Postpartum Blues Range From Mild, Brief to Dangerous

by Symptom Advice on February 29, 2012

Published: Saturday, February 25, 2012 at 12:01 a.m. Last Modified: Sunday, February 26, 2012 at 12:00 a.m.

WINTER HAVEN | Postpartum depression is far deeper and more dangerous than what’s frequently referred to as “baby blues.”

Facts QUICK CHECK

Is it baby blues, postpartum depression or postpartum psychosis?BABY BLUESMany women have the baby blues in the days after childbirth. Symptoms include:Having mood swings.Feeling sad, anxious or overwhelmed.Having crying spells.Losing your appetite.Having trouble sleeping.The baby blues usually go away within a few days or a week. POSTPARTUM DEPRESSIONSymptoms last longer and are more severe. Postpartum depression can start any time within the first year after childbirth. In addition to symptoms listed under baby blues, you could experience:Thoughts of hurting the baby.Thoughts of hurting yourself.Not having any interest in the baby.Postpartum depression needs to be treated by a doctor. POSTPARTUM PSYCHOSISOccurs in one to four of every 1,000 births, usually starting the first two weeks after childbirth. Women with bipolar disorder or schizoaffective disorder have a higher risk of postpartum psychosis. Symptoms may include:Trying to hurt yourself or your baby.seeing things that aren’t there.Feeling confused.Having rapid mood swings.Postpartum psychosis needs to be treated by a doctor. Source: U.S. Department of Health and Human Services Office on Women’s Health

“It is a very devastating disease,” said Dr. George Winny, psychiatrist and medical director of Winter Haven Hospital Center for Behavioral Health. “It is horrible for people to go through.”

Nurses at Regency Center for Women and Infants, where WHH has its childbirth unit, do depression screening with female patients who are there to give birth.

“If the score is high, they call us for ?consulting,” Winny said. “I have seen many cases of postpartum depression over the years.”

Postpartum depression and a much rarer condition, postpartum psychosis, came to Polk County residents’ attention this month with the death of 1-year-old Ishan Patel of Lakeland.

He drowned and had blunt force trauma on his face, according to autopsy results.

His mother, Neha Patel, 32, is charged with first-degree murder. Authorities said she suffered severe postpartum depression and had threatened suicide in the past.

Untreated, Winny said, the condition interferes with a mother’s inability to take care of and bond with her baby.

About 10 percent to 15 percent of women develop that condition after giving birth, said Dr. Latamia White-Green, a psychiatrist at Lakeland Regional Medical Center.

Such women aren’t able to take care of themselves or their babies, leading to feelings of being worthless, irritability, agitation and exhaustion beyond the normal stress of having a newborn. They need treatment by a doctor, White-Green said.

“The stress of caring for a newborn can take a toll,” Winny said. “You may feel overwhelmed and anxious about your ability to take care of the baby.”

In a small number of cases — fewer than 5 of every 1,000 births — the mother’s mental condition goes beyond postpartum depression into postpartum psychosis. Symptoms can include trying to hurt herself or the baby, seeing things that aren’t there, feeling confused and having rapid mood swings.

The difficulty for families and friends, as well as the mother, is determining when feelings are normal baby blues or something more serious.

Anywhere from 55 percent to 85 percent of women are likely to have some short-term baby blues, more accurately called an adjustment disorder, White-Green said.

Mood swings, crying, feeling sad or overwhelmed and other emotional reactions can occur during that period as the body goes through hormonal adjustments, she and Winny agreed.

If women or their family members feel the depression goes beyond baby blues, particularly if it interferes with the mother-child relationship, both psychiatrists advise them to call their doctors before the scheduled six-week check-up.

Too often, they’re reluctant to do that, said Teresa even, mental health therapist with Peace River Center.

“People feel they should be able to control it,” she said. “I spend a lot of time doing education on brain chemicals (and mental disorders).”

Teenage mothers are at greater risk of postpartum depression, as are mothers whose babies are born prematurely or with developmental problems.

In the case of Ishan Patel, the Lakeland baby killed, he was premature and spent months at Tampa General Hospital.

Other mothers at greater risk are those whose pregnancies are unplanned, who lack an adequate support system or who already have depression.

Cultural factors also can play a role.

“In India, women are not very vocal in talking about their feelings,” said Winny, a native of India who practiced there before coming to the United States.

“We used to see a lot of anxiety disorders,” he said, but added that in India there is likely to be more family support.

“Your mother or mother-in-law might help take care of your baby there,” he said. “Here you are living with your husband and child.”

White-Green, who is African-American, said her cultural experience is that “it’s really frowned upon to be out of the house until three or four weeks after the birth.”

Isolation can increase symptoms of depression, she said, encouraging women to ask for help with child care or housework and find ways to take care of themselves. Something as simple as a hairdo or manicure may help improve mood.

Winny offers this advice for significant others of any culture to follow in the days and weeks after a child is born:

“Listen to her without judging her or offering solutions, without trying to fix things. Simply be there.”

Volunteer to help with childcare and housework without waiting for her to ask, he said. Encourage her to exercise.

[ Robin Williams Adams can be reached at or 863-802-7558. Read her blog at robinsrx.blogs.theledger.com. Follow on Twitter @ ledgerROBIN. ]

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