Chapter V: Postpartum Depression vs. Empty Nest Syndrome

What is postpartum depression?

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.

Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

Postpartum depression is not the "baby blues," which many women have in the first couple of weeks after childbirth. With the blues, you may have trouble sleeping and feel moody, teary, and overwhelmed. You may have these feelings along with being happy about your baby. But the "baby blues" usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.

In rare cases, a woman may have a severe form of depression called postpartum psychosis. She may act strangely, see or hear things that aren't there, and be a danger to herself and her baby. This is an emergency, because it can quickly get worse and put her or others in danger.

It’s very important to get treatment for depression. The sooner you get treated, the sooner you'll feel better and enjoy your baby.

What causes postpartum depression?

Postpartum depression seems to be brought on by the changes in hormone levels that occur after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth.

You have a greater chance of getting postpartum depression if:

• You've had depression or postpartum depression before.
• You have poor support from your partner, friends, or family.
• You have a sick or colicky baby.
• You have a lot of other stress in your life.

You are more likely to get postpartum psychosis if you or someone in your family has bipolar disorder (also known as manic-depression).

What are the symptoms?

A woman who has postpartum depression may:

• Feel very sad, hopeless, and empty. Some women also may feel anxious.
• Lose pleasure in everyday things.
• Not feel hungry and may lose weight. (But some women feel more hungry and gain weight).
• Have trouble sleeping.
• Not be able to concentrate.

These symptoms can occur in the first day or two after the birth. Or they can follow the symptoms of the baby blues after a couple of weeks.

If you think you might have postpartum depression, fill out this postpartum depression checklist . Take it with you when you see your doctor.

A woman who has postpartum psychosis may feel cut off from her baby. She may see and hear things that aren't there. Any woman who has postpartum depression can have fleeting thoughts of suicide or of harming her baby. But a woman with postpartum psychosis may feel like she has to act on these thoughts.

Empty-nest syndrome

is the name given to a psychological condition that can affect a woman around the time that one or more of her children leave home.
It's not a term you'll find in many medical text books, but it has become a useful phrase for encapsulating the feelings of sadness and loss that many women experience when their children no longer live with them or need day-to-day care.
It's most common in autumn, when vast numbers of teenagers have just left home for college or university.
It can also happen when a child gets married, because matrimony is a clear signal that Mum is no longer needed in the same way she once was.
Normal reactions
It's natural for a mother to feel some sadness when her child leaves home.
It is quite normal to have a little weep now and again – or even go into the absent child's bedroom and sit there for a bit in an attempt to feel closer to him or her.
We know of a successful, busy and confident woman - an agony aunt, in fact - who admitted she went into her son's bedroom to sniff his T-shirt shortly after he left to go to university for the first time.
So don't be ashamed of your feelings - they are natural.
More troubling reactions
But if you experience any of the following severe symptoms, you should seek professional help - especially if they go on for longer than a week.

• You feel your useful life has ended.
  
• You are crying excessively.
  
• You're so sad you don't want to mix with friends or go to work.
  

In this kind of situation, what seems to happen is that the child's departure unleashes seriously depressed feelings, and these very definitely need treating.
If you know that your sadness is overwhelming you, do go and discuss your feelings with your GP as soon as possible.
You almost certainly could use some counselling to get your feelings into perspective, and you may need antidepressants.
A time of change
When a woman is at the stage in life where her kids are leaving, she may also be going through other major changes, such as dealing with the menopause or trying to cope with increasingly dependent elderly parents.
It can be a difficult time, and it's no disgrace if you need help of various kinds to get through it.
If menopausal symptoms are badly affecting you, and they seem worse because of your kids leaving home, see your GP who should be able to help.
You might also be interested in the work of the Natural Health Advisory Service or of the organisation called the Amarant Trust, which is devoted to improving the lot of women who are having difficulties with the menopause.