Depression and anxiety in new mothers: effects on the health of mothers and infants

Depression is an illness that affects the way people think, act and feel. About 6% of women will experience depression at some point in their lives. This number increases to about 10% (1 in 10) for women who are pregnant.

Women are more at risk of depression while they are pregnant, and during the weeks and months after having a baby. During pregnancy, hormone changes can affect brain chemicals and cause depression and anxiety. Sometimes, pregnant women don’t realize they are depressed. They may think they have symptoms of pregnancy or the “baby blues,” which many women experience right after birth.

It’s also important to know that as many as 10% of fathers experience postpartum depression after the birth of a child.

The good news is that depression can be treated. Read the signs listed below, and talk to your doctor if you have any of them. Let your partner and family members know the signs so that they can also be aware.

If you don’t get help, depression can cause problems for you and your baby.

What are the signs of depression?

Depression can come on slowly. The symptoms are different for everyone. They can be mild, moderate, or severe. Some of the more common signs are:

• changes in appetite, like eating too much or having little interest in food,
• changes in sleep, such as trouble sleeping or sleeping too much,
• lack of energy,
• feeling sad, hopeless, or worthless,
• crying for no reason, and
• loss of interest or pleasure in activities you normally enjoy.

New moms with depression may have trouble caring for their babies. They might not want to spend time with their baby, which can lead to a baby who cries a lot.

How does depression affect pregnant women?

If you have depression while you’re pregnant, you may have trouble caring for yourself.

Depression during pregnancy can also lead to:

• miscarriage,
• delivering before the due date (preterm),
• giving birth to a small baby (low birth weight).

If depression during pregnancy isn’t treated, it can lead to postpartum depression. Postpartum depression is a serious condition that can last for months after giving birth. It can affect your health and how well you bond with your baby.

What’s the difference between “baby blues” and postpartum depression?

The “baby blues” is a mild form of postpartum depression that many new moms experience. It usually starts 1 to 3 days after the birth and can last for 10 days to a few weeks. With “baby blues”, many women have mood swings—happy one minute and crying the next. They may feel anxious, confused, or have trouble eating or sleeping. Up to 80% of new moms have the “baby blues”. It’s common, and it will go away on its own.

About 13% of new mothers experience postpartum depression, which is more serious and lasts longer. You are at greater risk if you have a family history of depression or have had depression before.

Some of the symptoms include:

• feeling like you can’t care for your baby,
• extreme anxiety or panic attacks,
• trouble making decisions,
• feeling very sad,
• hopelessness, and
• feeling out of control.

No one knows exactly what causes postpartum depression. If you think you have the symptoms, it’s important to get help right away. Postpartum depression needs to be treated. Talk to your doctor or call your local public health officials.

If I’m depressed, will it affect my children?

Depression is treatable. But if it is not treated, it will affect your children.

Moms who are depressed may have trouble caring for their children. They may be loving one minute and withdrawn the next. They may respond to their child in a negative way or not respond at all. Your feelings and your behavior will affect your ability to care for your children.

Depression can also affect attachment, which is important for your child’s development. Attachment is a deep emotional bond that a baby forms with the person who provides most of his care. A “secure attachment” develops quite naturally. A mother responds to her crying infant, offering whatever she feels her baby needs—feeding, a diaper change, cuddling. Secure attachment helps protect against stress and is an important part of a baby’s long-term emotional health. It makes a baby feel safe and secure and helps him learn to trust others.

If you’re depressed, you may have trouble being loving and caring with your baby all the time. This can lead to an “insecure attachment,” which can cause problems later in childhood.

How a mother’s depression affects her child depends on the child’s age.

Babies who don’t develop a secure attachment may:

• have trouble interacting with their mother (they may not want to be with their mother, or maybe upset when with them),
• have problems sleeping,
• maybe delayed in their development,
• have more colic,
• be quiet or become passive, or
• develop skills or reach developmental milestones later than other babies.

Toddlers and preschoolers whose mothers are depressed may:

• be less independent,
• be less likely to socialize with others,
• have more trouble accepting discipline,
• be more aggressive and destructive, or
• not do as well in school.

School-aged children may:

• have behavior problems,
• have trouble learning,
• have a higher risk of attention deficit hyperactivity disorder (ADHD),
• not do as well in school, or
• have a higher risk of depression and anxiety, and other mental health problems.

Teens whose mothers suffer from depression are at high risk for a number of problems such as major depression, anxiety disorder, conduct disorder, substance abuse, ADHD, and learning difficulties.

Can depression be cured?

With treatment, most people recover from depression. Treatment can include one or more of the following:

• Social support: Community services or parenting education.
• Family therapy: With your partner and/or children. This can help when children are older.
• Individual therapy: Talking one-on-one with a family doctor, psychologist, psychiatrist, social worker, or other professional.
• Medication: Drugs used most often to treat depression are SSRIs (selective serotonin reuptake inhibitors).

If I take antidepressants during my pregnancy, will they hurt my baby?

You may think you should stop taking medication for depression when you are pregnant. Remember that, if left untreated, depression can have serious effects on both you and your baby. If you are taking antidepressants and are thinking about getting pregnant (or are already pregnant), talk to your doctor first, before stopping any medication. You can also consult the following trusted resources: www.mothertobaby.org, www.medicinesinpregnancy.org.

Some newborn babies may have symptoms such as irritability, fast breathing, tremors, and poor feeding if their mothers took antidepressants during pregnancy. These symptoms are usually mild and pass quickly, usually within 2 weeks. These babies typically respond well to a quiet environment, swaddling, skin-to-skin contact, and frequent small feeds. Serious problems such as heart defects or more severe breathing issues are very rare.

After your baby is born, they will be watched closely to make sure they are healthy. Your doctors and nurses will make sure that you are both well before letting you go home. You may need to stay an extra day or two in the hospital so that they can be sure.

If I am taking antidepressants, can I breastfeed my baby?

Breastfeeding provides many health benefits for babies. It also helps mothers and babies bond. If you are taking antidepressants, small amounts will come out through your breast milk. But studies have shown that children exposed to these drugs through breast milk have not had problems.

Even if you are taking antidepressants, you can breastfeed your baby for as long as you wish. Stopping an antidepressant during breastfeeding may cause the depression to return.

Can I take herbal remedies such as St. John’s Wort?

There is not enough information about St. John’s Wort to say that it is safe for pregnant or breastfeeding mothers. If you are pregnant or breastfeeding, talk to your doctor before taking any herbal products.

Is there anything else I should do?

If you are feeling any of the symptoms listed above, it is very important to tell someone. The early days of taking care of a new baby can be hard. You’re probably not sleeping much as you try to meet your baby’s needs around the clock. Find a friend, family member, or someone else you trust who can look after your baby for short periods while you get a break. If people offer help, accept it.

There are many support programs for new mothers. Talk to your doctor, nurse, midwife, or contact your local public health office for a listing of services in your area.