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Dr. G: Baby Blues vs Postpartum Depression
monkeybee posted:
Hi Dr G,

I gave birth to my sweet baby girl just 6 days ago. Since then, I have cried uncontrollably ALL day long. When I was in the hospital, there was a medication issue and I didn't get my lithium at all for 3 days. I've had postpartum depression before but I don't remember it to be as bad as I feel right now. How do I know the difference between "baby blues" and postpartum depression? Could missing that many doses of my lithium be causing this? When do the "baby blues," if that is all this is, end? Thanks for your response.

Joseph F Goldberg, MD responded:
Dear Sarah,

Congratulations on the birth of your daughter. Weepiness and moodswings in the first couple of weeks after delivery can be normal baby blues -- which can happen in up to 80% of women. Clinical depression comes into the picture (assuming it wasn't already there before delivery) when the sadness is present more days than not for at least two weeks and is accompanied by the associated symptoms of depression -- trouble concentrating, feeling hopeless or worthless, thoughts of death or suicide, getting little or no pleasure from life, having no appetite, disrupted sleep (apart from baby wakenings). In women with bipolar disorder, PPD is especially a risk, and there is compelling research to show that in bipolar women who had been taking lithium but then stopped during pregnancy, mood relapse rates can be as high as 70% in the first several weeks after delivery -- which is why most experts in this area strongly advise women who've stopped lithium during pregnancy to get back on it immediately after delivery (of not before).

Dr. G.
monkeybee replied to Joseph F Goldberg, MD's response:
Thanks so much Dr G.

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