Postpartum Depression: Causes, Symptoms, Diagnosis, Treatment

After the delivery of a baby, amidst all that happiness and excitement, telling people that you are feeling depressed is quite a challenge. Not only would they be shocked, they might even wonder what is wrong with you. But the truth is that one in every four new mothers gets affected by Postpartum Depression (PPD), also called Postnatal Depression.

Moreover, it is not just the mother that suffers from depression; at times, men are also said to fall victim to this medical condition (though that is very rare). Read more here on → Postnatal Depression (PND) in Men.

Postpartum Depression

It is least expected for depression to set in right after having a baby and that is exactly when postpartum depression is triggered. At one end, the new mothers are elated with joy over the arrival of their baby, whereas at the other end, they are depressed with feelings of irritation and a severe dislike not just for themselves, but the baby as well.

Postpartum depression sets in within the first week of childbirth and lasts for a few days. Also known as ‘baby blues’, this condition can also last for a few weeks and this is when you need to start worrying. If left untreated, this medical condition can last not just for months, but even years. It turns into a medical emergency situation when it develops into postpartum psychosis.

The basic symptoms of postpartum depression are inclusive of dullness, laziness, changes in sleeping and diet patterns together with a lack of interest in the baby and in herself. The desire to stay in bed all day, severe mood swings, lack of concentration, irritation are other frequently noticed signs of PPD.

These symptoms are quite like the ones that women face during hormonal changes. In extreme cases, the symptoms can include suicidal thoughts and rash treatment of the baby. It is quite normal for women suffering from this medical condition to feel inadequacy about the ways in which they look after the baby. This leads to a loss of self-esteem with incessant worries about even the smallest of tasks.

In the long run, this condition can affect the relationship that you share with your family and leave deep psychological scars, so make sure that you seek treatment right away. These should not be ignored considering that if they develop into severe conditions, you might even end up with suicidal thoughts.

According to doctors, postpartum depression can be cured just like any other form of depression through muscle-relaxants and anti-depressants. Hormonal treatment is also recommended. You can even take therapy sessions with your psychologist if need be. Try talking things out with your family and friends. They are surely going to support you once you tell them what you are going through!

  See also: Depression In Women: Understanding the issues

What Causes Postpartum Depression

The main reason behind the onset of postpartum depression is the hormonal changes that take place within the body after delivery.

Many doctors agree that postpartum depression is the result of a wide combination of factors.  A new mother is facing a surge of female hormones that often trigger emotional episodes, including depression. Many of her body’s systems are also maladjusted, and this includes some of the chemicals in the brain that regulate mood.

Moreover, PPD  may also be caused or aggravated by her lack of sleep from having to get up and take care of the baby several times during the night.  This combination of factors of course affects a mother’s health and emotional state!

It’s thought that some cases of postpartum depression symptoms are more likely to strike women who are already prone to depression or who have had this condition even before becoming pregnant. Having a condition before pregnancy would logically make one more prone to having it after pregnancy, and postpartum depression is no different.

There are also some who believe that many cases of postpartum depression are brought on by several emotional factors, not just physical ones. Some women have built themselves up to expect that motherhood will be this euphoric time of constant happiness, but then the reality of taking care of a crying child sets in. This disappointment can reach the point of depression.

Or some who experience PPD have expected the child to solve problems in their life, such as bringing them closer to their spouse, or making up for a lack of self-esteem, and so on.  When these things don’t happen just automatically with the arrival of the baby, the mother feels angry, guilty, let down, and so on. This too can progress to the point of postpartum depression.

The factors which affect the statistics of postpartum depression are inclusive of illiteracy, teenage pregnancy, smoking habits of the mother, physical abuse and poor financial conditions etc. Mothers who deliver low-birth-weight babies are believed to be at high risk of depression. This problem is also more frequently cited in older women, particularly black women as compared to those belonging to other races.

Postpartum Depression Symptoms

The symptoms of postpartum depression are generally rather mild and go away within a few days. But there are women who experience these symptoms for weeks, whereas chronic cases have reported the condition to be persistent for years at end.

To begin with, the very first symptoms of postpartum depression range from feelings of loneliness to mild irritation. These are followed by an elevated sense of inadequacy and frustration. With the passage of time, the symptoms make it uneasy for the patient to get out of bed and these alter the sleeping and eating patterns too.

Right after birth, as soon as the symptoms set in, the new mother loses interest in looking after the baby. As a patient, you might even have negative feelings towards your child. Women also stop looking after themselves and do not feel any energy, motivation or pleasure at all. Feelings of worthlessness and guilt over the smallest issues have been reported as well. In worst case scenario, the patient starts having suicidal thoughts.

Edinburgh Postnatal Depression Scale (EPDS)

The Edinburgh Postnatal Depression Scale (EPDS) is a screening tool used to assess symptoms of depression in women during the postnatal period, typically within the first few weeks after childbirth. It was developed in 1987 by John Cox, Jenifer Holden, and Ruth Sagovsky, and has since become widely used as a reliable and valid instrument for detecting postnatal depression.

The EPDS consists of ten questions, each with four possible responses, that ask about the mother's feelings and experiences over the past seven days. The questions cover a range of symptoms related to depression, such as feelings of sadness, guilt, and worthlessness, as well as sleep disturbances and loss of interest in activities.

The EPDS is not a diagnostic tool, but rather a screening tool that can help healthcare providers identify women who may be experiencing symptoms of postnatal depression and require further evaluation and treatment. A score of 10 or higher on the EPDS is typically used as an indicator of possible depression, but this may vary depending on the population being screened.

Postpartum Depression Diagnosis

In the Diagnostic and Statistical Manual of Mental Disorders, postpartum depression is not listed separately from other forms of depression. However, ‘Postpartum Onset’ has been said to set in within the first four weeks after delivery.

Known as the Edinburgh Postnatal Depression Scale, this formal system of screening for postpartum depression is widely used in different countries. This is basically a questionnaire that has a 10-item form. It is up to the women to score themselves on each question and then discuss the final score with their doctor. It is believed that a 12.5 or more score should immediately receive treatment, whereas scores less than that do not require medical attention. But according to doctors, this screening method is not fully effective as results vary in terms of medical history and individual temperament.

How to Treat Postpartum Depression

Women suffering from postpartum depression generally do not understand its symptoms when they strike. The overall happiness of having a new member in the family makes it impossible for them to work things out. This is why most women discard their initial symptoms as mere feelings of being overwhelmed or what can be called a passing whimsy. However, in worst cases, the symptoms can trigger crying bouts at very small matters, feeling dull and even, suicidal thoughts.

Anxiousness, refusal to get out of bed, frustration, irritation, difficulty in sleeping and eating are all symptoms of PPD and need to be treated as these can lead to other health complications.

Postpartum depression is believed by the doctors to be just like any other form of depression, which is why they use the regular medicinal options. Anti-depressants, sleeping pills and muscle relaxants are given to relieve the symptoms along with psychotherapy. Psychotherapy, in fact, is the most famous treatment choice amongst a majority of patients, as breastfeeding mothers want to avoid medicines that would harm their baby.

Another treatment option that are commonly practiced is that of hormone therapy in which estrogen is replaced in the mother’s body. This treatment however suggests the use of anti-depressants and has its own negative side-effects. Anti-depressants should only be given if the patient is not even able to take care of her baby or herself. Such treatment needs to be monitored closely as well. In case of patient going through relationship issues, marriage counselling is quite commonly recommended by doctors.

Natural supplements and herbs can be used to help cure the condition. Some basic alterations in diet, together with regular exercises and natural treatment methods can truly do wonders. With family support added in, you are sure to get treated in just a few days’ time!

The treatment of PPD is extremely important as it can later on turn into postpartum psychosis. Even though very rare, this condition is considered a medical emergency. It causes a disconnection between the mother and reality, which obviously is a high risk situation for not just the mother, but the baby as well. The symptoms of postpartum psychosis are inclusive of delusions, hallucinations, severe confusion, extreme anxiety and disorientation. Increasing mood swings also take place and hospitalization is necessary.

   Read more: Understanding Postpartum Psychosis

An increased risk of postpartum depression is found in women who suffer from bipolar disorder. Make sure that you do not discard those feelings of dullness as a part of baby blues and seek treatment right away.

One thing that you truly need for any treatment method to work is family support. If your spouse and family members are supportive, you can rest-assured that your symptoms would go away soon. Therefore, make sure that you talk to them and reach out for their support.

Postpartum Depression Treatment Options

PPD (Postpartum Depression) can be treated in a number of ways. For normal baby blues, it can be treated by bringing lifestyle changes and getting socially involved with other moms and family members. In severe cases, it would be better to seek a professional medical advice.

Professional Medical Treatment:

• Hormone therapy works best for postpartum depression. Though there are some side effects as well, make sure you consult your physician before going through it.
• Bright light therapy can also be useful since it is safe and easily accessible.
• An individual therapy with a good therapist can help solve your motherhood problems to a great extent.
• Group therapy can also prove to be effective.
• Transcranial Magnetic Stimulation is one of the newer ways of treating depression.
• In severe cases, when the mother is unable to take care of the baby and herself, physicians recommend intake of antidepressant drugs. However, it is best to avoid use of medicines since it passes in your baby through your breast milk.
• Mood stabilizers and antipsychotic medications can also help in postpartum depression treatment. Yet, it is advisable to take your doctor’s opinion before going for them.
• Consider going for marriage counseling if you feel that you are not getting adequate support from your husband or in-laws.
• Some doctors have also reported that acupuncture works well in postpartum depression treatment.
• In few cases, ECT (Electroconvulsive Therapy) is also given by the doctors.

Lifestyle Changes:

• Establish healthy eating habits. This will help you stay in good mood and ensure quality breast milk for your baby.
• Avoid alcohol consumption.
• Take help from your husband and family members in taking care of your baby and ensure an adequate 8 hours of sleep.
• In case of too much work at your place, consider hiring a part time or a full time servant.
• Expose yourself in the sun for at-least 10-15 minutes a day. This will keep your mood levels up.
• Do some breathing exercises. This will elevate your mood and keep you fresh.
• Take early morning walks for about 30 minutes. Another effective postpartum depression treatment
• Take some time out from your mom’s duties and indulge yourself in refreshing activities like sipping a hot coffee, watching your favorite program, taking a bubble bath, getting a massage done or listening to soothing music.

Social Involvement:

• Join online support groups. This will be a good place to get acquainted with all the new mothers worldwide and share your views with the same. A known and effective postpartum depression treatment.
• Constantly talk to your closed ones (whether friends, relatives or your husband) about your feelings and experiences (whether good or bad) in dealing with the new born. Seek advice and take help from them.
• Joining child massage classes can help strengthen the mom and baby relationship.
• Try to focus on other relationships as well like your relationship with your in-laws, husband, your parents etc. This will avoid any kind of loneliness.
• Joining parents coaching classes can also help overcome a lot of problems related to child care.

Other Helpful Tips:

• Start loving yourself. Consider yourself a perfect supermom even if you are not.
• Keep a diary and write your daily feelings in it just in case you don’t feel like talking to anyone about your emotions. Helps a lot in postpartum depression treatment.
• Don’t keep high expectations from yourself. Only do how much ever you can. Leave the rest. Ask for help.
• Credit yourself for small achievements you accomplish.

With the above mentioned ways, one can definitely overcome postpartum depression. Live a happy life and embrace the almighty’s most beautiful gift to women – MOTHERHOOD!

  Read also: Natural Treatment and Remedies for Postpartum Depression

Conclusion

Women have been known to become victims of depression amidst all the joys that having a baby brought to them. Looking around for support in such a state is not easy. It is one of the commonest issues that arise within a few days after delivery. According to statistics, one in every four new mothers suffers from postpartum depression. It can last for a few days, however, in extreme cases; it can last for weeks, months and even years. If the symptoms of postpartum depression linger on for a few weeks, then it is necessary for you to seek treatment.