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Postpartum Depression: More Common Than You Know

New mothers with postpartum depression can feel very alone. But at least 20% of new mothers experience it. Here's how to cope.

Perinatal Mood Disorders

To the 800,000 women who develop one of several types of perinatal mood disorders each year (that's about 20% of new mothers), Merritt's story is painfully familiar. Postpartum depression is often used as a catch-all description, but in fact, perinatal mood and anxiety disorders include a lot more than just classic depression -- and they can start before or well after delivery. New moms can develop:

Depression: This can include the typical signs, such as sadness and crying, as well as anger and irritability.

Anxiety and panic disorder: Like Merritt, mothers might feel anxious and fearful about their ability to take care of their baby and worry they will do something wrong. Some suffer debilitating panic attacks and feel unable to go out in public.

Obsessive-compulsive disorder: Women with postpartum depression can be plagued by constant worries about germs or intrusive thoughts about harming their baby. Others are obsessed with doing everything "perfectly."

Posttraumatic stress: If something went wrong during birth -- a medical complication or an emergency cesarean -- a mother might have anxiety attacks with flashbacks.

Postpartum Depression: a Hidden Epidemic

Although perinatal mood disorders are common, more than half of all cases are unrecognized and untreated. Some doctors attribute them to the "baby blues," a short-lived state of intense emotion that comes on and disappears quickly. In some cases, women don't confess their symptoms for fear of judgment or stigma. That's particularly tragic, experts say, because perinatal mood disorders -- such as postpartum depression -- respond well to counseling, medication, and other treatment.

"Even highly intelligent women don't recognize what they have, and when they do try to reach out, people just say, 'Yeah, that's motherhood. It's tough,'" says Birdie Gunyon Meyer, RN, MA, CLC, coordinator of the Perinatal Mood Disorders Program at Clarian Health in Indianapolis and president of Postpartum Support International. "Between 1% and 3% of women get gestational diabetes, and we check all women for it. About 20% of women get perinatal mood disorders, and we still don't routinely screen for that," she says. (That could change soon; see "The MOTHERS Act" below.)

Causes of perinatal mood disorders are still poorly understood, but researchers speculate that shifting chemicals in the brain during and after pregnancy -- such as oxytocin, a hormone related to mood -- play a role. It's more complicated than that, though, because new adoptive parents and fathers -- who are never pregnant -- can also develop depression and mood disorders.

Baby Blues vs. Postpartum Depression

When Merritt talked to her doctor at her six-week follow-up visit, she told him that she was crying a lot and that things didn't feel right. "He said 'Oh, that's just the baby blues. It's your hormones; it'll go away.'"

Her doctor was wrong. The baby blues and perinatal mood disorders are two very different things. Some 80% of women do have the baby blues after delivery, and it's true some symptoms are the same as for postpartum depression, such as mood swings, sleep disturbances, and loss of appetite. Sometimes the baby blues just involve an excess of emotion -- crying often, for no reason.

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