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I’m pregnant with my first baby and due to give birth in the next few months. I’ve experienced depression in the past, and am worried that I might develop post-partum depression. What are the risk factors and warning signs? What should I do to decrease my likelihood of developing post-partum depression?

Written by our mental health expert, Dr. Emily Koert, Registered Clinical Counsellor. We know that if you’ve had an episode of depression in the past, you’re more likely to develop post-partum depression. However, don’t despair – the fact that you’re aware of the risk means that you can intervene earlier, so that it’s less likely you’ll experience a full-blown depressive episode. It’s also important to recognize that the transition to parenthood is one of the most stressful events that an adult ever faces in life. So it’s normal that you’ll feel some growing pains or increased stress once you become a mother. It’s also normal to experience the “baby blues,” – the typical emotional ups and downs that occur soon after the baby is born. You have to adjust to the 24/7 demands and responsibilities of an infant, at the same time that your body and hormones are adjusting to breast-feeding and no longer being pregnant. Around 50-80% of women experience the baby blues, which generally subside within a few weeks after giving birth. A smaller proportion (approximately 10%) of women develop post-partum depression, which involves more intense symptoms that persist over weeks and sometimes months. There are things that you can do that may help decrease your likelihood of developing post-partum depression after you give birth, or that could alert you to the signs that you’re experiencing post-partum depression so that you can seek the necessary medical and social support. Educate yourself about post-partum depression so that you can recognize the symptoms and get help as soon as possible. Warning signs include feelings of intense sadness and weepiness, withdrawing from others, feelings of failure and inadequacy, and sometimes debilitating feelings of intense concern or anxiety about the baby. Talk to your doctor or mental health professional about any concerns you have. They’ll be able to monitor you closely after you give birth, to determine if you’re developing any symptoms of depression, and if those symptoms are typical of the baby blues or something more serious. Ensure that you have support (your partner, parents, family members, friends) and that you feel supported. It takes a village to raise a child, and in the immediate post-partum period you don’t need to do it on your own. Don’t be afraid to ask your family members and friends for assistance. Invite your partner to share in the childcare and household responsibilities. Find other mothers who are going through the same transition – there are often support groups in local communities. Feeling isolated can increase feelings of stress and anxiety, so knowing you have people you can count on is important. Take care of yourself – sleep when you can, eat nutritious food, and exercise – parents are likely to experience sleep-deprivation in the first weeks and months after they bring home a new baby. However, lack of sleep will make coping with the transition to parenthood more difficult. Perhaps you need to call on your partner, family members, or friends to take care of the baby while you get a few hours of sleep after a long stretch of sleepless nights. Express milk if you’re breastfeeding, so that your partner can take one of the night-time feedings. Eating well and getting regular fresh air and exercise (within reason with your doctor’s permission) will also go a long way toward reducing your stress and improving your mood. Monitor your expectations of yourself and be self-compassionate – it makes sense that there are bound to be some bumps in the road as you adjust to motherhood. Many new moms feel guilty if they’re not feeling overjoyed at becoming a new parent. Remind yourself that you’re learning, and that you don’t have to be the “perfect” mother! And definitely don’t expect to know intuitively what your child wants or to immediately feel bonded to your baby. It takes time to build your confidence and to get to know this new little person. And it takes time for you and your partner to adjust to the realities of new parenthood. Seek help – if you find yourself sinking into depression and experiencing symptoms like loss of appetite, insomnia, intense irritability, overwhelming fatigue, lack of joy in life, feelings of shame, guilt, or inadequacy, or severe mood swings, know that you’re not alone, and it’s not your fault. Talk to your doctor about your best options for treatment, which often include medication and/or therapy. It’s especially important to seek help immediately if you find yourself fearing that you might harm yourself or your baby. Read another Ask an Expert question about post-partum depression here. The following online resources and books may be helpful: http://www.apa.org/pi/women/resources/reports/postpartum-dep.aspx http://www.circleofmoms.com/top25/top-postpartum-depression-mom-blogs-2012

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