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My cousin is pregnant and has a history of depression. Is she at risk for postpartum depression? Is postpartum depression any different from regular depression? What can I do to help? - Cousin who cares

Postpartum depression occurs in 10 to 20 per cent of mothers up to a year after giving birth. Some women are more susceptible than others, including those who have:

- a history of depression

- a great deal of stress

- a family history of depression

- had difficulty giving birth

- a sick baby

- no friends or family to support them.

Postpartum depression is quite similar to ordinary depression. It may be triggered by hormonal changes involved in childbirth, or by all the changes that occur with the birth of a baby. Women with postpartum depression often have anxiety as well.

It's different than post-partum psychosis, in which moms lose touch with reality and may become quite agitated. postpartum psychosis is a medical emergency. Immediate treatment is mandatory for the safety of the mom and her baby.

The treatments for postpartum depression are the same as for other types of depression. Cognitive behaviour therapy and interpersonal therapy have been shown to be effective. Antidepressant medications also work.

Your cousin has probably discussed what to do with her doctor, and they probably have a plan. If your cousin is on antidepressant medication, she and her doctor may decide to continue with medication. They will have to weigh the risks and benefits of all options.

Depending on your relationship with your cousin, you might be able to provide lots of help for her. If you are close to her, she may want to talk to you. You may be a special friend to her.

As with any new mom, she will need support from family and friends. All moms need some assistance. Maybe you can help by minding the baby for a while so the new mom can get a nap, go out for a walk on her own or have a coffee with a friend.

Perhaps you can help her by:

- Noticing positive things, such as the way she soothes her baby.

- Taking her out for lunch.

- Having her over to your place.

- Chatting on the phone with her.

When dealing with people who are depressed, you must balance your wish to help and the need for depressed people to run their own lives as they see fit. Don't take over. Don't be over the top. She is not helpless. You will not help her by making her feel incompetent. She will need her space.

Remember, she can make her own decisions. Just because she is depressed or has been depressed doesn't mean she isn't in a position to run her own life. Be respectful of her.

Depressed people sometimes reject those around them. Don't take it personally. And don't give up your efforts to be helpful. Back off a little and let her know you care and want to be helpful. Ask her what you can do.

She is lucky you are concerned.

Note: This week's question is based on one Dr. Pat has been asked repeatedly throughout his career.