During pregnancy and following the birth of a baby, a wide range of emotions is possible. Often there are the expected feelings of excitement and joy, along with feelings of anxiety and worry.

Postpartum "blues" or "baby blues" affect 50% to 80% of new mothers. The condition represents a temporary state of heightened emotional responses. New mothers may present symptoms such as .

• mood
• swings
• weepiness
• anxiety
• irritability
• difficulty
• sleeping

Symptoms are normally interspersed with times of feeling well. Symptoms usually begin 3-4 days after delivery (often coinciding with the onset of lactation), worsen by days 5-7, and tend to go away by day 12.

The propensity to develop "baby blues" is unrelated to previous psychiatric history, environmental stressors, cultural context, breastfeeding, or number of pregnancies. However, those factors may influence whether the "blues" lead to major depression. If symptoms last longer than 2 weeks, it is important to seek professional attention, since one in five women (20%) with postpartum "blues" go on to develop postpartum major depression.

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At least one in 10 new mothers experiences various degrees of postpartum depression. Postpartum complications can occur within days of the delivery or appear gradually, sometimes up to a year or so later. Symptoms of postpartum depression may include:

• Sluggishness, fatigue, exhaustion
• Sadness, depression, hopelessness
• Appetite and sleep disturbances
• Poor concentration, confusion
• Memory loss
• Overconcern for the baby
• Uncontrollable crying, irritability
• Guilt, inadequacy, worthlessness
• Lack of interest in the baby
• Fear of harming the baby or yourself
• Fear of losing control or "going crazy"
• Exaggerated highs and/or lows
• Lack of interest in sex
• Insomnia
• Intrusive thoughts

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Some women may not feel depressed, but may feel very anxious. Postpartum anxiety and/or panic disorder is characterized by:

• Intense anxiety and/or fear
• Rapid breathing
• Fast heart rate, palpitations
• Sense of doom
• Hot or cold flashes
• Chest pains or discomfort
• Shaking
• Dizziness
• Insomnia
• Feelings of wanting to "run away"

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Symptoms of postpartum obsessive-compulsive disorder (OCD) can also occur for the first time in women following childbirth. Women may have thoughts that are often scary and perceived as being out of character for the woman experiencing them. These thoughts are symptoms of the illness: things one would never want to happen. In addition, if a woman has a history of OCD, her symptoms may intensify.

Symptoms include:

• Intrusive, repetitive thoughts (which may include thoughts of
  harming the baby or others)
• Obsessive thoughts
• Avoidance behavior (i.e., avoiding the baby to alleviate intrusive thoughts)
• Anxiety and/or depression
• Fears

Please remember that with good medical/psychiatric intervention, these illnesses are treatable and prognosis is excellent. Do seek help from someone specializing in these disorders.

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Treatment varies for disorders associated with depression after delivery, depending on the type and severity of symptoms. All of the symptoms, from the mild to the most severe, are temporary and treatable with skilled professional help and support.
A woman experiencing any of the symptoms described should contact her health care professional. She should have a complete medical evaluation, including a thyroid screening. When seeing her doctor, she should ask about having .

•   a medical evaluation to eliminate physiological causes, such as thyroid imbalance. Occasionally, levels of thyroid hormones may drop after giving birth. The thyroid is a small gland in the neck that helps to regulate your metabolism (how your body uses and stores energy from food). Low thyroid levels can cause symptoms of depression including depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain. A simple blood test can tell if this condition is causing a woman's depression. If so, thyroid medicine can be prescribed by a doctor.
• a psychiatric evaluation
• psychotherapy
• participation in a support group for emotional support and education

Reaching out for the proper help is an important step toward recovery. Some women don't tell anyone about their symptoms because they feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They worry that they will be viewed as unfit parents. Postpartum depression and the above-mentioned related postpartum mood disorders can happen to any woman. It does not mean you are a bad or "not together" mom. You and your baby don't have to suffer. There is help. If you are experiencing the symptoms described, do not continue to suffer in silence. Share your concerns with your health care professional.

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Some other helpful tips:

• Try to get as much rest as you can. Try to nap when the baby naps.
• Stop putting pressure on yourself to do everything. Do as much as you can and leave the rest!
• Ask for help with household chores and nighttime feedings. Ask your husband or partner to bring the baby to you so you can breastfeed. If you can, have a friend, family member, or professional support person help you in the home for part of the day.
• Talk to your husband, partner, family, and friends about how you are feeling.
• Do not spend a lot of time alone. Get dressed and leave the house. Run an errand or take a short walk.
• Spend time alone with your husband or partner.
• Talk with other mothers, so you can learn from their experiences.
• Join a support group for women with depression. Call a local hotline or look in your telephone book for information and services. Don't make any major life changes during pregnancy. Major changes can cause unneeded stress. Sometimes big changes cannot be avoided. When that happens, try to arrange support and help in your new situation ahead of time.