Postpartum Depression and Colic – Risk Factors, Warning Signs, and Prevention Plan

I’m a survivor of two life-threatening postpartum depressions. At the time of my illnesses, there was no help for me. The great news is that, if you’re suffering from postpartum depression or know someone who is, there are excellent resources now. For the last 27 years my mission has been to educate medical and mental health professionals, and work directly with women and their families around the world to make sure they don’t suffer the way my family and I did. I’ve worked with over 21,000 women, and I’ve never met one who did not fully recover when given proper help. 

Women are most vulnerable to mood and anxiety disorders during pregnancy and the postpartum period. If depression or anxiety is going to surface, it typically happens at this time. Postpartum depression (PPD) is one of six postpartum mood and anxiety disorders and is the most common, affecting about 15 percent of mothers around the world. The primary cause of PPD is thought to be the huge hormonal shifts after the baby is delivered which affect the neurotransmitters (brain chemicals). However, there are also powerful psychosocial factors such as moving, health issues, poor partner support, sleep deprivation, financial hardship, social isolation and a high needs baby that can negatively affect the woman’s emotional state.

This last important factor — having a high needs baby, such as one with colic — is often unfortunately minimized due to ignorance. Despite solid research linking colic in the baby with the mom’s depression, those who do not understand the extreme physical and emotional stress of colic sometimes wrongly assume that this is a lesser factor than the others. In fact, nothing could be further from the truth. I know this not only from the thousands of depressed mothers with colicky babies with whom I’ve worked, but from my own experience as well. What happened in my home after the birth of our first baby was nightmarish, and colic was definitely a part of that picture. 

Jenn, one of my clients recovering from PPD, described her experience with a colicky baby. 

When Justin was a few weeks old, he started screaming every single day and it would last for hours. And I don’t mean crying — I mean screaming. His screams went right up my spine. My husband and I were frantic and totally stressed out. Just knowing it was going to happen every day made me so anxious! My nerves were fried after a few weeks. No baby book or class prepared me for his stiff, arched body and bright red face! I felt like a horrible mother. I knew I loved him, but there were times when I didn’t like him and I was sorry he was born. I felt so guilty and resented him for it. I mean, a good mom is supposed to be able to make her baby stop crying, right?”

In the next segment of this article, we’ll delve into colic and its interesting interaction with postpartum depression and anxiety. We’ll discuss how to cope psychologically as well as physically, so the turmoil can end.

PPD should not be confused with the normal Baby Blues.

Fifty to 80% of new moms experience being teary and stressed beginning the first week. But Baby Blues are mild and they should also be gone by two – or at the most, three – weeks following delivery. If the symptoms are severe enough to disrupt a mom’s daily life, or if mild symptoms continue past two to three weeks after the birth, it is considered to be PPD and she needs extra help.

Postpartum Depression Often:

• Worsens if the mother doesn’t receive help. If untreated, the symptoms can be much harder to get rid of. Research shows that 25% of mothers untreated for PPD remain depressed after one year. All the relationships within the family are also being affected.
• Develops gradually, although it can occur immediately after delivery.
• Peaks around 3 months, but can start any time during the first year.

PPD can arise for the first time after any birth, not just after the first. Once a woman has had one occurrence, she is high risk for another after a subsequent birth unless she has a solid wellness strategy in place. Common symptoms are excessive worry, anger, feelings of guilt, sadness, hopelessness, sleep problems, uneasiness around the baby, poor concentration, loss of pleasure, decreased sex drive, and changes in appetite. Although there are high risk factors, no one is immune.

Risk Factors

• Fifty to 80 % chance of PPD if there was a previous PPD
• Depression or anxiety during pregnancy
• Health problems with the mother or baby, including colic
• Personal or family history of depression or anxiety
• Abrupt weaning
• Social isolation or poor support (especially poor partner support)
• History of mood problems with her menstrual cycle
• Negative mood changes while taking a birth control pill

Warning Signs

There are warning signs for which professionals, family, and friends can watch. She may need help if she exhibits some of these behaviors:

• Misses her doctor appointments
• Worries excessively about her health or the health of the baby
• Looks unusually tired
• Requires a support person to accompany her to appointments
• Loses or gains a lot of weight
• Has physical complaints without any apparent cause
• Has poor milk production
• Cries easily
• Shows discomfort being with her baby
• Is not willing to let another person care for the baby
• Has appetite problems in either direction
• Cannot sleep at night when her baby is sleeping
• Expresses concern that her baby does not like her or that she’s a bad mother

Warning signs in the baby include excessive weight gain or loss, delayed cognitive or language development, decreased responsiveness to the mother, and breastfeeding problems.

There are many important reasons why a new mother with PPD should receive help as soon as possible. If she remains untreated, there is an increased risk of psychiatric and developmental disturbances in her children. There is a potential for child abuse or neglect, an increased risk for the woman to develop chronic depression or relapse, and there is a negative impact on the marriage and on all the family relationships.

The serious consequences of untreated maternal depression on children have been studied extensively. Infants with depressed mothers often weigh less, vocalize less, have fewer facial expressions, and higher heart rates. They may be less active, slower to walk, fussier, and less responsive to others.  Toddlers with depressed moms are at higher risk for affective disorders. Studies show an increase in poor peer relationships, poor self-control, neurological delays, and attention problems. Their symptoms mimic the mom’s depressed behavior. At 36 months, children with depressed mothers are often less cooperative and more aggressive. They also exhibit less verbal comprehension, lower expressive language skills, more problem behaviors and they perform poorly on measures of school readiness. Only one to two months of exposure to severe maternal depression increases the child’s risk to develop depression by age 15. 

Fathers (as well as adoptive parents) can also experience depression after the baby joins the family — although not due, of course, to reproductive hormones. Fathers become depressed at the rate of about 10 percent. Their symptoms often differ from the fluctuating moods that moms with PPD exhibit. Fathers seem to have more tension and short-temperedness as their main symptoms, accompanied with some fear, anger, frustration, and feelings of helplessness. Depressed new dads are often concerned about their partners, disrupted family life, and finances. They typically have increased expectations for themselves and confusion about their new role. 

The strongest predictor of whether a new dad will become depressed is the presence of PPD in the mother. A father whose partner has PPD has between a 24 and 50 percent risk of developing depression.  The onset of his depression is usually later then the onset of PPD in the mother. In Chapter 16 of Postpartum Depression For Dummies I discuss why partners, if they aren’t receiving adequate help themselves, sometimes become depressed as the moms recover.

Tony expressed,

Alice was a nervous wreck around our baby for the first three months or so. When I got home from work every day, Jeffrey was already crying hard and he’d keep crying for a long time. Nothing we did helped him and Alice fell apart. She started avoiding him as soon as I came home. She’d go to our bedroom, close the door and start crying herself. Eventually I started dreading coming home, since both of them were miserable. Looking back, I can see I was probably depressed myself, but at the time I didn’t know it.’

When fathers suffer from depression after the baby is born, their baby boys are often negatively affected the most. These boys have been found to have twice as many behavioral problems in their early years as other children without depressed fathers. What’s most important for children is that both parents are healthy and happy.