Winter Babies and Postpartum Depression

When do the 'baby blues' become postpartum depression?

From the WebMD Archives

As many as three out of every four women will experience the short-term mood swings known as the "baby blues" after their baby is born. But nearly 12% experience more serious and longer-lasting postpartum depression.

How can you tell the difference between the normal mood changes that will abate, and those that could mean depression and a need for treatment? How can you manage postpartum emotions -- whether it's the baby blues or true depression -- in the colder, darker, and more isolated winter months?

Got the Baby Blues?

"Baby blues are very normal and very common," says Catherine Monk, PhD, Herbert Irving Assistant Professor of Clinical Psychology in the departments of psychiatry and obstetrics at Columbia University College of Physicians and Surgeons. "Having a baby, even if it's a second or third baby, is a sea change in your life. That, combined with the fluctuating hormones as your body goes from being pregnant to not pregnant, can lead to major mood swings."

There are two big differences between baby blues and true postpartum depression, experts say:

  • How long your depressed feelings last
  • How intense the feelings are

The baby blues usually begin a few days after delivery and last about 10 days to two weeks. But don't immediately assume that if you're still feeling weepy on day 15, it must be postpartum depression, cautions Monk: "It's not that exact a science."

The baby blues also feel different than postpartum depression. "They're not just about being sad. Baby blues seem to be about being full of feeling," explains Nada Stotland, MD, MPH, professor of psychiatry and obstetrics and gynecology at Rush Medical College in Chicago. "You may cry because you're feeling sad, but you may also just look at the baby and cry because you're full of emotion."

Could It Be Postpartum Depression?

Postpartum depression lasts longer, and it's more severe. Stotland describes it as "feeling dragged down all day long, with a gray lens in front of everything you do." The symptoms of postpartum depression include:

  • Sleep disruption. Everyone tells you to "sleep when the baby sleeps" -- but when you try to fall asleep, and know you need to, you just can't.
  • Appetite changes -- either loss of appetite and losing more postpartum weight than you should, or overeating.
  • Having no interest in seeing people.
  • Inability to enjoy the things you used to enjoy.
  • Inability to concentrate.
  • Intense self-criticism and self-blame, thinking that you're a bad mother and you can't do anything right.
  • Inability to bond with your baby, which can cause intense feelings of shame or guilt.

If you have several of these symptoms and they've persisted for some time, call your doctor to ask about being screened for postpartum depression. And if you've had any thoughts of harming the baby or yourself, make that call right away.

Continued

Winter: A SAD Time of Year?

Both postpartum depression and the baby blues may be more difficult in the winter months, when the days are shorter, colder, and darker. Some women may already have a condition known as Seasonal Affective Disorder (SAD), which makes them prone to depression in the light-deprived fall and winter months.

Even if you haven't been previously diagnosed with SAD, you might find that dark, wintry days increase a sense of isolation, especially since it's harder to get out and about with a newborn baby in January than in June.

Not a lot of research has been done on fluctuations in postpartum depression and the seasons, but a Finnish study published in 2003 found that women appeared to be at higher risk for mild postpartum depression in the winter months, and at lower risk in the spring.

Plan Ahead for Winter Depression

If you know you're prone to depression or just "feeling down" in the winter months, and your baby is due in January, it's a good idea to plan ahead. "Line up extra help at home," advises Shari Lusskin, MD, director of Reproductive Psychiatry at New York University Medical Center.

"Start making connections with other moms-to-be in your childbirth classes, your breastfeeding classes, or in local mothers' groups for your neighborhood," says Lusskin.

If you haven't managed to meet anyone simpatico through local resources, try:

  • The International Moms Club at http://www.momsclub.org/ for stay-at-home moms
  • Mothers of Preschoolers at http://www.mops.org for moms of kids from birth to preschool

Tips for Getting Out and Enjoying Life With Baby

Once your baby is born, you don't have to be housebound just because it's winter.

Stotland suggests a number of tricks for getting out of the house -- especially if it's light outside and you can be exposed to mood-boosting sunlight.

  • Walk around a mall or a museum with the baby in a carriage or sling. (If you need to nurse the baby and you're not yet comfortable nursing in public, grab a few clothing items and nurse in the dressing room.)
  • Seek out restaurants or cafes that are empty at off times, where they won't mind if the baby fusses. Arrange to meet another mom for an early afternoon in a coffee shop.
  • Many movie theaters now offer "Reel Moms" programs, where moms and babies can come to catch a new film without worrying about disrupting other patrons. If there isn't one in your area, just try going to a movie in the early afternoon on a weekday, when the theater is likely to be mostly empty and you can nurse baby in the dark.
  • Just go for a drive. Most (though not all!) babies will be soothed to sleep in the car. If it's a cold but sunny day, you can keep baby toasty with a car-seat wrap like the Bundle Me, and get some sun through the car window while listening to your favorite radio station.
  • On days when you just can't get out, stay connected online.

Says Stotland: "Both of my daughters are in online groups with moms from their neighborhood. Even if you can't get out to meet them, you can chat or email and support each other."

Continued

When Depression Persists in Winter: Try a Little Light

If the season is really weighing you down, you might benefit from physician-prescribed light therapy.

"Light box therapy has been studied for use in pregnancy-related depression, and it's a reasonable option," says Dorothy Sit, MD, assistant professor of psychiatry at the University of Pittsburgh Medical Center. "Women who may want to opt for non-drug options based on personal preferences should ask their doctor about light therapy."

"Whenever we see exacerbation of an otherwise nonseasonal depression in winter, light therapy can be extremely helpful," notes Michael Terman, PhD, director of the Center for Light Treatment and Biological Rhythms at Columbia University Medical Center. He has created personalized online guidelines for self-administration of light therapy, available online.

If you do have postpartum depression, it's important to know that you're not alone and there's nothing "wrong" with you, says Stotland.

"People tend to think you're ungrateful when you have postpartum depression, because you have this healthy baby," she says. "It's a wonderful thing to have a healthy baby, but when you have depression, you don't feel fortunate, especially when the world is telling you how happy you should be."

Seeking help, she says, can allow you to enjoy yourself and your baby the way you always wanted to.

WebMD Feature Reviewed by Brunilda Nazario, MD on October 17, 2008

Sources

SOURCES:

American Pregnancy Association, Irving, Texas.

CDC, Atlanta.

Catherine Monk, PhD, Herbert Irving Assistant Professor of Clinical Psychology, Columbia University College of Physicians and Surgeons, New York City.

Nada Stotland, MD, MPH, professor of psychiatry and obstetrics and gynecology, Rush Medical College, Chicago.

Shari Lusskin, MD, director of reproductive psychiatry, New York University Medical Center, New York City.

Dorothy Sit, MD, assistant professor of psychiatry, the University of Pittsburgh Medical Center, Pittsburgh.

Michael Terman, PhD, director, Center for Light Treatment and Biological Rhythms, Columbia University Medical Center, New York City.

© 2008 WebMD, LLC. All rights reserved.

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