Postpartum Depression

Postpartum Depression

Postpartum Depression

Postpartum depression (PPD), also called postnatal depression, is a mood disorder associated with childbirth. While most women experience a brief period of worry or low mood following delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks. PPD is officially called “depressive disorder with peripartum onset.” Peripartum onset is defined as starting anytime during pregnancy or within the four weeks following delivery.

PPD must be distinguished from postpartum blues, commonly known as “baby blues,” which is a transient postpartum mood disorder characterized by milder depressive symptoms than PPD and which resolve within two weeks.

Prevalence

Postnatal mood disorders are the most common complication of childbirth. Postpartum blues can occur in up to 80%, and PPD in approximately 15%, of all women following delivery. PPD can also affect men, and it is estimated that up to 26% of new fathers develop this condition.

Diagnosing Postpartum Depression:

The criteria required for the diagnosis of PPD are the same as those required to make a diagnosis of non-childbirth related major depressive disorder and include at least five of the following nine symptoms, within a two-week period:

  • Low mood – nearly every day, for most of the day
  • Anhedonia – loss of interest or pleasure in activities
  • Weight loss or gain – greater than a 5% change in a month
  • Insomnia or hypersomnia – sleeping too little or too much
  • Agitated movement or muscular activity or significantly impaired intellectual and adaptive functioning
  • Tiredness or loss of energy
  • Feeling worthless or feeling excessive or inappropriate guilt
  • Decreased concentration
  • Thoughts of suicide

Causes

While the causes of PPD are not fully understood, multiple factors have been identified that increase the risk of developing this condition which include:

  • Prenatal depression or anxiety
  • Stressful life events experienced during pregnancy
  • Adverse childhood experiences such as sexual abuse
  • Previous stillbirth or miscarriage
  • Marital disharmony or single marital status
  • Poverty
  • A lack of strong emotional support from spouse, partner, family, or friends

Risks

PPD can interfere with normal mother-infant bonding and negatively affect short- and long-term child development.

PPD might impair a mother’s ability to provide consistent childcare such as feeding routines and health maintenance. Mothers with PPD are at increased risk of suicide and self-harm and of harming their baby.

Postpartum psychosis is a psychiatric emergency that occurs in 1 in 1,000 women within the first two weeks of childbirth. Postpartum psychosis can happen suddenly and is characterized by profound changes in mood, severe confusion, lack of self-control and impulsivity, paranoia, and perceptual disturbances such as auditory hallucinations and delusions. Mothers with postpartum psychosis require urgent hospitalization and are often treated with antipsychotic medications.

Treatment and Drugs:

The treatment of choice depends on the severity of MDD and patient preference. Postpartum depression can be treated with:

  • Psychotherapy (talk therapy) such as cognitive behavioral therapy
  • Medications such as selective serotonin reuptake inhibitors

Diagnosing Postpartum Depression:

The criteria required for the diagnosis of PPD are the same as those required to make a diagnosis of non-childbirth related major depressive disorder and include at least five of the following nine symptoms, within a two-week period:

  • Low mood – nearly every day, for most of the day
  • Anhedonia – loss of interest or pleasure in activities
  • Weight loss or gain – greater than a 5% change in a month
  • Insomnia or hypersomnia – sleeping too little or too much
  • Agitated movement or muscular activity or significantly impaired intellectual and adaptive functioning
  • Tiredness or loss of energy
  • Feeling worthless or feeling excessive or inappropriate guilt
  • Decreased concentration
  • Thoughts of suicide

Causes

While the causes of PPD are not fully understood, multiple factors have been identified that increase the risk of developing this condition which include:

  • Prenatal depression or anxiety
  • Stressful life events experienced during pregnancy
  • Adverse childhood experiences such as sexual abuse
  • Previous stillbirth or miscarriage
  • Marital disharmony or single marital status
  • Poverty
  • A lack of strong emotional support from spouse, partner, family, or friends

Risks

PPD can interfere with normal mother-infant bonding and negatively affect short- and long-term child development.

PPD might impair a mother’s ability to provide consistent childcare such as feeding routines and health maintenance. Mothers with PPD are at increased risk of suicide and self-harm and of harming their baby.

Postpartum psychosis is a psychiatric emergency that occurs in 1 in 1,000 women within the first two weeks of childbirth. Postpartum psychosis can happen suddenly and is characterized by profound changes in mood, severe confusion, lack of self-control and impulsivity, paranoia, and perceptual disturbances such as auditory hallucinations and delusions. Mothers with postpartum psychosis require urgent hospitalization and are often treated with antipsychotic medications.

Treatment and Drugs:

The treatment of choice depends on the severity of MDD and patient preference. Postpartum depression can be treated with:

  • Psychotherapy (talk therapy) such as cognitive behavioral therapy
  • Medications such as selective serotonin reuptake inhibitors
Sources mayoclinic.org | WIKIPEDIA – Mood Disorder | WIKIPEDIA – Childbirth | WIKIPEDIA – Maternal bond