Postpartum Depression: Symptoms, Causes, Tests, Treatments and Prevention

Postpartum depression is a type of depression that some women develop after giving birth. It can affect first time mothers or mothers who have given birth previously with no signs of depression. The severity of the depression varies but treatment is almost always successful.

Symptoms

The types of symptoms experienced by individual women will vary depending on the severity of the postpartum depression. Postpartum depression encompasses three different levels of severity; baby blues, postpartum depression, postpartum psychosis. Individuals who suspect they, or a loved one, are experiencing postpartum depression should immediately seek medical attention.

• Baby Blues – This is the mildest form of postpartum depression and typically only lasts at a few weeks at most.

  • Anxiety
  • Crying
  • Difficulty concentrating
  • Insomnia
  • Irritability
  • Mood swings
  • Sadness

• Postpartum Depression – Mothers may at first think they simply have baby blues but these symptoms are more severe and will endure longer. They may eventually interfere with the mother’s ability to care for the baby or perform routine tasks. Untreated, symptoms can last for more than a year.

  • Decreased appetite
  • Decreased libido
  • Extreme fatigue
  • Feeling inadequate
  • Feelings of guilt or shame
  • Inability to bond with the baby
  • Inability to feel joy
  • Insomnia
  • Intense anger
  • Intense irritability
  • Thoughts of harming oneself or the baby
  • Withdrawal

• Postpartum Psychosis – This is the most severe form of postpartum depression and is extremely rare. It will usually develop within the first two weeks following the birth of a baby.

  • Attempts to harm oneself
  • Attempts to harm the baby
  • Confusion
  • Delusions
  • Disorientation
  • Hallucinations
  • Paranoia

Causes

There is no single preventable cause which leads to the development of postpartum depression. Physical changes, emotional distress, lifestyle complications, and genetic predisposition can all contribute to the development of postpartum depression. Contributing factors include:

  • Anxiety about caring for a newborn
  • Changes in blood volume and pressure
  • Changes in metabolism
  • Changes in the immune system
  • Decreased levels of estrogen
  • Decreased levels of hormones produced by the thyroid
  • Decreased levels of progesterone
  • Demanding baby
  • Difficulty breastfeeding
  • Financial problems
  • Lack of support
  • Sleep deprivation
  • Struggling with one’s identity

Tests

Postpartum depression is a type of major depression. While there are no medical tests available to diagnose postpartum depression there is a criteria in place to provide a diagnosis. Symptoms must develop within the first month after giving birth and must include:

  • Depressed mood most days for the majority of the day
  • Difficulty concentrating or making decisions
  • Fatigue
  • Feelings of being worthless
  • Insomnia or hypersomnia
  • Recurrent thoughts of suicide and death
  • Reduced interest in formerly pleasurable activities
  • Restlessness
  • Significant changes in appetite
  • Unintentional weight changes

Physicians may also order blood tests to rule out medical conditions which could be causing similar symptoms such as an underactive thyroid.

Treatments

Treatment options vary by the type and severity of the symptoms. The same three categories identified in the symptoms portion are used for determining treatment as well.

• Baby Blues – Symptoms usually resolve quickly. Until then patients are advised to get as much rest as possible and to accept offers of assistance from friends and family. It is important to connect with other new mothers and avoid alcohol which can increase the severity of symptoms.

• Postpartum depression

  • Counseling with a mental health professional can help the mother learn to cope with her feelings, learn new coping skills, and learn how to set realistic goals. Family therapy may be beneficial in teaching family members how to help the patient.
  • Antidepressants are an effective treatment for most women. Some antidepressants are safe for mothers who are breastfeeding.
  • Hormone therapy can help alleviate symptoms associated with the sudden decline in estrogen.

• Postpartum psychosis

  • Hospitalization is often required due to the severe nature of this form of depression.
  • A combination of medications such as antipsychotics, antidepressants, and mood stabilizers may be utilized to treat symptoms.
  • Electroconvulsive therapy may be used to trigger chemical changes which may alleviate symptoms. This is typically reserved for patients who are unresponsive to other treatments.

Prevention

Postpartum depression cannot always be prevented. However, patients with a history of depression or postpartum depression should notify their healthcare provider as soon as they become pregnant. The healthcare provider can then carefully monitor the patient before and after giving birth. Early screenings, group therapy, and preventative antidepressants may be indicated.

Postpartum depression is more common than many people realize. If you or a loved one is suffering from postpartum depression it is important to seek medical assistance immediately. Left untreated the symptoms can worsen and may eventually lead to the patient trying to harm themselves or their baby.

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