Baby Blues

By: Julien Jimenez, MD

Postpartum blues,Maternity
blues, orBaby blues
Is a transient condition that 75-80%
of mothers could experience shortly
afterchildbirthwith a wide variety of
symptoms which generally involve
moodlability, tearfulness, and some
mild anxiety and depressive
symptoms. Baby blues is
notpostpartum depression, unless it
is abnormally severe.

Causes
After theplacentais delivered, the placental
"hormone factory" shuts down causing radical
changes in hormone levels, and the woman
can suffer symptoms due to withdrawal from
the high pregnancy levels of estrogen,
progesterone and endorphins. Combined
with this shift in hormone levels is the
physical, mental and emotional exhaustion as well as sleep deprivation typical of
parenting a newborn. All of these factors
contribute to the condition.

Symptoms
Weepiness and
bursting into tears.
Suddenmood swings.
Anxiousness and
hypersensitivity to
criticism.
Low spirits and
irritability.
Poor concentration
and indecisiveness.
Feeling 'unbonded'
with baby.
Restless insomnia.

Baby pinks
Instead of suffering the
baby blues, some women
experiencebaby
pinkswhen they are
overly and illogically on
top of the world (a mild
to severe form ofmania).
These symptoms can
sometimes be a trigger
for a pending depressive
imbalance, such
aspostpartum
depressionor
postnatalpsychosis

Postpartum
depression(PPD)
Also calledpostnatal depression, is a type
ofclinical depressionwhich can affect parents
after childbirth. Symptoms may include
sadness,low energy, changes in sleeping and
eating patterns, reduced desire for sex,
crying episodes,anxiety, and irritability. While
many women experience self-limited, mild
symptoms postpartum, postpartum
depression should be suspected when
symptoms are severe and have lasted over
two weeks.

Signs and symptoms

Sadness
Hopelessness
Low self-esteem
Guilt
A feeling of being
overwhelmed
Sleep and eating
disturbances
Inability to be comforted
Exhaustion

Emptiness
Inability to experience
pleasure from activities
usually found enjoyable
Social withdrawal
Low or no energy
Becoming easily
frustrated
Feeling inadequate in
taking care of the baby
Decreasedsex drive

Risk factors
Prenatal depression or
anxiety
A personal or family history of
depression
Moderate to severe
premenstrual symptoms
Maternity blues
Birth-related psychological
trauma
Birth-related physical trauma
Previous stillbirth or
miscarriage
Formula-feeding rather
thanbreast-feeding

Cigarette smoking
Low self-esteem
Childcare or life stress
Low social support
Poor marital relationship
or single marital status
Low socioeconomic status
Infant temperament
problems
Unwanted pregnancy
Elevatedprolactinlevels
Oxytosin depletion

Diagnosis Criteria
Feelings of sadness, emptiness, or hopelessness,
nearly every day, for most of the day or the
observation of a depressed mood made by others
Loss of interest or pleasure in activities
Weight loss or decreased appetite
Changes in sleep patterns
Feelings of restlessness
Loss of energy
Feelings of worthlessness or guilt
Loss of concentration or increased indecisiveness
Recurrent thoughts of death, with or without plans of
suicide

Medication
There is evidence which suggests
thatselective serotonin reuptake
inhibitors(SSRIs) are effective
treatment for PPD.