Postpartum Depression – Symptoms, Risks, Causes, Tests and Treatments And Finding Help
Perinatal or postpartum depression (PPD) in new mothers is a common medical condition that needs empathy, care, and proper treatment.
Studies say that one out of seven new mothers can be hit by this form of depression. So, if you are a new mother and facing a bout of sadness or anxiety for the longest time, know there are many like you.
Identify your problems and seek help. You will overcome it as many others do with proper medical attention.
Here, I bring a detailed account of this common yet concerning postpartum hazard so that you can sail through your difficult times.
And hold on, just as the Linkin Park song says,
“I’m holding on
Why is everything so heavy?
Holding on
So much more than I can carry
I keep dragging around what’s bringing me down
If I just let go, I’d be set free
Holding on
Why is everything so heavy?”
What Is Postpartum Depression?
Postpartum depression is a form of depression that occurs when you feel a perennial feeling of emptiness engulfing you. This overwhelming feeling of emptiness fuels a lot of changes in your mental and physical health and reflects in your behavioral changes.
The physical and psychological changes mostly happen as there is a sharp fall in the estrogen and progesterone hormone levels after a woman delivers the baby. During pregnancy, these hormones are present in your body ten times more than your usual days. And within three days after your delivery, they are back to “normal” levels. These crazy hormones!
Perinatal depression usually starts showing its symptoms within four weeks after childbirth. But you can also have a delayed PPD with similar symptoms.
However, only the changes in estrogen and progesterone levels are not responsible for postpartum depression, and some other medical conditions can also cause it. Along with the physiological changes, psychological and social changes are crucial reasons for postpartum depression.
I will discuss the reasons in detail in the “causes” section.
Types of Postpartum Depression
The severity of postpartum depression will vary from one woman to another. From “baby blues” to the most severe postpartum psychosis, here are the different types of PPDs.
- Baby Blues
More than 50% of women suffer from this form of postpartum depression. It usually kicks in after one to four days of your delivery, and the symptoms involve frequent crying, emptiness, and anxiety.
Supports from friends, family, and partners are mostly enough for this type of PPD. It will go away within two weeks of your delivery and without the help of medications.
- Postpartum Depression
This form of postpartum mood disorder can happen to one in every seven women during the first pregnancy. If you had PPD during your last pregnancy, in this new pregnancy, you have more chances of going through the same phase again.
Along with mood swings, PPD comes with a feeling of anxiety, guilt, and irritability. In PPD, women also feel severely fatigued and may fail to take care of the baby.
PPD kicks in within a week or later. It can last for months but can be cured with antidepressants and psychotherapy.
- Postpartum Psychosis
This is the most severe form of PPD that occurs in 1 in 1000 women. Its symptoms include paranoia, hallucinations, rapid talking, agitation, confusion, insomnia, and hopelessness. Women suffering from postpartum psychosis get hit by the bout within a few hours of the delivery.
In postpartum psychosis, the new mother needs immediate medical treatment and psychotherapies. In worse scenarios, the patient may also need to get hospitalized.
- Postpartum Anxiety
Postpartum anxiety is different from postpartum depression. New mothers often are very stressed, and they are unable to relax.
These worries and anxieties get reflected in their actions. But the good news is that it usually goes away within a few weeks. However, in some women, postpartum anxiety can last for a longer time.
- Postpartum Panic Disorder
Postpartum panic disorder can be seen as a severer form of postpartum anxiety. With severe anxiety and frequent panic attacks, a woman suffering from postpartum panic disorder may suffer from shortness of breath, palpitations, and tightness in the chest.
- PTSD Or Post Traumatic Stress Disorder
Postpartum PTSD is a result of women facing some traumas or setbacks during their deliveries. There can be complications in the delivery, sudden C-sections, some health issues of the newborn, etc.
Also, the experience of any previous violence can cause and aggravate postpartum PTSD disorders.
- Postpartum Obsessive-Compulsive Disorder Or OCD
As the name suggests, the symptoms of postpartum OCD involve compulsive behaviors. New mothers tend to clean everything frequently or change the baby’s diaper when not needed as part of their compulsive behavior.
If postpartum OCD becomes more persistent or severe, psychotherapy can be of great help.
Symptoms Of Postpartum Depression
Postpartum depression is much beyond frequent crying, a feeling of emptiness. Other and more severe symptoms include:
- Self-harming thoughts
- Thoughts of harming the baby
- Feeling detached from the baby
- No energy or motivation
- Anxiety
- Insomnia or over-sleeping
- Sense of guilt
- Headache
- Body aches
- Pain or cramps in your abdomen
- Constant fear, and many more.
How Long Does Postpartum Depression Last?
Usually, postpartum depression becomes manageable, or the situation improves within one year after your delivery. However, coping with the situations and getting better each day does not mean that you are completely cured yet.
You need to be empathetic toward your feelings and need to acknowledge them. Be minute in assessing whether you feel any better than the earlier days or not.
Most importantly, don’t skip medicines, visits with your doctors, and psychotherapy sessions. You need to be honest while communicating with your doctor or therapist, as the duration of the treatment will depend on the progress in your mental health.
Causes of Postpartum Depression
We can divide the causes of postpartum depression into three sections, physical, psychological, and social. Whatever the cause is, you will need proper medication, therapy, and support from your close ones. Have a look at the table below.
Physical Reasons For PPD | Psychological Reasons For PPD | Social Reasons For PPD |
A sudden drop in estrogen and progesterone levels | Stress due to marital conflict | Being a single parent |
A drop in thyroid hormone levels | Anxiety over financial issues | Lack of support from the partner, friends, or family |
Lack of sleep | Sadness caused by the sudden demise of a loved one | Fear of social stigma for giving birth to a child with special needs |
Previous medical conditions | Uncertainty about the pregnancy | |
Overconsumption of drugs and alcohol | ||
Difficulties faced during delivery |
What Increases The Risks Of Postpartum Depression?
The risks of PPD increase in a woman with a family history of depression. Further, if a woman has had PPD during her first pregnancy, she is likely to experience the symptoms in a severer form during her next pregnancy.
Also, a woman with PMDD or premenstrual dysphoric disorder is always at a higher risk of developing PPD.
Off topic What Is Pregnancy Nose? checkout this artical once.
How Is Postpartum Depression Diagnosed?
Unfortunately, there are no lab tests yet to detect postpartum depression. Doctors recommend a thyroid test to check the level of hormones in your body, as a drop in it can cause depression.
Otherwise, doctors schedule postpartum appointments for new moms every two or three weeks. They ask the mother some questions about her health and the condition of the baby. Many doctors use the “Edinburgh Postnatal Depression Scale” for assessing PPD.
Based on your answers to the questions, the doctor will decide whether you have PPD. So, be completely honest with your answers, as hiding your feelings will not help.
Treatment Of Postpartum Depression
A woman suffering from postpartum depression needs immediate medical attention. Medicines and psychotherapies can help you overcome the crisis faster when you work on specific natural remedies.
- Treatment Of Postpartum Depression With Antidepressants
Using antidepressant medications is the safest method while treating a mother who has just delivered a baby and is suffering from PPD. However, don’t assume that the medicines will work like some magic tricks. Even these medicines need some time to act. Usually, you will notice the improvements within six to eight weeks of taking these medicines.
There are mainly four types of antidepressants that are used to treat postpartum depression.
Brexanolone
In 2019, Brexanolone received FDA approval, and it is now being widely used as an effective medicine to specifically treat postpartum depression. Doctors administer this antidepressant medication through an IV infusion, and the same is done over a span of sixty hours.
In some cases, doctors prescribe this antidepressant when women suffering from PPD do not respond to other medicines.
Atypical Antidepressants
Atypical antidepressants target specific neurotransmitters in the brain to improve the mood of a person suffering from depression.
Doctors prescribe atypical depressants when a patient does not respond to the most commonly used antidepressant medicines or SSRIs.
Some atypical antidepressants used in treating PPD are:
- Trazodone
- Bupropion
- Nefazodone
Tricyclic Antidepressants and Monoamine Oxidase Inhibitors
These antidepressants are less in use these days. Most doctors prescribe SSRIs and Brexanolone.
Selective serotonin reuptake inhibitors (SSRIs)
This is the most common type of antidepressant medication prescribed by doctors. These medicines are very popular as they are known to have lesser side effects in comparison to other forms of antidepressants. Some common SSRIs antidepressants are fluoxetine, paroxetine, and sertraline.
Despite being the most effective method for treating postpartum depression, these antidepressants also have multiple side effects. Anxiety, headaches, and gastrointestinal issues are very common side effects of these medications. Further, based on the type of antidepressant you are taking and the doses, the severity of the side effects will differ. So, always adhere to the doses prescribed by your medical advisor.
- Treating Postpartum Depression With Hormonal Therapies
I have said that once you deliver the baby, the estrogen and progesterone levels in your body will dramatically drop within the next three days. With this sudden drop, you can face mood disorders related to postpartum depression.
Often hormone therapy is used to combat this situation. Especially doctors suggest hormone therapies when a woman has a very low level of estrogen after her delivery, and that is the main cause behind her PPD. Also, if medications are not working for a particular patient, hormone therapy seems to be an effective remedy.
However, hormone therapy with estrogen comes with several side effects mentioned below.
- Yeast infections in the vagina
- Unusual vaginal discharge
- Changes in weight
- Uterine fibroids enlargement
- Edema
- High BP
- Cramps in the abdomen
- Regular headaches or migraines
- Loss of hair
- Nausea and vomiting
- Diarrhea
- Pain or tenderness in the breasts
- Changes in menstrual health
- Acne, rash, or itchy skin
- Treating Postpartum Depression With Electroconvulsive Therapy
Electroconvulsive therapy, or ECT, is often used for the treatment of women suffering from severe postpartum depression. ECT is also used in people suffering from depression that cannot be cured with medications.
Further, it can be a standalone treatment or a treatment coupled with therapies and medications. Seek your healthcare provider’s suggestions regarding this.
In this process, the patient is under general anesthesia, and minor electrical stimulations are sent to the brain. These stimulations trigger changes in brain chemistry and can help in overcoming depression.
However, there are not enough studies to prove how effective this treatment method is. And it can have many side effects.
- PPD Treatment With Cognitive Behavioral Therapy
Cognitive behavioral therapy, or CBT, is a kind of psychotherapy that’s most effective for women suffering from postpartum depression. Today, it’s known that a person gets to cope with depression faster when medications are coupled with cognitive behavioral therapy.
Cognitive behavioral therapy makes use of unique strategies and techniques so that the patient suffering from depression gets to learn new things. There are also some other benefits of this therapy.
- Change in thinking patterns.
- Ability to identify irregularities or distortions in the thought process
- Development of problem-solving abilities
- Using problem-solving skills to overcome difficult conditions instead of being confused, anxious, or sad over the situation
- Better confidence level
- Natural Remedies
Postpartum depression cannot be dealt with casually and without the help of a medical practitioner. However, sometimes a little extra effort on your part can alleviate the problems a little faster. And these practices should be done in association with the medications and therapies your doctor has suggested.
As natural remedies, you can bring changes to your diet and cut on too much salt and refined sugar. Try incorporating nuts, whole grains, lean proteins, fruits, and veggies into your regular diet.
With good changes in your diet, you can also do some mild activities, and of course, those should be approved by your medical practitioner. Yoga, meditation, and similar practices are also helpful as natural remedies as they calm your mind and lessen distortions in your thought process.
You can even try spending some time in the company of nature or gardening as natural remedial processes.
Finally, minimize and, if possible, quit smoking or alcohol consumption.
With the presence of many methods for treating postpartum depression, your doctor will suggest which method is the safest and the most effective for you. Especially for a lactating mother, the treatment she receives directly impacts the health of her child.
Finding Help From Postpartum Support Groups And Organizations
There are many support groups and organizations in the USA helping people suffering from PPD. Some of the most prominent names are mentioned below.
- ACOG or American Congress of Obstetricians and Gynaecologists
- Mental Health America
- NAMI or the National Alliance on Mental Illness
- Postpartum Support International
- U.S. Department of Health and Human Services – Women’s Health
- State-wise Postpartum depression support groups
But most importantly, a woman suffering from PPD needs care, empathy, and support from her partner, family, and friends. If she gets to vent her honest feelings with her loved ones, fighting PPD will be much easier for her.
Can Postpartum Depression In A Mother Affect The Baby?
The physical and mental health of the mother definitely impacts the health and growth of the baby. The Office on Women’s Health (The US Government) states that the first problem in this context is creating a proper mother and child bond. In PPD, the mother is often nonchalant about the child and fails to take care of the newborn.
Further, the children of mothers suffering from PPD are crankier, and they often develop behavioral problems. Also, these children have difficulty learning, and their language development is delayed.
These children even find it difficult to handle stress and adjust to various social conditions.
Beyond these psychological and behavioral problems, the children of mothers suffering from postpartum depression often do not thrive well. To put it simply, they have a shorter height. Moreover, they are at a higher risk of having obesity.
Final Words
When we discuss postpartum pregnancy, naturally, we shift all our focus to women. But don’t forget that men also go through PPD after they have a new baby.
It is obvious and natural to be a little anxious when someone becomes a parent for the first time. But be very careful about how you feel after the baby is delivered. If you are feeling extremely anxious, sad, or confused and having harmful thoughts, make haste to get in touch with a medical practitioner.
There is no shame in seeking help! With help, everyone can overcome it.
That’s it! If you have found this guide helpful, please let me know. And share if you have gone through or seen anyone going through PPD and overcoming it with flying colors.
Frequently Asked Questions (FAQs)
Despite the absence of studies showing the risks associated with Gabapentin during pregnancy, this medication to control seizures is not recommended in pregnancy. This medicine reduces the level of folic acid in the blood, and maintaining an adequate level of folic acid is crucial for a healthy pregnancy.
When you stop taking Gabapentin, specific withdrawal symptoms can occur. Anxiety, nausea, tachycardia, and gastrointestinal distress are some of the most common Gabapentin withdrawal symptoms.
Adderall, a medication used to treat attention deficit hyperactivity disorder or ADHD, is not considered safe during pregnancy and for lactating mothers. This medication is harmful to pregnant or lactating mothers because it can risk the thriving embryos and babies.
As you stop taking this medicine during your pregnancy, you can face Adderall withdrawal symptoms. As part of the multiple withdrawal symptoms, you can have depression during your pregnancy or postpartum days. Further, the existing postpartum depression can worsen with this withdrawal symptom.
Other withdrawal symptoms include fatigue, nausea, insomnia, and stomach cramps.
Yes, you can have delayed postpartum depression. Postpartum depression does not always hit the mother right after the baby is born.
PPD can happen to you, or you may start to notice the signs of PPD after some weeks or months after your baby is born.
There are some reasons why a new mother has delayed PPD. Your body undergoes a lot of changes at this stage, and the hormones go crazy at this stage. Also, new mothers are mostly sleep-deprived, and they may find it difficult to manage the baby care regime.
So, delayed PPD is valid, and it demands the same care, treatment, and support as usual postpartum depression.
High-functioning depression is a form of depression in which people suffer from sadness or emptiness, but it affects their regular activities. People suffering from this mental condition are often known to have PDD or persistent depressive disorder.
Suicidal thoughts are one of the most harmful effects of this mental condition.
Despite the absence of strict guidelines, some measures can prevent postpartum depression. Some medical practitioners suggest antidepressants, certain nutrients, and psychological therapies to prevent PPD from getting severe.
Further, you can have a balanced diet, do light exercises regularly, and ask your friends and family to catch up to make the overwhelming feeling during and after pregnancy less severe. Proper sleep, rest, and attending educational classes can also be of great help.
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