Postpartum Depression
Postpartum depression, although more common that gestational diabetes, preeclampsia, and premature labor, receives much less attention in the media and in a pregnant women’s medical care. Pregnant women go through weeks of tests and checkups, childbirth education classes, and pampering. But once the baby is born, all focus is centered on the baby and little additional attention is paid to the postpartum care of the mother.
Women who become depressed during this period feel guilty and selfish and often too embarrassed to seek help. But postpartum depression is a medical condition that affects roughly 40% of women after childbirth. It can be treated with the help of your doctor and the support of your family and friends. Here’s what you need to know if you think you or a loved one is suffering from postpartum depression.
The Baby Blues
Postpartum depression is loosely categorized in three classifications, although the margins between the three tend to blend significantly. At one end of the spectrum is what doctors call the baby blues. This condition affects 40%-85% of postpartum women with symptoms such as depressed mood, irritability, anxiety, confusion, sleep and appetite disturbances, and crying spells.
Because it affects so many women, it is accepted as normal; however, it’s still quite distressing to these new mothers. The baby blues tend to peak within three to five days after delivery and usually resolve within one to three days after that. Extra support and care from family and friends and a reminder that this condition is transient, is the best treatment for the baby blues.
At the other end of the spectrum is the devastating form of postpartum psychosis. This is a rare condition, compared to the baby blues, but this psychosis is roughly thirteen times more likely to affect a woman in the postpartum period than during other phases of her life. The symptoms of this condition usually involve severe hallucinations and delusions that often focus on the newborn baby either dying or possessing divine or demonic qualities. These mothers are at the greatest risk for hurting themselves or their children during this period. The symptoms of psychosis usually develop within the first four weeks after delivery, but they can manifest as late as three months after delivery.
Postpartum Depression
Between these two extreme ends of the spectrum is postpartum depression. This condition affects more than 10% of all new mothers, and if untreated, its symptoms may last for more than a year. Postpartum depression is usually diagnosed as the development and persistence of at least four of the following symptoms within the first six weeks after childbirth and lasting for at least two weeks:
- sadness
- loss of interest in daily activities
- irritability
- fatigue
- difficulty concentrating
- sleep or appetite disturbances
- excessive anxiety over the child’s health and failure at motherhood
- suicidal thoughts
Diagnosing and treating postpartum depression is critical to the care of both the mother and her new baby. And since some of these symptoms such as weight changes and fatigue, occur universally with new motherhood, it’s essential for your health care provider to ask specific questions to detect if the symptoms are indeed those of postpartum depression. For example, your doctor might ask if your food is appealing to you right now, or if you are able to sleep when your baby is sleeping.
Who Sufferers from Postpartum Depression
Although all new mothers are at risk for developing some type of postpartum depression, there are certain factors that place some woman at greater risk. A family history of depression, or a prior personal period of depression, raises a women’s risk by 30%.
Women who are lacking a strong social network, or who are involved in a stressful or abusive relationship are also at greater risk. Substance abuse substantially increases the risk of postpartum depression. Other factors such as breastfeeding, length and difficulty of delivery, and maternal age, have a somewhat less clear role in the development of the condition.
Treatment of Postpartum Depression
Researchers have yet to identify the exact cause of postpartum depression. Nonetheless, this condition responds similarly to treatment just like other types of depression. It can be treated with medication, therapy, or a combination of both.
Breastfeeding women must be given special consideration when medication is considered. Tricyclic antidepressants have been studied extensively and have shown no detectable serum levels in the newborn babies or their mothers.
Preventing Postpartum Depression
Knowledge is power and educating women about the symptoms and impact of postpartum depression should be an integral part prenatal care. Health care providers can also ensure that the pregnant woman is enrolled in a supportive new-mom class and that she has access to a network of family and friends that she can turn to for help. In addition, careful postpartum follow up care can help to identify women who are developing postpartum depression.