Having a baby is a wonderfully joyous time for most women. But many women may feel sad, afraid, angry or anxious after childbirth. This is normal and means that you are adjusting to caring for your new infant. Most times these symptoms are mild and are called postpartum blues (or "the baby blues"). These symptoms usually go away in a few days. About 10% of new mothers have a more serious form called postpartum depression. This typically lasts longer and is more intense requiring counseling and treatment.

Baby Blues:  Many new mothers can be shocked at having feelings of loneliness, weakness, and sadness after giving birth. They often wonder "Why am I feeling this way?" Sometimes they fear this means they are not a good mother. About 70-80% of women have "baby blues" after delivery. Usually 2-3 days after childbirth, a woman can began to feel depressed, anxious, or upset for no apparant reason. She may show mood changes with her new baby, friends and/or family, or other children. Other symptoms could include: crying for no clear reason and having trouble sleeping, eating or decision making. These symptoms could come and go in the first few days after childbirth, but often go away within a week or two.

Postpartum Depression: Women who have postpartum depression can have extremely strong feelings of sadness, anxiety or despair. This will cause in trouble maintaining daily tasks and dealing with any type of stress. Postpartum depression can come on at any time after delivery, but usually starts within 1-3 weeks. It most likely occurs in women without emotional support or who have had previous postpartum depression, a psychiatric condition, or recent extreme stress (like the loss of a loved one, moving to a new city or change in life situation). Postpartum depression could also occur in women who do not have any risk factors. Symptoms of postpartum depression could include: "baby blues" that do not get better after a week or two, not being able to care for self or baby, changes in appetite, no longer enjoying things or activities that you used to love, anxiety or panic attacks, extreme worry lack of concern of newborn. If you or someone you know have any of these symptoms, you need to get help from your doctor as soon as possible. Rarely, a women can develop a very severe mental illness called postpartum psychosis. Women at increased risk for this have (or have family members with) disorders like bipolar disorder or schizophrenia.

Reasons for Postpartum Depression: No two women have the same biological makeup or life experiences, and this may be why some women will suffer from this condition and others will not. It is believed that postpartum depression results from a combination of hormonal, emotional, and lifestyle factors. Many women feel they have to be "the perfect mother". This can make them feel let down and depressed by the daily demands of childcare. A lot of first time mothers believe they should have a "mother's instinct" and know how to care for their infant when, in fact, mothering skills have to be learned just like all other skills. This can often cause feelings of extreme anxiety and depression. A new mother may find adjusting to a new baby is harder than expected. Babies have distinctive personalities right from birth. Some are easy to care for, while others can be fussy and needy. Most women will have trouble keeping a balance between caring for a new infant and previous responsiblities (like housework, caring for other children, giving attention to their partners or their jobs).

What can be done to help: If you are feeling depressed after the birth of your child, these are some things you can do to take care of yourself and your baby:

• Get plenty of rest. Nap when the baby naps.
• You can't do everything, so don't try. Be sure to ask for help when you need it.
• Take extra care of yourself. Get out of the house whenever possible. Ask for a babysitter or take the baby with you. You could take a walk outside, go see a friend, or talk to other mothers.
• Talk to someone you trust about how you are feeling. It is important to share your feelings with your partner or friend so they can help provide you with relief.
• Call your doctor immediately if your "baby blues" do not improve in a few days, or if you have thoughts of hurting yourself or others. If you have feelings of anxiety or helplessness, these could also be signs that you need to consult with your doctor.

If you indeed have postpartum depression and not just postpartum blues, there are many things that can be done to help. There are medications called antidepressants that your doctor may prescribe. You may also benefit from being referred to a counselor who can give you emotional support and help you sort through your thoughts and feelings. Hotlines and support groups are often available for women with postpartum depression. Be sure to talk with your doctor about finding what is best for you.