Postpartum Depression

Postpartum depression is one of the most common conditions faced by the new mothers where the mother has a sense of hopelessness and the loss of self-worth. This leads to neglecting of the baby. Postpartum depression usually gets overlooked by people around but it needs serious attention because it severe cases the mother can cause harm to herself as well as the new born.  This serious situation is called postpartum psychosis which is dangerous not only for the mother and child but also for the people around. Thus, the best which can be done is to get the treatment as soon as possible so that the mother can get well soon and enjoy her motherhood.

What is Postpartum Depression?

Postpartum depression can be defined as the occurrence of mood disorder in a woman after giving birth. There is a sustained feeling of anxiety, fatigue and sadness which the women may find greatly difficult to cope with. This in turn leads in difficulty in taking care of self as well as the baby. The onset of the condition may occur anytime post child birth up to the first year.

Contrary to the postpartum depression, the baby blues is a short term condition which is denoted by the presence of irritated, weepy and moody behavior of the mother opposite to the expected behavior of joy and happiness.

Symptoms of Baby blues and Postpartum Depression

The symptoms of baby blues and postpartum depression are similar; the prime difference lies in the severity. The baby blues go off soon but the postpartum depression persists longer and is much more intense. The symptoms for baby blues and postpartum depression are:

Symptoms of Baby blues: The symptoms of this condition are more related to worry with respect to the child. The other symptoms include:

  • Fear and worry regarding the health of the baby even when the baby is alright
  • Continuous sense of anxiety
  • Loss of focus and concentration
  • Persistent sleeplessness
  • Fatigue
  • Frequent tears and weeping for unknown reasons.

Symptoms of Postpartum Depression: These include-

  • Hypersensitive behavior
  • Enhanced levels of irritability
  • Finding it difficult to concentrate
  • Constant urge to weep and cry
  • Easy agitation
  • Increased amount of anger
  • Exhaustion and tiredness
  • Changes in appetite, the patient could suffer from loss of appetite as well as increase of the same.
  • Increased amount of aches and pain in head, stomach, back and muscular region.

Prevalence of Postpartum Depression

Studies have found that around 10-15% of new mothers are affected with postpartum depression in developed countries. In a study conducted in Canada in 2005 and 2006 on 6421 Canadian women, it was found that around 8.46% and 8.69% women suffered from minor/major and major postpartum depressions respectively. In India, the rates have been found to be 23%, 16% ad 6% in Goa, rural South India and New Delhi respectively. The significant factors that contribute towards the condition were identified as low income, poor literacy among women, birth of a female child, marital relationship problems and depression during pregnancy. However, it must be noted in this respect that awareness regarding Mental Health is very poor in India and thus very few women would actually come and report the symptoms due to negligence, being unawareness and also due to shame associated with being diagnosed with mental illness. It must also be noted that according to National Family Health Survey-2, 34% of pregnant women do not receive a single antenatal check-up and also only 35% of all childbirth are done in healthcare setups. It was also stated that in some states of India, 65% of pregnant women do not get a single antenatal or postnatal checkup.

Causes of Postpartum Depression

There are no special causes that can pin-point the condition but physical and emotional wellbeing of the mother plays a pivotal role in the presence or absence of the condition.

  • Physical Health: There occurs a sudden drop in the levels of hormones like estrogen, progesterone, and thyroid in the mother’s body post childbirth leading to a feeling of exhaustion, depression and anxiety, contributing to the postpartum depression. The changes in the metabolism as well as in immune system and blood pressure can also increase the risk of postpartum depression.
  • Increased Stress and Emotional Challenges: Initial phases of sleep deprivation, fatigue and state of being overwhelmed gives a feeling to the mother that there is lot more on the plate than that can be handled. This in turn, keeps the mother in the state of judging her ability and suitability to care for the new born. Furthermore, the changes in the body occurring post-delivery lead to loss of self-esteem and sense of worth. The increased amount of stress as a result of taking care of the baby can also lead to mood problems and depression.

Risk Factors for Postpartum Depression

Studies suggest a woman can have an increased risk for postpartum depression when they have experienced depression before or during pregnancy. Other factors which increase the risk for a woman to have postpartum depression are:

  • History of postpartum depression in earlier pregnancy
  • Lack of proper support from partner, family or friends
  • Depression during pregnancy
  • Life stress such as illness of newborn, family problems, financial problems.
  • Poor physical health of the woman post childbirth
  • Family history of depression or bipolar disorder
  • History of premenstrual syndrome or premenstrual dysphoric disorder
  • Being in an abusive relationship either physical or sexual.

Diagnosis of Postpartum Depression

The process of diagnosis involves analysis of the mental health by the medical supervisor. The initial stage of diagnosis involves the identification of the stage of depression being suffered by the patient. This helps in verifying whether the patient suffers from a short term condition like baby blues or a long term ailment like postpartum depression. For the purpose of identification the patient has to answer a questionnaire related to depression screening. Furthermore, blood tests are also conducted to assess the thyroid activity, which may also act as a contributing factor for depression.

Treatment of Postpartum Depression

The results of treatment and the recovery of an individual are entirely dependent on the emotional and physical health. The treatment may also include psychiatric help to deal with severe depressions.

  • Treatment for Baby Blues: Since, it is a short term condition; it does not persist long enough and subsides by itself. However, certain steps when followed ensure that the condition does not get worse. Individuals should take loads of rest, happily accept the help offered by the people around, interact with other mothers and share the experiences and worries, spend some alone time and adopt a lifestyle modification in case taking alcohol or other drugs.
  • Treatment for Postpartum Depression: The treatment usually requires mental health counseling and medications. A key rule to consider for the treatment is to ensure continuity of the treatment ever after there is a recovery observed because early finishing of treatment may lead to relapse of the condition. The treatment could include the following methods:

Psychotherapy: Interaction with mental health providers like psychologist and psychiatrist, helps in coping up with the condition well. It always helps to talk it out resulting in the feeling of positivity.

Antidepressants: After analyzing the condition and the potential risks associated, the doctors can also provide antidepressants, antipsychotic medications and mood stabilizers or a combination of them. The effect of the medication on the baby is carefully evaluated since the newborn is on breast feeding.

Electroconvulsive Therapy (ECT): It is recommended in severe cases when the patient fails to respond even to the medications. The therapy involves application of small amount of current to the brain to minimize the symptoms of depression.

Coping and Lifestyle Changes for Postpartum Depression

The medical help and people around shall always be present but certain choices made by an individual also help in dealing with the situation. These may include:

  • Making lifestyle changes by adopting a healthy lifestyle by incorporating exercise and healthy food.
  • Be realistic and prevent tension and self-pressurizing.
  • Spend some alone time and relax.
  • Taking out sometime for pleasurable activities.
  • Escape the isolation.
  • Whenever required do not hesitate to ask for help.

Conclusion

Postpartum depression is a condition that ails many women post their delivery up to the first year. It may also occur after a miscarriage or a still birth. The condition usually goes unnoticed by the family and caregivers but it is and can turn into a serious illness if left unattended. It may pose a risk to both the mother and the baby. Whenever the symptoms are observed, the patients should take medical help for the treatment to ensure the wellbeing of both mother and the child.

Reference:

  • Chandra PS. Post-partum Psychiatric care in India: The need for integration and innovation. World Psychiatry. 2004 Jun; 3(2):99–100.[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414679/]
  • Dubey C, Gupta N, Bhasin S, Muthal RA, Arora R. Prevalence and associated risk factors for postpartum depression in women attending a tertiary hospital, Delhi, India. International Journal Social Psychiatry.2012 Nov; 58(6):577-80. [http://www.ncbi.nlm.nih.gov/pubmed/21821632]

 

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Note: This information is only for reference and is not a substitute of a medical care in any form. Kindly consult with a Healthcare Professional for detailed diagnosis, treatment and follow up.

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