Understanding Postpartum Depression

Postpartum Depression

Postpartum depression is a clinical condition affecting women, usually after childbirth. After giving birth, a woman undergoes a normal postpartum emotional change and it is important to distinguish it from a postpartum depression. The distinguishable features of a postpartum depression consist of the frequency, duration and intensity of the emotional changes felt by the woman.

Mothers who just gave birth to a child usually feel emotional changes such as feeling sad and anxious periodically that may occur during the first few days after birth. This condition is called baby blues or postpartum blues which normally occurs after childbirth. This emotional transitory moodiness is often manifested by sadness, hypochondriasis, irritability, impaired concentration, sleeplessness, headache and isolation. This condition is different from postpartum depression and they are not a precursor to any postnatal psychosis and postpartum depression that may occur. The periods of depression usually last for 10 days in postpartum/baby blues.

Another condition similar to postpartum depression is the postpartum exhaustion which is often triggered by extreme fatigue with symptoms that include sleep deprivation with hormonal changes from the woman's body after giving birth. The condition may either be mild or severe and the condition usually lasts only between 1 to 20 days, which is highly responsive to improvements by getting enough sleep. This condition usually occurs in women whose babies suffer from severe colic or other causes that make the mother observe abnormal sleep schedules.

Postpartum depression usually occurs when the depression felt usually persist for up to 6 months or more. The severity and duration may vary for every woman. Those with severe depression usually take longer to get well. In extreme cases a more severe form of postpartum depression usually develops into postpartum psychosis.

What Causes Postpartum Depression?

There has been no identified single cause to the development of postpartum depression, but there are several possible causes for mothers to develop the condition influenced by the following factors:

Biological and Physical Changes

• The dramatic drop in the estrogen and progesterone levels after birth causes hormonal changes in the mother's body, thereby making them prone to experience depression.
• Changes from the thyroid gland hormone secretion can also cause a woman to feel tired, sluggish and intensely depressed.
• Mood swings and fatigue often occur due to the changes in the blood pressure, metabolism, immune system and blood volume.

Emotional Factors

• Mothers often experience emotionally distress caused by lack of sleep and overwhelming responsibility to take care of their children that they often have trouble handling minor problems. They feel anxiousness in taking care of the child and they may feel less attractive and may experience struggling with their sense of identity.  These emotional factors often make them feel they have lost control over their life and may contribute to postpartum depression to occur.

 Lifestyle Influences

Lifestyle factors can also contribute to the risk of developing a postpartum depression. Taking care of a crying baby while one has to take care of the house and do some chores can make a woman more depression. Moreover, financial problems, difficulty with breastfeeding and the lack of support from the partner or their loved ones are likewise common issues that contribute to the worsening of the condition.

Other Risk Factors:

• Unwanted pregnancy
• Unsupportive spouse
• Marital difficulties
• Family history of depression or mental illness
• Personal history of previous depression during pregnancy or at other times
• External stressful events such as loss of job and financial problems
• Recent separation or divorce
• Obstetric complication
• Early childhood trauma or abuse
• History of thyroid problems
• Formula feeding other than breastfeeding
• Cigarette smoking
• Low self-esteem
• Childcare stress
• Pre-natal depression and anxiety
• Life stressors
• Low social support
• Lower economic status
• Sever premenstrual syndrome
• Infant temperament problem/colic problem
• Maternity blues
• Single parent

The formula feeding, cigarette smoking and the history of depression are risk factors with the highest correlation with the occurrence of prenatal depression. Studies have shown that women with the highest prenatal depression will likely experience a higher level of postpartum depression while those with mild prenatal depression will also have low levels of postpartum depression.

getting help for Postpartum Depression

Common Symptoms of Postpartum Depression

It is important to identify the different symptoms of postpartum blues, postpartum depression and postpartum psychosis since these conditions have overlapping manifestation of symptoms which can be mistaken one from the other.

Postpartum Blues (occurs during the first few weeks after delivery)

• Insomnia
• Irritability
• Tears/crying
• Mood swings
• Anxiety
• Sadness
• Decreased concentration
• Sleep disturbance such as trouble sleeping
• Loss of interest in sex
• Unhappy
• Severe mood swings
• Withdrawal from the family and friends
• Difficulty bonding with the baby
• Thought of harming oneself or the baby
• Hopelessness and emptiness
• Depression
• Loss of weight
• Sluggishness
• Difficulty in making decisions
• Suicide
• Confusion
• Disorientation
• Paranoia
• Hallucinations
• Delusions
• Attempt to harm oneself or the baby
• Disturbed sleep even when the baby is sleeping
• Drastic changes in mood
• Drastic behavior

Diagnosing postpartum depression 

The physicians are required to recognize the distinguishable features of a postpartum depression from the normal postpartum blues experienced by women after childbirth. Weight and appetite changes, most especially during breastfeeding, as well as sleep deprivation for taking care of the child, are universal in early motherhood. The onset of the postpartum depression in 60% of the patients occurs in the first 6 weeks postpartum giving the physician the perfect opportunity in making a diagnosis. 

Once postpartum depression is left untreated, it can interfere with the bonding between the mother and child causing great family distress. Children of mothers with untreated and undiagnosed postpartum depression are at risk of developing behavioral problems that can equate to the following conditions:

• Difficulty in sleeping and eating
• Hyperactivity
• Tantrums and delay in language development.
• Mothers with undiagnosed and untreated postpartum depression are likely to have their condition progress into a chronic depressive disorder.

How is postpartum treated?

The treatments involved with postpartum depression are similar to the treatment provided for common depressive disorders. The condition naturally disappears after three months, but when the symptoms persist beyond this period, the following treatments are usually prescribed:

Medication

Prescribing medications help address to resolve the immediate problems of sleep deprivation and changes in appetite. The main choice of medication for postpartum depression is antidepressants. There are various antidepressants with less potential risk to the baby. Breastfeeding mothers should be aware that the medication they take will enter their breast milk, thus they should discuss with their physicians the benefits and risks of taking any drugs.

Hormonal Treatment

Estrogen therapy helps in counteracting the sudden drop of estrogen during childbirth. This helps ease the symptoms of depression in women.

Psychotherapy

Counseling provides mothers a good outlet in expressing their feelings to a psychologist or psychiatrist. They are taught with positive coping mechanisms to their depression and resolve conflicting problems and set realistic goals. Talk therapy provides mothers emotional support to resolve their depression. In some cases of postpartum depression, talk therapy alone can be an effective treatment for the condition.  Support groups can provide mothers useful information on how to cope with their everyday stress by learning from the experiences of those who have surpassed the condition.

Make sure to take your loved ones to a doctor the moment she manifests the symptoms of postpartum depression.

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