From Mary Shomon,
Your Guide to Thyroid Disease.
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One in 10 new mothers experience some degree of postpartum depression. These complications usually occur within just days after the delivery, but can can happen anytime during the first year after a baby is born.

Postpartum Depression Symptoms

The new mother may have a number of symptoms that include:

• feelings of sadness, even uncontrollable crying
• lack of energy, sluggishness
• severe fatigue or total exhaustion
• trouble concentrating, confusion
• anxiety
• feelings of guilt and worthlessness
• a sense of hopelessness or depression
• disturbances with appetite and sleep
• Lack of interest in the baby
• Mood swings – highs and lows

Of course, the demands of a new baby mean that many new mothers are tired and anxious. But the difference between postpartum depression and the more common "baby blues" is that postpartum depression can affect a woman's well-being and keep her from functioning for a longer period of time. Baby blues typically lift after a few weeks.

Postpartum depression should be evaluated and treated by a doctor. Counseling, support groups, and various medications -- including antidepressants, antianxiety drugs, and hormonal supplements -- are all options to help.

NOTE: If you have any fear of harming yourself or your baby, please call your doctor or 911 immediately, or go to the nearest emergency room -- help is available.

Identifying Underlying Thyroid Problems

Because some degree of fatigue and mood change is "expected" by doctors after the arrival of a baby, it's unfortunate that both PPD and postpartum thyroid disease are being written off as normal for a new mother, and not diagnosed and treated properly.

So, before your doctor diagnoses postpartum depression, you should be evaluated for postpartum thyroid disease.

Even among women who have never had any thyroid problems prior to pregnancy, thyroid problems after pregnancy occur in as many as 10 percent of all new mothers.

The Unique Signs of Postpartum Thyroid Disease

Symptoms of postpartum thyroid problems can be much the same as postpartum depression, with a few critical differences...

• An underactive thyroid -- postpartum hypothyroidism -- may worsen the fatigue and exhaustion. It's not unusual for a new mother to be tired, but to sleep 14, 16 or 18 hours and wake unrefreshed -- this is not normal.
• Postpartum hypothyroidism may cause a woman to gain weight during the postpartum period, when most women start to shed pregnancy weight. Or, a woman who is rigorously dieting and exercising to take off her pregnancy weight may find that she can't lose an ounce.
• Finally, an overactive thyroidafter pregnancy -- postpartum hyperthyroidism -- may cause rapid weight loss...some women report losing 10 or 20 pounds in just a few weeks. This may also be accompanied by other hyperthyroidism symptom such as diarrhea, rapid pulse, feeling overheated, anxiety, and difficulty sleeping.

Typically, a woman with postpartum thyroiditis enters the hyperthyroid phase first, followed by the hypothyroid phase, and then may bounce between the two -- several times, even -- before things settle down to normal again.

Postpartum Thyroid Problems: How Long Do They Last?

For some women, postpartum thyroid problems can be temporary, lasting anywhere from several months to as long as a year. For other women, however, thyroid imbalances after birth are the beginning of a lifelong autoimmune condition, such as Hashimoto's or Graves' Disease, that requires ongoing monitoring and treatment.

Women who tested positive before or during pregnancy for antithyroid antibodies have a 33% to 50% chance of developing thyroiditis after childbirth. Interestingly, researchers have found that the presence of thyroid peroxidase antibodies also make a pregnant woman nearly three times more likely to develop postpartum depression.

If your doctor suspects postpartum thyroid disease, you will have various tests -- including blood tests, and in some cases, ultrasound or other imaging tests -- to determine the nature of the problem.

Treating Postpartum Thyroid Disease

Treatment options vary. For some women, no treatment is necessary, and the condition resolves on its own fairly quickly. A majority of women will return to normal in several months to as much as a year after postpartum thyroid diagnosis, and will never have another problem. Other women have postpartum thyroid problems after every pregnancy, but otherwise things return to normal, until menopause, when thyroid problems again appear. Some women -- possibly as many as 30 percent -- remain hypothyroid because their thyroid glands were too heavily damaged by the imbalance, or because the pregnancy has activated an inherent case of autoimmune thyroid disease.

More on treatment...