Medication
Among the women who did not seek medical help for postpartum depression symptoms, 30 percent said it was because they felt strong enough to "get over" their feelings without a doctor, while 26 percent felt their symptoms were not serious enough to warrant a discussion.
Therapy
It is thought that the abrupt decrease in hormone levels after having a baby can lead to the development of postpartum depression in susceptible women. We also can’t say for sure what makes a woman particularly vulnerable to postpartum depression.
Self-care
Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression.
Nutrition
The survey found that the majority of conversations about postpartum depression that did happen occurred in the final trimester, while a woman was in the hospital after giving birth or at her postpartum appointment, which generally takes place six weeks after delivery.
Why don't women seek medical help for postpartum depression?
What is postpartum depression and why does it happen?
How can childbirth educators help with postpartum depression?
When do women talk about postpartum depression?
What happens when you are tired from depression?
When you are tired from depression and consumed by your thoughts, you might have difficulty concentrating, remembering details, or even making decisions. You might forget birthdays, appointments, or something as simple as your keys in the door.
What to do if your baby blues are not going away?
If your baby blues are not going away or you suspect that you have postpartum depression, the most important thing to do is seek treatment and not allow it to continue.
Is postpartum depression a myth?
Like most conditions, postpartum depression is surrounded by myths and misunderstandings. Some of these are old wives' tales, while others are incorrect facts you hear from family, friends, and possibly the internet.
Is it normal to be upset during postpartum?
Being overwhelmed or upset every now and again is normal. However, if you are depressed, crying, feeling upset, blaming yourself, or feeling guilty about your life, you are entering the first stage s of postpartum depression.
Can postpartum depression turn into mood disorder?
Regardless of what might have caused your postpartum depression, the symptoms start to show relatively quickly. Knowing the symptoms and warnings signs could keep the depression from turning into a more severe mood disorder.
How soon can you call your doctor for postpartum depression?
It's important to call your doctor as soon as possible if the signs and symptoms of depression have any of these features: Don't fade after two weeks. Are getting worse. Make it hard for you to care for your baby.
What to do if you are depressed after a baby is born?
If you're feeling depressed after your baby's birth, you may be reluctant or embarrassed to admit it. But if you experience any symptoms of postpartum baby blues or postpartum depression, call your doctor and schedule an appointment. If you have symptoms that suggest you may have postpartum psychosis, get help immediately.
What are the symptoms of postpartum psychosis?
Signs and symptoms may include: Confusion and disorientation. Obsessive thoughts about your baby.
How long does it take for depression to develop after birth?
Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth. Postpartum depression signs and symptoms may include: Depressed mood or severe mood swings. Excessive crying. Difficulty bonding with your baby.
What happens to your body after you have a baby?
Physical changes. After childbirth, a dramatic drop in hormones (estrogen and progesterone) in your body may contribute to postpartum depression. Other hormones produced by your thyroid gland also may drop sharply — which can leave you feeling tired, sluggish and depressed. Emotional issues.
What are the effects of having a baby?
The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect — depression. Most new moms experience postpartum "baby blues" after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping.
What to do if you think you are harming your baby?
If at any point you have thoughts of harming yourself or your baby, immediately seek help from your partner or loved ones in taking care of your baby and call 911 or your local emergency assistance number to get help.
Why don't women seek medical help for postpartum depression?
Among the women who did not seek medical help for postpartum depression symptoms, 30 percent said it was because they felt strong enough to "get over" their feelings without a doctor, while 26 percent felt their symptoms were not serious enough to warrant a discussion. Twenty-five percent said they were too embarrassed ...
How long does postpartum depression last?
The survey found that the majority of conversations about postpartum depression that did happen occurred in the final trimester, while a woman was in the hospital after giving birth or at her postpartum appointment, which generally takes place six weeks after delivery .
What is the best treatment for postpartum depression?
interpersonal therapy. When a formal diagnosis of postpartum depression is made, it is very important to make sure a new mother gets the care she needs. The appropriate treatment is based on the severity of a woman’s symptoms and how she responds to the intervention.
Why is it important to screen for postpartum depression?
Because postpartum depression affects the health of the woman, her infant, and her entire family, it is very important to screen for postpartum depression risk. Most obstetricians are now implementing some type of screening tool during the postpartum checkup. Screening is very important because studies have shown that many women with postpartum ...
Why is postpartum screening important?
Screening is very important because studies have shown that many women with postpartum depression are ashamed of their symptoms and are afraid of the social stigma associated with the diagnosis. Although symptoms of postpartum depression can vary, the typical symptoms include: sleep disturbances. anxiety. irritability.
How long does postpartum depression last?
For most women, the symptoms go away without treatment, but about 20% of women will still have significant depressive symptoms after one year.
What are the first days after having a baby?
For most new mothers, the first several days after having a baby is an emotional roller coaster ride. Thrilling moments of happiness and joy are abruptly interrupted by a plunge into moments of depressive symptoms including weeping, anxiety, anger, and sadness.
Can a baby cause postpartum depression?
It is thought that the abrupt decrease in hormone levels after having a baby can lead to the development of postpartum depression in susceptible women. We also can’t say for sure what makes a woman particularly vulnerable to postpartum depression.
Is postpartum depression a personal disorder?
We do know that the strongest predictor of postpartum depression is a personal history of a mood disorder or anxiety, especially if present and untreated during pregnancy. In fact, women with a history of depression during pregnancy are seven times more likely to experience significant postpartum depression.
How common is postpartum depression?
Postpartum depression is a major international public health problem that affects at least 1 in 8 mothers and their children in the year after childbirth worldwide. PPD may be more common and may be associated with more morbidity for both mothers and children in resource-poor countries. PPD has been associated with significant negative effects not only on depressed women themselves, but on the physical, cognitive and emotional development of their children. Early detection and intervention are important in mitigating these risks. There are validated and easily administered screening tools for PPD available in many languages, such as the Edinburgh Postnatal Depression Scale; most experts recommend screening women for PPD 4–6 weeks after delivery.
What are the symptoms of a postpartum depression episode?
However, studies suggest that depressive episodes are significantly more common in women in the first three months after delivery, 32 and an increased vulnerability to psychiatric illness may persist for a year or more. 33 It is important to differentiate PPD from other psychiatric and nonpsychiatric diagnoses. The “postpartum blues” or “baby blues” is a transient mood disturbance that affects up to 75% of new mothers in the 10 days following delivery, and consists of crying, irritability, fatigue, anxiety, and emotional lability. Symptoms are generally mild and self-limited, and do not involve total loss of pleasure or interest, persistent low mood, or suicidal ideation. 34 On the other extreme, postpartum psychosis is a psychiatric emergency that requires immediate intervention, and is characterized by the rapid onset of severe mood swings, a waxing and waning sensorium, delusions, hallucinations or disorganized behaviors, and a relatively high incidence of suicidal ideation or homicidal ideation toward the infant. 35 Women presenting with a depressive episode, mood elevation, or psychotic symptoms should be screened for any prior history of mania or hypomania to rule out previously undiagnosed bipolar disorder. 36 Anxiety disorders are common in perinatal women, and women may have depression comorbid with obsessive-compulsive symptoms, generalized anxiety disorder, panic disorder or post-traumatic stress disorder. 37 Substance use and medical causes of psychiatric symptoms, such as thyroid disorders, should also be considered.
What is psychosocial intervention?
As compared with IPT or CBT, psychosocial interventions are unstructured and nonmanualized, and include nondirective counseling and peer support. Nondirective counseling (also known as “person-centered”) is based on the use of empathic and nonjudgmental listening and support. In the first notable study evaluating this intervention, Holden randomized 50 women with PPD to 8 weekly nondirective counseling sessions with a health visitor or routine primary care. 108 A health visitor in the UK is a public health nurse who conducts home visits with pregnant and postpartum women. This study found that the rate of recovery from PPD for counseling (69%) was significantly greater than that of the control group (38%). In a similar study conducted in Sweden, Wickberg and Hwang randomized 31 women with PPD to receive six nondirective counseling sessions by child health clinic nurses or routine primary care. 109 As in the Holden study, a significantly greater percentage of women in the treatment group (80%) had remission of depression than in the control group (25%). Study limitations include the removal of four study participants, two in each group, for more intensive mental health services due to illness severity.
What is the best treatment for depression?
Cognitive behavioral therapy (CBT), a well-studied and effective treatment for major depression, 105 is based on the premise that both perceptions and behaviors are intimately linked to mood. CBT focuses on helping depressed patients to modify distorted patterns of negative thinking and to make behavioral changes that enhance coping and reduce distress. 106 There have been several trials assessing CBT alone or with other interventions for the treatment of PPD. In a randomized controlled psychotherapy-pharmacotherapy study, Appleby et al assigned 87 women with PPD to one of four conditions in a factorial design, varying based on treatment with either one or six sessions of CBT-based counseling, and treatment with fluoxetine or placebo. 52 All four treatment groups had significant improvement in depressive symptoms. Women who received six CBT sessions versus one had greater decrease in depressive symptoms. Six sessions of CBT plus placebo pill was as effective as treatment with fluoxetine plus one session of CBT, but there was no added benefit in the group receiving 6 counseling sessions in combination with fluoxetine. It should be noted that the counseling sessions were delivered by briefly trained nonspecialists, and six sessions of CBT may not be a sufficient representation of a standard course of treatment. In another combination medication-CBT study, Misri et al randomized 35 women with PPD and comorbid anxiety either to paroxetine monotherapy or paroxetine and 12 weekly manualized CBT sessions with a psychologist. 53 While both groups had significant decreases in depressive symptoms, there were no significant differences between the two groups in response rates, time to remission or dose of medication required, suggesting no measurable added benefit to the CBT treatment in combination with an SSRI over the 12 week study period, as consistent with Appleby’s findings. In a randomized controlled trial looking at the effectiveness of CBT versus a control condition, Prendergast and Austin assigned 37 women with PPD either to six weekly one-hour home-based CBT sessions delivered by early childhood nurses (ECNs) or to “ideal standard care”, which consisted of six weekly visits to ECNs in a clinic setting. 107 Both groups with PPD had significant mood improvement, though there was a nonsignificant trend towards CBT being more effective at six-month follow-up. Among study limitations, ECNs administering CBT were not experienced therapists, though they received CBT training prior to the study and supervision throughout. Additionally, the control group more closely resembled a supportive psychotherapy rather than no-treament. These studies support CBT interventions as helpful in the treatment of PPD, though they do not support an additional benefit to CBT in combination with pharmacotherapy and do not clarify a specific benefit of CBT for this population in comparison with other treatments. Two of these studies also suggest a role for the training of nonmental-health professionals in this modality.
How long can a woman breastfeed?
The benefits of breastfeeding have been well described 66 – 73 and have led the World Health Organization, the American Academy of Pediatrics and the American Academy of Family Practitioners to recommend breastfeeding for at least the first 6 months for most women. 66, 67, 73 Potential effects of antidepressant medication on breastfeeding are of concern to many mothers and clinicians. 49, 74 Neonates and young infants are especially vulnerable to potential drug effects due to their immature hepatic and renal systems, immature blood–brain barriers, and developing neurological systems. 75, 76 Because relatively little is known about the effects of antidepressant medication in breast milk, some experts have recommended nonpharmacologic treatment modalities when possible, particularly for mild to moderate depression. 76 However, non-pharmacologic treatments are not effective for some women, and may not be accessible for many women.
Is postpartum depression a major depression?
A small but growing literature suggests that postpartum depression can be thought of as a variant of major depression that responds similarly to antidepressant medication. 46, 47 Concerns unique to pharmacologic treatment of PPD include metabolic changes in the postpartum period, exposure of the infant to medication in breast milk, the effect of depression and treatment on the ability of the depressed mother to care for a new baby, and the perceived stigma of being seen as a “bad mother” for requiring medication. 48 – 50 These factors, as well as the woman’s level of distress, access to care, and experience with past treatment may influence the decision of the patient and her caregiver regarding the choice of pharmacologic and nonpharmacologic treatments for PPD. Data comparing the effectiveness of medication against other treatment modalities for PPD are scarce, though do suggest that medications are at least as effective as most psychological interventions based on effect size. 51 To date, four randomized controlled studies on the treatment of PPD with antidepressant medications have been published, along with several open trials. Additionally, two randomized studies have looked at the prevention of PPD with antidepressant medication.
Is social support a risk factor for postpartum depression?
Epidemiologic data as well as some prospective studies have consistently identified inadequate social support as a risk factor for developing postpartum depression, 110 – 112 thus raising the possibility of interventions aimed at increasing social supports as treatment options for perinatal depression.
What is postpartum depression?
Thanks to awareness efforts, postpartum depression is getting more attention. But some new moms who develop this condition still slip through the cracks without getting the help they need. After giving birth, most women experience some form of the “baby blues,” a mild state of sadness, fatigue and worry that may last a couple ...
When should women meet with a mental health professional?
1. Women should know their risk factors and, if at risk, consider establishing care with a mental health professional before the baby is born. Ideally, they would meet with a counselor or psychiatrist even when planning to conceive, but they definitely should make this connection by the third trimester.
Why are women reluctant to admit to themselves?
Women may be reluctant to admit to themselves or others that they need help because they may feel like failures.
Can depression be misinterpreted as anger?
Anxiety and depression can be misinterpreted as anger and irritability. Sudden changes in mood are worth checking out, whether it’s being angry all the time, no longer getting joy out of life or exhibiting other drastic changes. 4. Remember that support and treatment do exist.
Is it hard to admit you need help?
Admitting you need help is difficult. Unfortunately, there remains some stigma surrounding PPD. Our culture inundates women with messages that they should be floating on a cloud of happiness after they give birth and that, to be a good mom, you have it together from day zero. These messages simply aren’t true.
Should mothers take care of themselves during postpartum?
Postpartum depression is hard to go through without blaming yourself. But it’s not the mother’s fault.
Why don't women share their PPD?
PPD, despite being the most common medical complication of childbirth, carries a stigma that may be at the root of why so many women don't share their PPD symptoms with a healthcare professional. HealthyWomen recently conducted a survey, sponsored by Sage Therapeutics, with more than 1,000 female respondents between the ages of 18 and 49 years old who are either pregnant or planning to become pregnant. The results showed 91 percent of the women surveyed agreed that there is a societal pressure on mothers to hide the struggles, anxieties and sadness that may accompany motherhood.
How to diagnose PPD?
To diagnose PPD, a healthcare professional may: 1 Conduct a depression screening that may include asking you questions or having you fill out a questionnaire 2 Order other tests, if warranted, to rule out other causes for your symptoms
Is PPD preventable?
More than half of our survey respondents thought it would be possible to prevent PPD. PPD is not preventable. The thought that it is a preventable condition may place blame on the mother if she experiences symptoms of or is diagnosed with PPD. Any woman who is pregnant or has recently had a baby is at risk for PPD.
Is PPD a normal side effect of motherhood?
PPD side effects may mask themselves as "normal" consequences of motherhood. Some of the symptoms of PPD, like irritability, excessive crying or loss of energy, could be brushed off as normal side effects of motherhood. These are also symptoms of what is known as "baby blues," which affect about 80% of new mothers; however, ...
Is it difficult to diagnose PPD?
PPD may be difficult to diagnose. There's also some confusion among women about how PPD is diagnosed. Thirty percent of women surveyed didn't know how or whether healthcare providers truly diagnose PPD.
Can you have bipolar after a previous pregnancy?
You have bipolar disorder. You had postpartum depression after a previous pregnancy. You have family members who've had depression or other mood disorders (family history). You've experienced stressful events during the past year, such as pregnancy complications, illness or job loss.
Is a woman at risk for PPD?
Any woman who is pregnant or has recently had a baby is at risk for PPD. However, you may have an increased risk of developing PPD if any of the following apply to you: You have a history of depression, either during pregnancy or at other times. You have bipolar disorder.
How rare is postpartum psychosis?
It is rare, occurring in 1 to 3 mothers per 1,000 births. Onset is within the first 24 to 72 hours after giving birth. Postpartum psychosis has a 5% suicide and a 4% infanticide rate.
How long do postpartum blues last?
Approximately 80% of postpartum women experience the “blues,” which are mild hormonal changes that take place within the first 48 hours after giving birth. These symptoms may last up to 6 weeks (Bennett & Indman, 2003).
What is the role of a childbirth educator?
Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period , including postpartum depression.
How can childbirth educators help?
Second, educators can help increase a woman's understanding of how to meet her own needs.
What are the two largest national organizations for postpartum women?
Many different resources are available to postpartum women. The two largest national organizations are Depression After Delivery and Postpartum Support International. These organizations focus on helping women through education, information, support, and referrals in the event of difficulties after birth.
Why do we need childbirth classes?
Childbirth education classes provide an opportunity to teach a new mother to anticipate the help and support she might need for the birth of her child . According to Day (2007), depression and abuse are not adequately attended to prior to childbirth, and weaknesses exist in identifying and supporting women at risk.
What is puerperium transition?
It is a time of extreme physical and emotional transition with intense hormonal, psychological, and biological changes, all of which can have an effect on the central nervous system (Studd & Panay, 2004). The puerperium may be a time of high vulnerability for women, coupled with feelings of loss of control.