Postpartum Depression – Causes, Symptoms and Treatment

Many new mothers suffer from some fleeting form of the “baby blues.” Postpartum depression, in contrast, is a longer lasting and more serious depression thought to be triggered by hormonal changes associated with having a baby. The baby blues are considered to be a normal part of new motherhood—probably caused by the hormonal changes that occur following birth. As many as 80% of women experience some mood disturbances after pregnancy (“postpartum”). They feel upset, alone, afraid, or unloving toward their baby, and guilt for having these feelings. A woman with PPD may have feelings similar to the baby blues — sadness, despair, anxiety, irritability — but she feels them much more strongly than she would with the baby blues. PPD often keeps her from doing the things she needs to do every day.Postpartum depression, or PPD, is often differentiated from postpartum psychosis – the most severe form of postnatal depression which, although rare, is extremely serious and often requires hospitalization.

Postpartum psychosis, which is a much more severe and dangerous form of postpartum depression is extremely rare and only affects about 3 women in every 1000. Very rarely – in about 1 or 2 out of 1,000 previously-normal women – the depressive symptoms precede an acute psychosis. Most of the psychoses appear within two weeks of childbirth and disappear within two months, although they can continue longer. Signs of postpartum psychosis usually occur within the first few weeks postpartum. In some cases childbirth may result in low thyroid levels, which may also be a cause of depression. As with premenstrual syndrome, very little is known about psychiatric illnesses that develop following childbirth and whether or not they differ from depressions and psychoses that occur at other times.According to some theories, women who become depressed postpartum may be struggling with internal conflicts regarding the nurturing they received from their own mothers.

Causes of Postpartum Depression

The exact causes of postpartum depression are unknown,but rapid hormonal changes that accompany pregnancy and delivery may trigger depression. Levels of the hormones estrogen, progesterone, and cortisol fall dramatically within 48 hours after delivery. Women who go on to develop postpartum depression may be more sensitive to these hormonal changes.
Postpartum depression (PPD) is a condition that describes a range of physical and emotional changes that many mothers can have after having a baby. Psychosocial factors-Women who report inadequate social supports, marital discord or dissatisfaction, or recent negative life events are more likely to experience postpartum depression.

Biologic vulnerability-Women with prior history of depression or family history of a mood disorder are at increased risk for postpartum depression. Women with a prior history of postpartum depression or psychosis have up to 90% risk of recurrence.Childbirth is a time of great change for a woman. The adjustment to these changes can contribute to depression. A mother’s age and the number of children she has had do not relate to her likelihood of getting postpartum depression. Common emotional changes after delivery-Feelings of loss of an old identity, feeling trapped at home and Feeling overwhelmed with responsibilities of motherhood

Symptoms of Acute Stress Disorder

1.Lack of pleasure in all or most activities.

2.Decreased appetite.

3.Loss of energy experienced.

4. Headaches and chest pains.

5.Feelings of worthlessness or guilt.

6.Agitation and irritability.

7.Trouble sleeping.

Treatment of Postpartum depression

Postpartum depression responds to the same types of treatment as regular depression. Psychotherapy – Individual therapy or group therapy can be very effective in the treatment of postpartum depression. Psychotherapy is often the treatment of choice because of concerns over taking medication while breastfeeding. Interpersonal therapy (IPT), which focuses on interpersonal relationships and issues, is believed to be particularly effective for postpartum depression. Hormone therapy – Estrogen replacement therapy sometimes helps with postpartum depression. Estrogen is often used in combination with an antidepressant. Marriage counseling – If you are experiencing martial difficulties or are feeling unsupported at home, marriage counseling could be very beneficial. Postpartum depression manifests along a continuum; some patients may experience relatively mild or moderate symptoms, or they may present with a more severe form of depression, characterized by prominent neurovegetative symptoms and marked impairment of functioning.

Antidepressants commonly used for postpartum depression include tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) such as Prozac. Women should be screened by their physician to determine their risk for acquiring postpartum depression. Nonpharmacologic treatment strategies are useful for women with mild-to-moderate depressive symptoms. Individual or group psychotherapy (cognitive-behavioral and interpersonal therapy) are effective. Psychoeducational or support groups may also be helpful. New mothers and their families should never take for granted mood or behavior changes following childbirth. If bad moods, stress, and conflicts plague the pregnancy, try to head off the probable later depression by getting help before the baby is born.