Postpartum Depression: When To Call A Doctor

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When To Call a Doctor

Call 911 or other emergency services if you think you cannot keep from harming yourself, your baby, or another person. You can also call the national suicide hotline, National Hopeline Network, at 1-800-784-2433 or the National Child Abuse Hotline at 1-800-422-4453.

Call your doctor immediately if:

• You are not having symptoms of postpartum depression (listed below), but you have hallucinations involving smell, touch, hearing, or sight or have thoughts that may not be based in reality (delusions). Examples of delusions are fears that someone is watching you, stealing from you, or reading your mind.
• You have severe symptoms of postpartum depression.
• You have any symptoms of depression and have had depression or postpartum depression before.
• You have had any symptoms of depression for longer than 2 weeks. You don't necessarily have all possible symptoms when you have depression. Call sooner rather than later, before your condition gets worse.

Symptoms of postpartum depression include:

• Depressed mood—tearfulness, hopelessness, and feeling empty inside, with or without severe anxiety.
• Loss of pleasure in either all or almost all of your daily activities.
• Appetite and weight change—usually a drop in appetite and weight, but sometimes the opposite.
• Sleep problems—usually trouble with sleeping, even when your baby is sleeping.
• Noticeable change in how you walk and talk—usually restlessness, but sometimes sluggishness.
• Extreme fatigue or loss of energy.
• Feelings of worthlessness or guilt, with no reasonable cause.
• Difficulty concentrating and making decisions.
• Thoughts about death or suicide. Some women with PPD have fleeting, frightening thoughts of harming their babies: these tend to be fearful thoughts, rather than urges to harm.

Watchful Waiting

If your symptoms are new and not severe, you can wait up to 2 weeks to see if they will go away. Otherwise, call your doctor as soon as you notice symptoms. The earlier you are treated, the more quickly you will recover, and the less your baby's development will be affected by your condition.⁵

Who To See

Your obstetrician may be the first doctor to note and diagnose PPD. This is one of many reasons why it's important to have a medical check 3 to 6 weeks after childbirth. Treatment for PPD ideally involves both medicine and some form of professional counseling. To effectively treat depression, it's important that you and your counselor have a comfortable relationship.

Diagnosis and medication management of postpartum depression can be provided by a:

• General practitioner.
• Family doctor.
• Psychiatrist.
• Physician assistant.
• Nurse practitioner.

Professional counseling can be provided by a:

• Psychologist.
• Social worker.
• Licensed professional counselor.
• Psychiatrist (all prescribe medicine, and many also provide counseling).

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Last updated:	June 24, 2008
Author:	Jeannette Curtis
Reviewed By:	Kathleen Romito, MD - Family Medicine, Lisa S. Weinstock, MD - Psychiatry
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC