When Your Baby Makes You Sad

The time surrounding the birth of a new baby is supposed to be a joyous time for many families. The media portrays those first months with everything soft and new, pink and blue. However, for some, it just doesn’t seem very happy. Sometimes other stressors that come to young families at the same time as a new baby can be identified – financial difficulties, complications with the pregnancy, delivery or baby’s health. But for some there is no obvious cause. The new mother or new father just doesn’t feel good.

How big is the problem?

Perinatal depression has existed throughout time, being first documented in 1875. The World Health Organization considers the disability resulting from depression during the childbearing years of 14 to 44 only second to the disability caused by HIV. Studies estimate that 10-19% of women worldwide experience perinatal depression as a complication of pregnancy or the early post-birth period. For women experiencing poverty, rates can be as high as 30%. In comparison, only 2 to 5% of women experience gestational diabetes (diabetes of pregnancy). Chances are you yourself or someone you know has experienced postpartum depression prior to or following the birth of your child.

KEY SIGNS AND SYMPTOMS

Inability to sleep or sleeping a lot, even when baby is awake
Mood swings
Change in appetite
Fear of harming, extreme concern and worry about baby.
Sadness or excessive crying
Feelings of doubt, guilt and helplessness
Difficulty concentrating and remembering
Loss of interest in hobbies and usual activities
Recurrent thoughts of death, which may include thinking about or even planning suicide

_Sources:

_{American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed.). 2000.}

_{Wisner K, et al. Postpartum depression. New England Journal of Medicine. 2002;347:194–9.}

What you can do to prevent problems.

Remember to take care of yourself, especially when expecting or caring for a new baby. This is not the time to be Super-Parent.
Get help. Ask family or friends for whatever help you want and need. Support is a key factor in staying healthy.
If you feel anxious or have any of the listed signs and symptoms, contact your doctor or nurse and ask for a referral to a counselor. Remember – you are not alone – many women experience this, but don’t seek the help they need. It may take some time to find a helpful professional near you. Be patient and continue to follow steps #1 and 2.

What you can do if you or a loved one feels bad.

Read the signs and symptoms as well as the steps above and do what you can to help, or get help. Early support can help prevent later problems. Plan ahead.
Don’t dismiss a woman who seems anxious and stressed by a new baby. She is crying for help. It may be temporary, but provide support.
If your loved one remains depressed or seems to be considering harming themselves or the baby, make sure that the baby is in a safe place and get help! You may need to take them to a hospital for treatment.
Remember, fathers can experience postpartum depression too. And when caring for a woman with postpartum depression, fathers are under lots of stress as well. This is the time for everyone to step up and lend a hand, and not a time for criticism of parenting techniques.
It’s OK to get treatment. Getting treatment is MUCH healthier for you and your baby than avoiding something out of fear. We know much more today about postpartum depression and psychosis in both women and men than ever before.

Information for Professionals
The following citation contains an excellent recent review of the scholarly literature on postpartum depression, including differential diagnosis with postpartum (baby) blues, and postpartum psychosis, a rare disorder occurring in only 1 in 1,000 births and information on medications.

^{Patel, M. & Bailey, R. K. & Jabeen, S. & Ali, S. & Barker, N. C. & Osiezagha, K. (2012). Postpartum Depression: A Review. Journal of Health Care for the Poor and Underserved 23(2), 534-542. The Johns Hopkins University Press.}