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Dr. Zach’s Guide to Postpartum Depression

BT Montreal | posted Monday, Jan 16th, 2017

By Dr. Zach Levine, ER physician, MUHC



A postpartum (PP) mood disorder begins within one-year of delivery with most occurring within four to eight weeks and lasts two weeks.

Distinguished by baby blues (BB) which is sadness interspersed with happiness, onset usually two-to-three days with a peak of seven-to-10 days.  Subsides within two weeks.

Baby blues affect 75 to 80% of new mothers, while 10-20% of new mothers are affected by postpartum depression.

Note — other postpartum mental health problems may be associated — anxiety disorders (PP Panic disorder, PP OCD), PP psychosis

Symptoms of PPD

  • Sadness
  • Crying
  • Insomnia
  • Appetite change
  • Difficulty concentrating
  • Feelings of worthlessness
  • Racing & obsessive thoughts
  • Anger
  • Fear
  • Guilt



  • Biological –  sudden drop in hormones (estrogen progesterone neurotransmitters) at delivery
  • Genetic – predisposition to mood disorders
  • Psychological – coping mechanisms, myths (below)


Freedom, identity, control, slim figure, feeling of unattractiveness. Usually comes down to a combination of factors.

  • Social – lack of support systems
  • Infant-related – even healthy infants require regular feedings around the clock and care, along with regular household needs. Unhealthy infants cause extra stress, as well as premature, those with colic.


The problem with myths is they don’t help – not meeting them can lead to guilt and shame. The fairytale image can be problematic: A happy mother, intuitive mothering, unremitting love, perfect baby, fathers being equally involved, being the perfect mother.


Risk Factors for PPD

  • First time mother
  • ambivalence about the pregnancy
  • History of mood disorder
  • Lack of social support
  • Lack of stable relationship with partner or parents
  • Unrealistic expectations about parenthood
  • Previous PPD


  • Therapy — individual or couple of group
  • Support groups
  • Practical help (every visitor brings food or does a load of laundry)
  • Medications

It is common and it is treatable and you are not alone.

Athena’s 2017 must-reads

BT Montreal | posted Thursday, Jan 12th, 2017

Athena the Book Explorer offers a selection of children’s books in English and French that she recommends to look at in 2017:

Book Series

  • ‘Magnus Chase and the Gods of Asgard’ by Rick Riordan
  • ‘The Trials of Appollo’ by Rick Riordan
  • ‘Diary of a Wimpy Kid: Double Down’
  • ‘Mother-Daughter Book Club’ series by Heather Vogel Frederick


  • ‘The Boy Who Dared’ by Susan Campbell Bartolleti
  • ‘Pax’ by Sarah Pennypacker
  • ‘Raymie Nightingale’ by Kate di Camilo
  • ‘Lily and Dunkin’ by Donna  Gephart
  • Escape from Mr. Lemoncello’s Library by Chris Grabenstein
  • (The sequel) Mr. Lemoncello’s Library Olympics by Chris Grabenstein

Graphic Novels

  • ‘Ghosts’ by Raina Telgemeier
  • ‘El Deafo’ by Cece Bell

French Suggestions

  • ‘Juliette’ series by Quebec author Rose Line Brasset
  • ‘Le comedien de Moliere’ by Annie Jay