A friend of mine recently had a baby, and she is struggling emotionally. She finds herself having sudden feelings of rage that are totally contrary to her normal personality. Could these be due to hormone fluctuations? Is there anything that can be done to help her medically?

--Karen

Both the intense hormone fluctuations after a delivery and the major changes a newborn brings into one's life (such as sleep deprivation) can contribute to feelings of sadness, depression and even rage. As many as 10-15 percent of women will experience fairly severe symptoms after having a baby, and 50 percent will have a mild case of the "baby blues." Having a baby has got to be one of the most dramatically life-altering events one can experience, and life-altering events, even if they are happy events, are stressful.

If it is a case of the blues, it will be short-lived, and most of the time support and encouragement from family and friends are all that are necessary. Extra help around the house, an involved and loving husband/significant other, friends who will listen and share similar experiences -- all these do a world of good. For more severe cases, a visit to the doctor is necessary. There are certain groups of women who are at higher risk for more severe depression: adolescents, women with a past history of depression, women without good social supports, women who had postpartum depression before (70 percent of these women will experience it again). The obstetrician is a good starting point, but co-management with a psychologist or psychiatrist may be needed. Again, a supportive home environment is vital, but in these more severe cases antidepressant therapy is often necessary as well. Counseling is key here; medication alone is not nearly as effective as medication and sessions with an experienced therapist.

As a friend, you can offer to help with the baby or with household chores. You can listen. Let her know she is not alone -- that she is not the first nor will she be the last new mom to have such feelings. You can encourage your friend to seek professional help if this has been going on for more than a week or two, if she seems severely depressed, or if you are afraid she will hurt the baby or herself in a fit of rage -- this latter circumstance calls for immediate attention!