Originally published in The Ottawa Citizen, June 21, 2001

Post Partum Depression (PPD) is a severe debilitating illness. It occurs in about one in ten childbearing women. It can cause women untold and unnecessary suffering and guilt. It is important to keep in mind the difference between the “baby blues” and PPD. The “baby blues” usually shows up three to four days after delivery. Mothers may feel a little down, have lost their appetite, have difficulty concentrating or have problems sleeping even while the baby is sleeping. These symptoms usually resolve by the tenth day after delivery. These blues are considered normal.

When these symptoms persist for more than two weeks PPD has to be considered. The family and friends who support the new mother are essential in detecting PPD. Family members may observe that the new mom is “just not quite right” or “not like their usual selves”. This information helps the mom’s caregiver investigate the risk of PPD. Recent news events have brought to light how overlooking the early signs of depression can lead to disaster. PPD can show up as late as six months after the delivery but there are usually warning signs before the full blown illness occurs.

Depression comes in many forms. These are signs and symptoms that are commonly seen in PPD:

* Mood swings (depression, panic and anxiety) and agitation
* Fatigue and loss of energy
* Loss of enjoyment or interest participating in activities that were once enjoyed
* Feelings of guilt, shame and worthlessness
* Suicidal thoughts
* Difficulty concentrating and indecisiveness
* Lack of motivation and drive
* Difficulty falling or staying asleep
* Loss of appetite and weight loss
* Thoughts of harming the baby
* It is important not to overlook or minimize the symptoms that you are feeling or for that matter what one tells their doctor.

Some women are more at risk for PPD. These women have either had PPD before, have a history of depression not due to pregnancy, marital problems or severe premenstrual syndrome. Isolation from extended family or friends or lack family support structures can increase their risk. Life circumstances and stressors such as loss of a job, recent death of a friend or relative or financial pressures during and after the pregnancy should alert you to the risk of PPD.

If anything this brief outline of PPD should be remembered for this reason: PPD is a medical illness. The hormonal changes that a woman experiences after birth can have a tremendous impact upon their ability to function. They are not “going crazy” as some might say. They are experiencing a lack of brain chemicals (neurotransmitters) necessary for normal mood. They can no more be held accountable for their depression than someone with Diabetes or Thyroid disease. They cannot will themselves to make the necessary brain chemicals for normal mood anymore than someone can will their thyroid gland to make more thyroid hormone.

Think of it this way. When someone is drunk, can they sober-up immediately after drinking just because you have asked them to do so? Obviously they can’t because the alcohol affects brain function by temporarily altering brain chemistry. In the case of PPD it is the lack of certain chemicals that affects their mood and behavior. If you can accept how alcohol affects the brain then logically one has to accept how the lack of certain neurotransmitters can alter behavior. This illness must be aggressively and compassionately treated. It is important to listen and offer support to the mom who suffers from PPD. Medications available today can make the difference between needless suffering and a normal healthy post partum period. They can completely reverse the depression, are non-addictive and can give the mother her life back.

Do not feel afraid or embarrassed to talk about your concerns. Talk to friends, family and your doctor or caregiver. It may just save your life.