- 27/April/2019
Postpartum Depression & Its Symptoms - Ananthapuri Hospitals
Postpartum Depression
Do you experience feelings of deep sadness and indifference towards your baby and loved ones around you soon after delivery?
You are not alone.
Postpartum depression is a well-established condition which often takes a toll on you and the family members who have come to celebrate with you.
With the help of medicines, your doctor prescribes and adequate emotional support from loved ones, you can recover and regain a positive outlook on life.
What is Postpartum Depression?
Postpartum depression comprises the emotional, behavioural, and emotional changes characterized by sadness, gloominess, hopelessness, and helplessness a woman experiences in the weeks following childbirth.
The postpartum period is a particularly vulnerable period for a woman, being overwhelmed by a mix of emotions and a lot of physical and psychological changes. Postpartum depression is more common in the first 4 months after childbirth; however, it can occur any time within the first year of delivery.
About 85% of women experience mood changes soon after birth. However, for most women, these symptoms may be short-lived and resolve spontaneously. This is referred to as postpartum blues or baby blues and is considered normal. However, in about one of every 10 of these women after childbirth, a more persistent form of depression occurs.
Causes and Risk Factors of Postpartum Depression
Without a doubt, you must have wondered why, with such a joyful experience as having a lovely child, you will experience such unexplainable sadness. People around you may also find it strange that you are sad and indifferent at this time. Rest assured that the problem is not with you, there are a number of factors which may be responsible for this.
Hormones
During pregnancy, the levels of the female sex hormones (estrogens and progesterone) and the stress hormones (cortisol) increase. After you deliver, these hormones drop sharply in all women. However, it appears that some women are more sensitive to this sudden drop in the levels of these hormones, causing mental and behavioural changes.
Social Factors
This has a strong contribution to the risk of postpartum depression. You are more likely to experience postpartum depression if you lack adequate social or emotional support or experience negative or traumatic experiences.
For example, losing a loved one, losing a job, going through a divorce, or dealing with financial stress during pregnancy or in the postpartum period can predispose you to postpartum depression.
Some studies have revealed that the risk of postpartum depression is lower in women who report marital stability, workplace support, and social support are less likely to experience postpartum depression.
Social factors, such as living alone, unintended pregnancy, and age at the time of pregnancy are also risk factor of postpartum depression: The younger the age at the time of pregnancy, the more likely a woman is to develop postpartum depression.
Physical Predisposition
It is possible that your risk of postpartum depression results from a biological vulnerability. For instance, research shows that a previous history of depression (not necessarily postpartum) and a family history of mood disorders, or presence of depression in the current pregnancy increases your risk of postpartum depression.
A study revealed that a history of depression in women increases the risk of postpartum depression by almost 20 times. Generally, this is the strongest risk factor for postpartum depression.
In addition, one’s premorbid personality can also help reduce the risk of postpartum depression.
Symptoms of Postpartum Depression
The symptoms and signs of postpartum depression do not differ from those of depression. The condition usually develops gradually right after childbirth, progressing gradually over the first few months. However, in other women, the changes may be more acute.
Some of the symptoms you may experience with postpartum depression include:
- Depressed mood: You may feel sad and tearful most of the times and for a long time. A depressed mood is characterised by feelings of hopelessness, worthlessness, helplessness and a general lack of excitement about life.
- Irritability: This is one of the major symptoms you may experience. Nothing seems to give you pleasure and you find even the kindest gestures irritating.
- Fatigue: You may experience both physical and mental fatigue. You feel tired from all the worry and stress. In addition, with a depressed mood comes low energy levels, and you find that you do not want to do anything - even the things you once enjoyed.
- Sleep changes: You may find that you have little sleep or you sleep too much.
- Appetite changes: You may not feel the need to eat or may find yourself eating too much because of how empty you feel.
- Anxiety: You may become very worried about your wellbeing and that of your infant.
- Despair and a feeling of impending doom
- Ambivalence: You may feel intermittent negative feelings towards your newborn, and this places the infant at great risk.
- Self-harm: This usually occurs in severe cases and without support. Such women may pose a risk to themselves, their newborns, and those around them
- Suicidal thoughts: This occurs in severe cases of postpartum depression.
These symptoms typically occur in a continuum: some women only experience mild or moderate symptoms, while others may experience the extremely severe form characterized by suicidal thoughts and a severely impaired quality of life.
Treatment for Postpartum Depression
Postpartum depression is definitely treatable: You can get out of this situation and feel enthusiastic about life again. Seek help even if you feel just mild symptoms.
The earlier you seek for help, the earlier you will get out of this condition! Failure to seek help may compromise not just your health, but that of your infant too..
Some of the treatment approaches for postpartum depression include:
Psychotherapy
This is the first line of management and is considered for women with mild and moderate symptoms. Psychotherapy may be in the form of individual or group psychotherapy. In the latter case, you will be in session with other women who are experiencing the same thing. In group psychotherapy, other women will share their journey, talking about their struggles as well as happy moments, providing support to other women.
Psychotherapy techniques that doctors use to treat postpartum depression are cognitive behavioural therapy and interpersonal therapy. These techniques help you understand your symptoms and emotions better, to help you recreate them. These psychotherapy techniques have been found to be very effective at lowering the symptoms of postpartum depression.
Psychotherapy may also be recommended for nursing mothers who do not want to use medicines for the condition.
Medical Treatment
A combination of psychotherapy and medical treatment is effective for patients with postpartum depression. This is considered in women whose symptoms do not resolve following psychotherapy, or in women who have severe symptoms from the start.
Some of the medicines used for the treatment of postpartum depression include antidepressants, which are the mainstay of treatment, anti-anxiety medications and hormonal therapy.
Anti-anxiety medications are used as a supportive treatment for patients with postpartum depression, who have anxiety and sleep difficulties.
Usually, you will begin to feel better with these medicines after about two to three weeks. You may not experience full remission of your symptoms until after several months. Therefore, doctors will recommend that you take these drugs for up to 6-12 months.
Doctors may recommend inpatient hospitalization for electroconvulsive therapy if your symptoms are severe or if they do not respond to medicines or psychotherapy. Electroconvulsive or electroshock therapy provides fast remission of symptoms in these patients. Rest assured also, that electroconvulsive therapy is safe.
Tips to Help You Cope with Postpartum Depression
You can prevent or lower your risk of postpartum depression. Here are tips that can help:
- Seek Help: Do not let yourself drown in your emotions. Even if you experience what you consider ‘mild symptoms’, get help: tell a friend or a loved one about how you feel, so they can give you the support you need.
Also, if you need help around the house, ask for it. If your partners seem unsupportive and unhelpful with house chores, and you want them to be more supportive, point it out. If this is not discussed, it can cause resentment that will trigger or exacerbate depressive symptoms and anxiety.
- Take it Easy on Yourself: It could be sad and underwhelming when you don’t feel as excited as you should. However, take it a little easy on yourself. A high expectation for yourself and your infant may worsen or increase your risk of postpartum depression.
Be kind to yourself, don’t beat yourself up when you don’t seem to clothe or feed your infant right. Take things as they come and learn as you go. Expect that all days will not be happy, some days may be bad. So do not raise your expectations too high.
- Maintain a Healthy Diet: Eat healthy, nutritious foods before and after delivery. Eat foods that would boost your mood, such as bananas. Avoid foods that can dehydrate you or disturb your sleep, such as coffee and alcohol.
- Bond: Do not stay in isolation. Even if you don’t feel like it, make time for your partner and loved ones. Make time for play and laughter with your partner and ensure that you keep in touch with loved ones. This reduces the risk of intrusive negative thoughts and moodiness. However, avoid negative people or toxic experiences! Avoid friends who will bring back memories of negative experiences or who will make you feel bad about something. Stay around positive people to keep your mind filled with positive thoughts.
- Limit Visitors: When you just arrive home from the hospital, many of your neighbours, loved ones, and friends may want to visit to see the newborn. Limit this, so you can recuperate from the physical and mental stress of labour and childbirth.
For the first few days, be with those you truly want to be around: your partner and family. Having too many guests at a short time may overwhelm and stress you both physically and mentally, increasing your risk of postpartum depression.
- Exercise: Exercise boosts your body’s levels of endorphins, the feel-good hormones. Endorphins boost your mood and energy levels, making you feel pumped up. Be careful, however, not to engage in strenuous or prolonged exercises. These may cause muscle aches and joint pains that may make you feel sick for the next couple days, and may even affect your sleep.
- Sleep: Visitors and phone calls may want to creep in on your sleep – screen them. You need as much rest as you can have during the postpartum period. Whenever you can, catch enough sleep.
Sleep-deprivation, before and after childbirth, has a strong link with postpartum depression. Your partner could help with the chores or take care of your newborn while you catch some sleep.
Practice sleep hygiene – ensure that your lights are off and noise is minimal before going to bed. These sleep hygiene practices help to combat the sleep difficulty that may occur in the postpartum period.
Screening for Postpartum Depression
There are a few screening tools for postpartum depression. One of these is the Edinburgh Postnatal Depression Scale (EPDS), which contains 10 questions to evaluate the presence of postpartum depression.
Doctors use this self-rated questionnaire in routine pediatric or well-baby clinics to assess a new mother’s wellbeing. A score of 10 or greater, or an affirmative response to question 10 (Do you have suicidal thoughts?) suggests postpartum depression and requires further evaluation.
Postpartum depression is often overlooked by women and their loved ones to signify “normal” changes in a woman. However, it may be serious and may lead to physical harm to the mother or her newborn. If you feel even mild symptoms of sadness, seek help. Tell your partner or a friend, and consult with a healthcare professional for advice and treatment recommendations.
In such a situation, do not hesitate to talk to someone. Mental health is just as important as physical health. If you are struggling to manage your symptoms, book a consultation today with the doctors from our excellent Psychiatry and Behavioural Sciences Department. Call us at +919400332777 or visit our hospital at Chacka, NH Bypass, Thiruvananthapuram.