Table of Contents
Overview:
- Postpartum depression (PPD) is a type of depression that occurs after childbirth, affecting up to 15% of new parents. It can cause emotional fluctuations, frequent crying, fatigue, guilt, anxiety, and difficulty caring for the baby. Fortunately, postpartum depression can be treated effectively with medication and counseling.
What is postpartum depression?
- Giving birth to a child is a transformative experience, bringing both excitement and challenges. It’s normal to feel anxious or doubtful, especially for first-time parents. However, if these feelings include extreme sadness, loneliness, severe mood swings, and frequent crying, you may be experiencing postpartum depression. PPD doesn’t just affect the birth parent; It can also affect surrogates and adoptive parents because of the hormonal, physical, emotional, financial, and social changes that come with childbirth. If you have postpartum depression, remember that you are not alone, it is not your fault, and help is available. Your healthcare provider can help you manage your symptoms and support your recovery.
Types of Postpartum Depression:
Three main types of postpartum mood disorders:
Postpartum Blues (Baby Blues):
- The baby blues affect between 50% and 75% of new parents. Symptoms include frequent crying without a clear reason, sadness, and anxiety. These symptoms usually start within the first week after delivery and typically resolve within two weeks without treatment. Seeking support from friends, family, or your partner can be very helpful.
Postpartum Depression:
- Postpartum depression is more serious than the baby blues, affecting about 1 in 7 new parents. If you have had postpartum depression in the past, your risk increases to 30% with each pregnancy. Symptoms can include alternating highs and lows, frequent crying, irritability, fatigue, guilt, anxiety, and an inability to care for your baby or yourself. Symptoms may appear within a week of delivery or gradually, up to a year later, and can last several months. Treatment with psychotherapy or antidepressants is highly effective.
Postpartum Psychosis:
- Postpartum psychosis is a severe form of postpartum depression that requires emergency medical attention. It is relatively rare, affecting only 1 in 1,000 new parents. Symptoms include severe agitation, confusion, hopelessness, shame, insomnia, paranoia, delusions or hallucinations, hyperactivity, rapid speech, or mania. These symptoms usually appear quickly after delivery and can last for weeks or months. Immediate medical intervention is important, as there is an increased risk to her life and harm to the baby. Treatment typically involves hospitalization, psychotherapy, and medication.
Who is Affected by Postpartum Depression?
- Postpartum depression is common. Up to 75% of new parents experience the baby blues, and about 15% of these develop postpartum depression. Additionally, 1 in 1,000 new parents may develop postpartum psychosis.
Distinguishing Baby Blues from Postpartum Depression:
- Both baby blues and postpartum depression have similar symptoms, but there are key differences. Baby blues symptoms are less intense and last about 10 days, while postpartum depression symptoms are more severe and can last weeks or months. If you experience crying spells, feel overwhelmed, lose your appetite, have trouble sleeping, or experience sudden mood changes, it’s important to talk to your healthcare provider to assess your symptoms and determine if treatment is needed.
Duration of Postpartum Depression:
- Postpartum depression can last up to a year after childbirth. However, recovery times vary, and it’s important to communicate openly with your healthcare provider about your symptoms and treatment progress.
Risk Factors for Postpartum Depression:
- Several factors may increase the risk of postpartum depression, including:
- Personal or family history of depression, postpartum depression, or premenstrual dysphoric disorder (PMDD)
- Limited social support
- Marital or relationship conflict
- Ambivalence about the pregnancy
- Pregnancy complications such as health issues, difficult delivery, or premature birth
- Being younger than 20 or a single parent
- Having a child with special needs or a baby who cries a lot
Symptoms and Causes of Postpartum Depression:
Symptoms of Postpartum Depression:
- Postpartum depression is common, and experiencing it’s symptoms does not make you a bad parent. If you have postpartum depression, you might feel ashamed or like you are failing as a parent. However, don’t forget that you’re not alone.
You may have postpartum depression if you experience some of the following symptoms:
- Feeling sad, worthless, hopeless, or guilty
- Excessive worry or constant feelings of anxiety
- Loss of interest in hobbies or activities you once enjoyed
- Changes in appetite or eating habits
- Loss of energy and motivation
- Trouble sleeping or wanting to sleep all the time
- Frequent or excessive crying
- Difficulty thinking or focusing
- Thoughts of suicide or wishing you were dead
- Lack of interest in your baby or feeling anxious around them
- Thoughts of harming your baby or not wanting your baby
If you think you have postpartum depression, you can contact a healthcare provider, whether it’s your obstetrician, primary care provider, or your doctor.. Even your baby’s pediatrician can provide assistance.
Causes of Postpartum Depression:
- The exact cause of postpartum depression is still being studied, but it is believed to be linked to the rapid hormonal changes that occur after childbirth. During pregnancy, levels of estrogen and progesterone increase dramatically but drop sharply after delivery, returning to pre-pregnancy levels within three days postpartum.
- In addition to these chemical changes, social and psychological changes associated with having a baby can also increase your risk of postpartum depression. These changes can include physical changes to your body, lack of sleep, worries about parenting, and changes in your relationships.
- If you experience any of the following symptoms, notify your healthcare provider immediately:
- Thoughts of harming your baby or yourself
- Recurrent thoughts of death or suicide
- Depressed mood for most of the day, nearly every day, for the past two weeks
- Feeling anxious, scared, guilty, panicked, worthless, or hopeless
- Difficulty thinking, concentrating, making decisions, or handling everyday situations
- Loss of interest or pleasure in most activities nearly every day for the past two weeks
Impact of Postpartum Depression on Your Baby:
- Postpartum depression can also affect your baby, making it crucial to seek treatment for both your and your baby’s well-being. Research suggests that postpartum depression can impact your baby in several ways:
- Difficulty bonding with your baby and establishing a connection
- Potential behavior or learning problems in your child
- Skipping appointments with your child’s pediatrician
- Feeding and sleeping issues for your child
- Increased risk of obesity or developmental disorders in your child
- Neglecting your child’s care or not recognizing when they are ill
- Impaired social skills in your baby
^Getting treatment for postpartum depression is essential to ensure both you and your baby can thrive.
Diagnosis and Tests:
How is Postpartum Depression Diagnosed?
- There is no specific test to diagnose postpartum depression. Your healthcare provider will evaluate you at your postpartum visit, which may include discussing your health history, how you’ve felt since delivery, a physical exam, pelvic exam, and lab tests. Many providers schedule visits at two or three weeks postpartum to screen for depression, ensuring you get the help you need as soon as possible.
- Your provider may perform a depression screening or ask you a series of questions to assess if you have postpartum depression. They’ll inquire about your feelings and how your baby is doing. Being open and honest with your provider is crucial to give them an accurate picture of your emotions and thoughts. They can help determine if your feelings are typical or symptoms of postpartum depression.
- Your healthcare provider may also order a blood test since postpartum depression can cause symptoms similar to many thyroid conditions. Remember, your healthcare provider is there to support you and ensure you are healthy, so be honest with them. Remember that you aren’t alone in your feelings.
How Do Doctors Screen for Postpartum Depression?
- Detecting mild cases of postpartum depression can be challenging. Healthcare providers rely heavily on your responses to their questions. Many providers use the Edinburgh Postnatal Depression Scale to screen for postpartum depression. This scale consists of 10 questions related to symptoms of depression, such as feeling unhappy, anxious, or guilty. You are asked to check the response that best describes how you’ve felt in the last seven days. A higher score hints possible postpartum depression.
- If your provider identifies signs of postpartum depression, they will recommend an appropriate treatment plan.
Management and treatment:
How is postpartum depression treated?
- Treatment for postpartum depression varies depending on the type and severity of symptoms. Options include anti-anxiety or antidepressant medications, psychotherapy (such as talk therapy or cognitive behavioral therapy), and participation in support groups.
- For postpartum psychosis, treatment may include medications to relieve depression, anxiety, and psychosis. Hospitalization may be necessary until you stabilize. If standard treatments don’t work, electroconvulsive therapy (ECT) may be effective. If you’re breastfeeding, discuss with your healthcare provider about safe medication options for depression, anxiety, or psychosis.
What medications can I take for postpartum depression?
- Healthcare providers may prescribe antidepressant medications to manage symptoms of postpartum depression. These medications help balance brain chemicals that affect mood. If you are breastfeeding, discuss the risks and benefits with your provider, as medications can transfer to your baby through breast milk. Transfer levels are generally low, and many antidepressants are considered safe. Common antidepressants include:
– **Selective serotonin reuptake inhibitors (SSRIs):** sertraline (Zoloft®) and fluoxetine (Prozac®)
– **Serotonin and norepinephrine reuptake inhibitors (SNRIs):- **Desvenlafaxine (Pristiq®) and duloxetine (Cymbalta®).
– **Bupropion:** Wellbutrin® or Zyban®
– **Tricyclic antidepressants (TCAs):** Amitriptyline (Elavil®) or Imipramine (Tofranil®)
- Antidepressants usually take three to four weeks to work. Consult your provider before stopping the medication, as stopping too early can cause withdrawal symptoms. Most providers recommend slowly reducing the dose before stopping completely. If postpartum depression is diagnosed while you are still in the hospital, your provider may recommend an IV medication containing brexanolone.
What are ways to cope with postpartum depression?
- It’s normal to feel overwhelmed. Parenting involves many ups and downs, and giving birth to a baby can be challenging. You don’t have to suffer alone if you have depression. Your healthcare provider can help find appropriate treatment. Here are some coping strategies:
- Talk to someone – a therapist, friend, family member, or someone who will listen and support you.
- Join a support group for newly parents.
- Try to eat healthy foods and make time for exercise.
- Prioritize rest.
- Spend time with friends or talk to them on the phone.
- Engage in self-care activities and your favourite hobbies, such as reading.
- Seek help with household chores or errands.
What happens if postpartum depression goes untreated?
Leaving postpartum depression untreated can be dangerous and affect you, your baby, and your loved ones. This can lead to:
– Constant fatigue and low energy.
– Mood swings.
– Difficulty caring for your baby.
– Inability to concentrate or make decisions.
– Thoughts of self-harm.
Prevention:
Can Postpartum Depression Be Prevented?
- While postpartum depression isn’t entirely preventable, being aware of its warning signs and understanding the risk factors can help. Here are some tips to reduce your risk of developing postpartum depression:
– Be realistic about your expectations: Understand that both you and your baby are adjusting, and perfection is not required.
– Limit visitors initially: Too many visitors can be overwhelming. Manage the flow of guests to give yourself time to adjust.
– Ask for help: Don’t hesitate to let others know how they can support you.
– Rest when your baby sleeps: Prioritize your rest to avoid exhaustion.
– Exercise: Taking a walk and getting fresh air can significantly improve your mood.
– Stay connected: Maintain regular contact with family and friends to avoid feeling isolated.
– Nurture your relationship: Spend quality time with your partner to strengthen your bond.
– Anticipate ups and downs: Understand that some days will be better than others, and that’s okay.
Outlook / Prognosis:
What is the Outlook for Women with Postpartum Depression?
- With professional help, almost all individuals who experience postpartum depression can overcome their symptoms. Seeking timely treatment and support can lead to a significant improvement in your mental health and overall well-being.
Living With:
When Should I Seek:
- Professional Medical Treatment for Symptoms Related to Postpartum Depression?
If you experience the following then professional help:
- Symptoms persist beyond two weeks.
- Inability to function normally or cope with everyday situations.
- Thoughts of harming yourself or your baby.
- Extreme anxiety, fear, or panic most of the day.
- For immediate help or if you have thoughts of harming yourself or others, call 911 in an emergency, or contact the Suicide and Crisis Lifeline at 988 for free and confidential emotional support, including their online chat feature.
Additional Common Questions:
Do I Have Postpartum Anxiety or Postpartum Depression?
A. Postpartum anxiety and postpartum depression share some symptoms but are different conditions. Signs of postpartum anxiety include excessive worrying, feeling panicky for no reason, and having irrational fears or obsessions. Discuss all your symptoms with your healthcare provider to receive the appropriate help.
Can Dads Get Postpartum Depression?
A. Yes, both partners can experience postpartum depression. Seek medical care if you or your partner show signs of depression or anxiety after bringing home your baby. About 4% of partners experience depression within the first year after their child’s birth.
What is Postpartum Dysphoria?
A. Postpartum dysphoria, also known as the baby blues, begins during the first week after childbirth and typically resolves without medical treatment within several days.
How Can I Help Someone suffering from Postpartum Depression?
A. Supporting someone with postpartum depression is crucial. Here are some methods you can help:
– Recognize the signs of depression and anxiety and encourage them to seek medical care.
– Be a good listener and let them know you are there to support them.
– Assist with daily tasks like cleaning and running errands.
– Offer to watch their baby so they can sleep or rest.
– Encourage them to seek help from a doctor or other mental health provider. Offer to set up an appointment or accompany them as a support person.
