Postpartum Depression

Along with the joy of welcoming a new baby into the world, many mothers feel sad, anxious, or afraid. These feelings can be indicative of the "baby blues" or of postpartum depression.

Baby Blues

About 70-80% of all new mothers experience the mild symptoms associated with baby blues within 2-4 days after birth. Symptoms include:

• Frequent, prolonged crying for no clear reason
• Trouble sleeping, eating, or making choices
• Irritability or quick mood changes
• Anxiety over ability to care for the baby

This can last a maximum of weeks, and it resolves without treatment.

Postpartum Depression

About 10-20% of new mothers experience the more debilitating and longer lasting symptoms of postpartum depression. These symptoms can appear anytime during the first year after birth, but typically begin within three months of birth:

• Baby blues that do not go away after 2 weeks
• Strong feelings of depression, anxiety and anger
• Sadness, doubt, guilt, or helplessness that get in the way of normal daily functions
• Withdrawal from family, friends, or pleasurable activities
• Constant fatigue, trouble sleeping, or change in appetite
• Inability to care for self or baby
• Intense worry about the baby or a lack of feeling for the baby
• Thoughts about suicide; fears of harming the baby

This form of depression can be successfully treated with many types of therapy, but many women who experience it do not seek treatment. The attached questionnaire, the Edinburgh Postnatal Depression Scale, is used to screen for postpartum depression. A score of 10 or more indicates that you should speak with a health professional about postpartum depression, and a score of 5-9 indicates that you are at risk for developing the illness.

Treatment Options

Katherine L. Wisner, M.D., M.S., of Women's Behavioral HealthCARE of WPIC/UPMC, is a leading researcher and expert in treating depression during pregnancy and postpartum. Her numerous NIMH-funded research projects and articles have provided insight into the treatment and management of depression. She is currently studying the use of antidepressants during pregnancy and the effects of depression and antidepressant medication on the outcome of the pregnancy and the growth and development of the child. Women ages 15-45 who are 0-20 weeks pregnant may be eligible for this study. For more information call (412) 246-5349.

Antidepressant medications are effective in the treatment of postpartum depression. Dr. Wisner is comparing the antidepressant medications Nortriptyline (Pamelor) and Sertraline (Zoloft) for the treatment of postpartum depression. Both of these medications are reasonable choices (according to the American Academy of Pediatrics) for breastfeeding mothers. Women ages 15-45 who have had a baby within the last three months and are either recently depressed or were depressed before the birth of their child may be eligible for this study. For more information call Stacy Stull at (412) 246-6562. Interpersonal psychotherapy is an available treatment option that does not involve the use of medication.

Dr. Wisner and team are working hard to find ways of preventing postpartum depression as well. She has received a grant to study the prevention of recurrent postpartum depression. She and her team will examine whether treatment with an antidepressant before the onset of postpartum depressive symptoms can prevent the occurrence of the illness.

Any new mother who experiences symptoms of postpartum depression should contact a health professional for treatment. Women's Behavioral HealthCARE is happy to provide resources and information to these women as well, just call (412) 586-9072 for information!