untreated. We hear about women with fistulas and leaking urine all their life in Africa or in Bangladesh. But we don't really think about this happening here. And because, of course, we take care of that stuff here, or it doesn't happen here. But it does happen here.

Dr. Hill: Definitely, I think with our more differences is that we have more modern medicine, opportunities to intervene in the vaginal birth process, but the same trauma still occurs. And so women can have, you know, urinary leakage, prolapse or a vaginal bulge after delivery, fecal leakage. And just, you know, those muscles and nerves have had a lot of trauma. And how to help new moms even just understand what happened is a huge part that I think can be very reassuring.

Dr. Jones: Right. It isn't something you usually share with your girlfriends, right?

Dr. Hill: No, this is one of those things that once you start talking about it, it's amazing how many people say, "Oh, yeah, me too. I've experienced that." But it doesn't come up. And, you know, everybody wants to know how their baby is doing after delivery.

Dr. Jones: Right. Well, everybody would share their labor story, how long it was, their pain. They'll talk about how hard they pushed. They'll talk about their breastfeeding problems. But when it comes to down there, they don't talk about it.

Dr. Hill: No. And some people feel it's their price they have to pay for having children, and it's a common thing, and they just have to live with it.

Dr. Jones: Well, you mentioned, as we were talking before we got started, that the resident that was in clinic with you said there are a lot of tears in your clinic. So talk to me about that, about, you know, women who are . . . they're hormonal, they've had a new baby, they just are overwhelmed. Talk about the tears around this difficult issue.

Dr. Hill: As you were saying, it's not necessarily tears of . . .

Dr. Jones: Despair.

Dr. Hill: Yeah. Despair or fear. I think it's a validation and acceptance to tell them this is what happened to you, educating them on their pelvic floor, what this means for future childbearing. Does this change any of their options? Also looking at that telling them, "You're not broken. You're not damaged. You're just different because a baby's been there. And that doesn't mean that this is something that means you're abnormal. You're just differently from your prior normal."

Dr. Jones: That's a lovely way to put it because I always think of a vaginal birth as being a moderately traumatic process from an evolutionary perspective, but I think you've a much healthier way of bringing this process of getting a baby out. That's a good way to put it. Well, can a woman who has these problems call your clinic directly, or do they need a referral from their OB or midwife or a family physician?

Dr. Hill: So I think, though, how we're starting to work on this and, again, there's many bugs as you start to start a clinic is to give our offices a call. And we are currently looking through them to make sure (a) it's one, the appropriate provider for you. Because, again, if it's been three or four years after the delivery, there may be somebody better suited to help treat some of your symptoms. But for right now, it doesn't require referrals because I do not want to hinder patients being able to come in and see us. But primarily, always going back to your delivery and provider addressing these symptoms and concerns and asking, is there anything else that can be done is very helpful because you may not need to come to a specialty clinic. And a lot of these things can be taken care of with your own provider. But if things aren't improving, if there's complications, we are always here to help.

Dr. Jones: Right. There are a lot of women who have either bladder leakage or not being able to empty or your bladder is just not the same, and luckily, sometimes time can help. If women . . . I think women in Idaho who may be far from their own OB and farther from you, but if their own OB can help them understand that things get better. Or they could always call you and say, "This is what I got, you know. What could we do from here?" And sometimes time and things tighten back up a little bit.

Dr. Hill: You are absolutely correct. I think those first six months following a vaginal delivery, there's so much remodeling of the muscles and the tissues, and fluid shifts in the body. And if you're breastfeeding or not, the hormonal status, lots of things can change. And majority of the symptoms actually get better and go away. But I think if they're not getting better, and if you are really bothered and your quality of life is suffering, talk to your provider.

Dr. Jones: Right. Exactly.

Dr. Jones: The normal vaginal birth of a baby can be a joyful time, but most women will say that nothing is ever the same down there.

Humans are not the only species that can have trouble getting their babies out, but we seem to have the most trouble. Our babies' heads have evolved to get bigger and bigger, and good nutrition have made babies get bigger and bigger. And the baby has to pass by muscles and tissue and bowel and bladder on the way out, and often there are long-term consequences.

Today in The Scope studio we're talking with Dr. Audra Jo Hill. Dr. Hill is a urogynecologist, a gynecologist who specializes in problems with the pelvic floor, the "down there" that isn't always the same after childbirth. Welcome to The Scope, Dr. Hill.

So what are the reasons that those happen? How come women who, having just vaginal birth . . . we populated the planet with vaginal births, even though people think C-section is the most common. In fact, it's not. But what are kinds of things that happened during a birth that can lead to these kinds of problems?

Dr. Hill: So some of the risk factors that we've identified have to do with having a larger baby, sometimes an older mom and just how their tissues are different than younger moms, also genetics.

Dr. Jones: Not so stretchy or tear . . . I mean, I'm way too past older mom. I mean, what do you mean by older mom?

Dr. Hill: I think after the age of 35, just the complications of pregnancy in general, albeit still small, do increase. I think more medical comorbidities also increase. And I would say that the recovery of the tissues after the normal birthing event sometimes is slower.

Dr. Jones: Right. Well, we were engineered to get to 35, to get one generation of children to childbearing age. And so we're over-engineered, but everything starts to . . . You know, our eyes, our bones, our everything tends to be a little less resilient after 35. Oh, dear. Okay, well, I'm way after that, but that's . . . Well, let's go back to babies being bigger and mom's tissues maybe not so stretchy. What other kinds of things can make these problems happen?

Dr. Hill: We find an increased risk of these complications or disorders, such as prolapse, incontinence, or higher-level tears are associated with operative deliveries, which kind of means if we used forceps or a vacuum versus just a spontaneous vaginal delivery.

Dr. Jones: Okay. So if the baby needed some help coming out, and the obstetrician, or midwife, or family doc used something to help the baby through, that usually means that the baby was bigger anyway. So we don't know. They might have torn even if you didn't put those things on.

Dr. Hill: Correct.

Dr. Jones: It's just those things just help out. I don't want people to say, "Oh, I'm never going to have any equipment to help my baby out." Okay, that would be one too.

And then we stopped doing episiotomies routinely. That used to be pretty much commonplace, meaning to cut the opening so it got a little bit bigger. Our fear back not that long ago was, "If it tore, it would tear irregularly. If we just cut it, it would be easier to repair." I think that that's kind of old science and wrong medicine now. But people do tear.

Dr. Hill: They do. And so, again, an episiotomy, they're still performed for appropriate indications. That does increase the risk of some of these symptoms after birth. But, at the same time, it's just because you maybe had all of these, a big baby, and an operative delivery. That doesn't necessarily mean you're going to experience any of these symptoms. And so, sometimes, that's how all these risk factors are joined together with your genetics, and how your body repairs after injury, and things that we can't control for.

Dr. Jones: Well, having a new baby can be a wonderful turning point in a woman's life. But, if your body isn't getting back to normal, and you're having problems down there after your vaginal birth, you don't have to grin and bear it. We're here to help. And 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: 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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