Postpartum depression is related to chemical, psychological, and social changes linked to having a baby. The term describes a range of emotional and physical changes that many new moms experience. The good news is that postpartum depression can be quickly addressed with counseling and medication.
The chemical changes involve a rapid drop in hormones after giving birth. The actual link between this drop and depression is still not clear. However, what is known is that the levels of progesterone and estrogen, the female reproductive hormones incline tenfold during pregnancy. Then, they decrease sharply after delivery. By three days after delivering, the levels of these hormones drop back to what they were before getting pregnant.
It means these chemical, psychological, and social changes related to having a baby create an increased risk of depression in most cases.
What Are the Symptoms of Postpartum Depression?
Symptoms of postpartum depression are similar to what occurs the following childbirth typically. They include difficulty sleeping, excessive fatigue, appetite changes, frequent mood changes, and decreased libido. Nonetheless, these signs also appear with other symptoms of major depression, which are not normal after giving birth. They usually include helplessness, thoughts of death or suicide or thoughts of hurting someone else or depressed mood; loss of pleasure; feelings of worthlessness, and hopelessness.
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Different Types of Postpartum Depression
Postpartum Blues: Postpartum blues, also known as baby blues, is the most usual type of postpartum mood disorders. It affects 50% to 85% of women approximately. It typically happens in most women during the period right after childbirth. The new mother has sudden mood fluctuations, such as feeling very sad and then feeling very happy. You might cry without any reason and can feel impatient, restless, irritable, anxious, sad, and lonely. The baby blues might last as long as one to two weeks after delivery or only a few hours.
Blues is known as the mildest kind of postpartum depression. Postpartum blues symptoms do not interfere with your ability to function in your routine life. The symptoms will be passed quickly and do not leave lasting effects on you or your family. Thus, it is considered normal and not severe for postpartum women.
Postpartum Psychosis: It is the most severe kind of any postpartum mood disorder, which is extremely rare. Approximately, 1 or 2 moms out of 1,000 childbirths will have postpartum psychosis. Postpartum psychosis generally begins within the first few weeks after delivering the child.
Mother can lose touch with reality, delusions (strongly believing things that are clearly irrational), and having auditory hallucinations (hearing things that aren't happening actually such as a person talking). Visual hallucinations (seeing things that aren't there) are less usual.
Symptoms include pacing, insomnia (not being able to sleep), feeling agitated and angry, restlessness, and strange behaviors or feelings.
Behaviors of a mother with postpartum psychosis are comparable to the manic episodes of a person with bipolar disorder. Female with past histories of bipolar disorder and other psychotic issues are at a higher risk of the development of postpartum psychosis.
Psychosis causes moms to become unaware of their behaviors and actions. Therefore, this disorder presents a serious risk of infanticide and suicide. This risk equates to about 10%, so immediate treatment and even hospitalization are necessary.
The mother who has postpartum psychosis needs treatment right away and almost always require medication. Sometimes the female is put into the hospital because they are at risk for hurting themselves or someone else.
Postpartum Anxiety: Postpartum anxiety is another common mood disorder that develops after giving birth. It often goes undiagnosed since many people believe that new mothers are naturally anxious. Consequently, some symptoms of postpartum anxiety might seem "normal." Postpartum anxiety differs from other forms of PPD because its symptoms include far more anxious behaviors rather than primarily depressed behavior. Predominant signs of postpartum anxiety include:
- High tension and stress
- Persistent fears and worries
- Inability to relax
Like postpartum depression in general, these symptoms might last only a few weeks. However, they might persist for a longer period of time depending on the female struggling with the condition. It's important to be aware of the differences between the symptoms of postpartum anxiety, postpartum depression, and other types of postpartum mood disorders.
Postpartum depression (PPD): Based on the DSM-5 (a manual used for diagnosing mental disorders), PPD is a major depression that appears within four weeks after delivery. In some situations, it can occur a few days or even months after childbirth. PPD may happen after the birth of any child, not just the first one. A female can have feelings similar to the baby blues (sadness, anxiety, despair, and irritability). Still, she feels them much more strongly rather than she would with the baby blues. PPD often keeps a woman from the things she needs to do in her daily routine life. When a female's ability to function is affected, she needs to see her health care provider who can screen her for symptoms of depression for the development of a treatment plan. If a female does not get treatment for PPD, symptoms might get worse. While PPD is a serious issue, it can be easily treated with counseling and medication.
Postpartum Obsessive-Compulsive Disorder (OCD): It is another kind of postpartum depression, which is an anxiety mood disorder and affects roughly 3% to 5% of postpartum females.
Postpartum OCD includes persistent and intrusive thoughts, which usually involve harming or even killing the baby. These thoughts are rarely acted upon since moms with postpartum OCD are horrified and aware of the thoughts.
Behavioral characteristics of postpartum OCD include compulsive habits, such as changing the baby and repetitive cleaning. Because mothers are ashamed and embarrassed by these behaviors and thoughts, postpartum OCD often goes unreported. As a result, it won't be diagnosed and treated.
Postpartum Panic Disorder: It is a postpartum mood disorder that includes severe levels of anxiety. It happens in up to 10% of postpartum females. Women with postpartum panic disorder suffer from repeated panic attacks and extreme anxiousness. Symptoms of postpartum panic attacks include:
- Consistent and excessive worry/fear
- Shortness of breath
- Heart palpitations
- Tightening of the chest
Generally, these fears involve dying, going crazy, or losing control. Female with a history which includes panic attacks and severe anxiety are at a higher risk of the development of the postpartum panic disorder. Thyroid dysfunction may also create a higher risk of postpartum panic disorder.
Postpartum Post-Traumatic Stress Disorder (PTSD): It is a unique form of postpartum depression. It has effects on over 9% of postpartum mothers. Like general PTSD, symptoms of postpartum PTSD are the result of some perceived or real threats to the mothers. This threat or trauma usually happens during childbirth or shortly after. Postpartum PTSD traumas might include:
- Unplanned C-sections
- The baby being sent to the NICU
- Birth complications
- Other injuries the female suffered during delivery
Females who have suffered from other past traumas, including sexual violence or assault, might be at a greater risk of developing postpartum PTSD. Postpartum PTSD symptoms include:
- Panic and anxiety attacks
- Avoiding trauma triggers
- Reliving the trauma in flashbacks and memories
- Irritability
- Feeling detached or numb to reality
- Difficulty sleeping
- Many females with postpartum PTSD also feel a strong sense of guilt, self-blame, and shame regarding their feelings about their trauma.
Is Postpartum Depression Common?
Most new moms experience the baby blues after delivery. Approximately, one out of every 10 of these women will develop a more longer-lasting and severe depression after childbirth. About one in 1,000 females develop a more severe condition, such as postpartum psychosis.
Causes
PPD is likely to be the result of multiple parameters. However, the exact reasons have not been found yet. Usually, depression is caused by stressful events, emotional, a biological change that triggers an imbalance of brain chemicals, or both. The following factors might contribute to PPD:
- The physical changes of pregnancy
- Complicated or difficult labor and childbirth
- Lack of family support
- Excessive worry about the responsibilities of baby
- Financial difficulties
- Worries about relationships
- A history of mental health problems
- Loneliness, not having family and close friends around
- Changes to the sleep cycle
- Marital conflict
- Hormonal changes, because of a sudden and severe drop in progesterone and estrogen levels following birth
- The health consequences of childbirth, including blood pressure, change anemia, alterations in metabolism, and urinary incontinence.
- Having a history of depression or premenstrual dysphoric disorder (PMDD)
- Having a history of depression before becoming pregnant, or during pregnancy
- Mother's age at the time of pregnancy (The younger you are, the higher the risk)
- Ambivalence about the pregnancy
- The number of children (the more kids you have, the more likely you are to be depressed in a subsequent pregnancy)
Difficulties with breastfeeding might also be linked to PPD. New mothers who experience breastfeeding difficulties in the two weeks following the birth of the infant have a higher risk of PPD 2 months later. It is according to a urinary incontinence study done at the University of North Carolina at Chapel Hill.
Individuals with a family history of depression have a higher risk of suffering from it. However, nobody knows why this happens. A previous diagnosis of bipolar disorder may also increase the risk of developing PPD when comparing with other individuals with a new infant.
The diagnosis of postpartum depression will be made based on several factors, including the length of time between delivery and onset, the severity of the depression, and the mother's overall health and mental condition.
Depending on the symptoms, doctors may employ various techniques to treat postpartum depression. The type and severity of a mother's symptoms play a significant role in this regard. Treatment options usually include anti-anxiety or antidepressant medications, psychotherapy, and participation in a support group for emotional support and education. Nonetheless, for severe cases, these treatments may not work properly. Intravenous infusion of a new medication called brexanolone (Zulresso) is mostly prescribed in these situations.
In the case of postpartum psychosis, drugs will be added to regular treatments. Hospital admission is often necessary, as well.
It's important to note that you should take medication for depression, anxiety, or even psychosis, even if you are breastfeeding. Thus, you don't need to worry about your child's growth. Nonetheless, before taking any medication during this period, you must consult with your doctor to make sure that the drugs you use do not interfere with breastfeeding. Your doctor will select the best course of action, considering your overall health and mental condition.
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