Postpartum Depression
What is Postpartum Depression?
Postpartum depression (PPD) is a serious mental illness that occurs among new mothers and involves negative emotions such as sadness, hopelessness, anxiety, anger, or indifference combined with sleep and appetite disturbances. According to the Office on Women's Health, 1 in every 9 new mothers experiences postpartum depression.
Causes
There is no one cause of postpartum depression, but rather a variety of emotional and physical factors that contribute to the development of PPD. The major ones include:
Hormones:
After birth, drastic hormonal changes occur, including a dramatic decrease in both estrogen and progesterone. Other hormone levels can also drop sharply and, in turn, result in fatigue and depression.
Lack of sleep:
Sleep deprivation affects the moods and energy levels.
Anxiety:
There is much anxiety around one's ability to care for a newborn.
Self-image:
During pregnancy and following birth, there are a lot of physical, mental, and environmental changes that occur. Some individuals may feel less attractive, or even as if they have lost a part of their identity.
Signs and Symptoms of Postpartum Depression
Signs and symptoms of postpartum depression can be hard to detect, as they vary from person to person and in severity. Some common symptoms include:
Depressed mood
Severe mood swings
Intense anger, irritability
Excessive crying
High anxiety or panic attacks
Difficulty bonding with your baby; disinterest in your baby
Changes in appetite (overeating, undereating, loss of appetite)
Sleep disturbances (insomnia or hypersomnia - sleeping too much)
Extreme fatigue
Social withdrawal
Lower libido
Feelings of worthlessness, guilt, or inadequacy relating to motherhood
Diminished ability to concentrate and make decisions
Thoughts of harming self or the baby
Thoughts of death or suicide
Types of Postpartum Depression
There are three distinct types of postpartum depression, which vary in both duration and severity.
The "baby blues":
occur in about 70% of women right after childbirth and last no longer than one or two weeks after delivery. The baby blues are characterized by acute mood swings, feelings of anxiety and depression, irritability, and disturbances in appetite and sleep. But the baby blues do not require treatment.
Postpartum depression:
PPD may seem similar to the baby blues at first, but the signs and symptoms are more severe and pervasive in nature, as they continue to develop over two weeks after childbirth. This is characterized by intense mood swings, excessive crying, extreme fatigue, and intense negative emotions relating to self or the newborn. These symptoms can likely interfere with the ability to care for the newborn or other daily responsibilities. These symptoms can last up to a year after childbirth. PPD can be treated with counselling or medication.
Postpartum psychosis:
This rare but serious condition develops within the first week to three months following childbirth when new mothers lose touch with reality. The symptoms are severe and include confusion, disorientation, obsessive thoughts about the baby, hallucinations, delusions, sleep disturbances, paranoia, and attempts to harm self or the newborn. The need for treatment is immediate and often requires medication or hospitalization.
Treatment
Because postpartum depression is a subjective experience, PPD is treated based on what symptoms are present and their severity. Common types of treatment for postpartum depression are as follows:
Therapy:
Individual talk therapy without medication is the first line of treatment used with PPD patients to address emotional and environmental changes and create a supportive environment for individuals with PPD.
Join a support group:
Joining a general "moms" support group, a group for new moms, or a group for moms experiencing PPD could be helpful to individuals with PPD and provide additional emotional and social support.
Medication:
Other treatment options include using anti-anxiety or antidepressant medications to relieve emotional symptoms and stabilize moods. It is important to consult with your doctor, as breastfeeding mothers may be limited in their options for medication.
Lifestyle changes:
Incorporating exercise, managing stress, and sticking to a diet high in nutrients and protein will further assist mood regulation. Avoiding caffeine, alcohol, and high sugar foods may also alleviate physical symptoms.
Frequently Ask Questions
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There are several ways to offer support to a friend or loved one experiencing postpartum depression:
Learn to recognize the signs and symptoms of depression and anxiety.
Encourage them not to compare themselves to other mothers.
Listen and validate their emotions.
Offer support, whether emotional or physical tasks.
Encourage your loved one to seek treatment, if the latter is needed.
Make concrete plans to improve stress around support or scheduling.
Support and reinforce the decisions made by your loved one.
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Aside from a variety of emotional and physical factors related to causes, there are also a variety of risk factors that have been found to be associated with the development of PPD in some women, according to researchers. Some of these risk factors include:
A history of depression prior to pregnancy or during pregnancy
Family history of PPD, mood disorder or premenstrual dysphoric disorder (PMDD)
Young age at the time of pregnancy
Ambivalence about the pregnancy
Number of children at the time of pregnancy (PPD is more likely in later pregnancies.)
Extreme life stress
Living/parenting alone
Marital conflicts
Having twins or triplets
Limited social or familial support
Difficulty with breastfeeding.
But, as mentioned, 1 in 9 mothers is diagnosed with postpartum depression, and any new mother can potentially experience PPD.
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Suppose you have a personal or family history of depression, mood disorders, or PPD or align with the risk factors described. In that case, the first step is to discuss this with your doctor upon pregnancy. There are precautions both during and after pregnancy that can be taken to prevent PPD, including:
During pregnancy: Self-monitoring stress and anxiety levels, having your doctor monitor depression symptoms, completing depression screening questionnaires throughout pregnancy, and joining a support group are all helpful suggestions for prevention.
After pregnancy: Engaging in early postpartum check-ups with a doctor to screen for PPD signs, managing stress, incorporating exercise, monitoring, and logging symptoms, and asking for help when you need it are ways that can help. Be realistic about your expectations for yourself and others.
Disclaimer
The information on this page, or elsewhere on this site, is not intended to take the place of diagnosis, treatment or informed advice from a qualified mental health professional. You should not take or avoid any action without consultation with the latter.
If you would like to talk to a counselor, please click here.
References
American Psychiatric Association. (2020, October). What is peripartum depression (formerly postpartum)? Retrieved from https://www.psychiatry.org/patients-families/postpartum-depression/what-is-postpartum-depression#section_4
American Psychological Association. (2008). Postpartum Depression. Retrieved from
https://www.apa.org/pi/women/resources/reports/postpartum-depression
Bruce, D. F. (2020, August 4). Postpartum depression: Symptoms, causes, risks, types, tests, professional and self-care. WebMD. Retrieved from https://www.webmd.com/depression/guide/postpartum-depression#091e9c5e800088af-3-7
Mayo Foundation for Medical Education and Research. (2018, September 1). Postpartum depression. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617
Postpartum depression. (2019, May 14). Office on Women's Health. Retrieved from
https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression
Thatcher, D. T. (2022, January 24). How to help someone with postpartum depression. Highland Springs Specialty Clinic. Retrieved from https://highlandspringsclinic.org/blog/help-someone-postpartum-depression/