Postpartum Depression Diagnosis and Treatment
Postpartum Depression Diagnosis and Treatment
Learn about the causes, signs, symptoms, and treatment methods for postpartum depression.
Table of Contents
What Is Postpartum Depression?
The term postpartum depression can occur after a woman gives birth. All the changes the body and mind go through during and after pregnancy can result in feelings of depression. One in nine women often develops emptiness, loneliness, and detachment from their babies.
These signs are linked to postpartum depression. Symptoms usually develop after birth, and if they persist for longer than two weeks, new mothers are diagnosed with postpartum depression. Diagnosis depends on the duration and severity of the symptoms.
A Further Look
The birth of a baby often brings about a whirlwind of emotions—from excitement and joy to fear and anxiety. Nonetheless, it can cause a period marked by a persistent low mood leading to depression.
This period usually involves mood swings, anxiety, insomnia, and crying spells. While these symptoms commonly clear up after two weeks, new mothers with postpartum depression continue experiencing them. In some extreme cases, the mother could lose touch with reality and even harbor thoughts of harming the baby.1
When Does Postpartum Depression Start?
The onset of postpartum depression occurs within two to four weeks after the delivery of the baby. While it is normal to develop “baby blues” in the days after delivery due to changes in hormone levels and various chemical, social, and psychological factors linked to birth, mothers with postpartum depression find their condition persisting for longer.
How Common Is Postpartum Depression?
Here are statistics regarding postpartum depression:2
- Around 80% of mothers develop a shift in their emotions after birth, the baby blues.
- 15% of women develop postpartum depression and exhibit more severe symptoms that last longer than normal.
- 33.4% of women reported feeling symptoms before giving birth.
- 40.1% reported feeling symptoms after birth.
- Only 15% of women received professional help.
Baby Blues vs. Postpartum Depression
Baby blues refers to the sudden mood swings new mothers experience after birth, usually lasting one to two weeks. These mood swings include fluctuating feelings of happiness, sadness, and restlessness. Many mothers who experience baby blues do not require treatment; however, they can easily overcome it by joining a support group of women who have been through the same situation.
In contrast, postpartum depression (PPD) lasts for a few months up to a few years, with intensified symptoms associated with baby blues. It often requires medical treatment to prevent symptoms from worsening.
What Is Postpartum Psychosis?
Postpartum psychosis is a more intense mental illness that affects new mothers and usually develops in the first three months after childbirth. Symptoms include losing touch with reality, hallucinations, delusions, insomnia, unusual behaviors, restlessness, agitation, and feelings of self-harm or harm to others.
Postpartum psychosis is severe and dangerous; therefore, women affected need immediate medical intervention and medication.
Postpartum Depression Causes and Risk Factors
PPD is associated with certain risk factors and causes that predispose a new mother to develop the condition.
Causes
Research has linked postpartum depression to certain genes that trigger the development of the condition. Postpartum psychosis is the most extreme form of postnatal depression and is most likely triggered by gene alteration.
Experts are still working on the possible isolation of the two genes known for their involvement in hippocampal activity (TTC9B and HP1BP3). Doctors can detect if that genetic alteration occurred in a pregnant woman with a blood test, allowing them to identify the risk and treat women before they develop the condition.3
Hormone Levels
Mothers usually experience intense drops in hormone levels after birth. Lower levels of hormones, such as progesterone, estrogen, and allopregnanolone, in the second trimester have been associated with the development of postpartum depression.
Changes in other hormones produced by the thyroid gland also cause the new mother to feel sluggish, tired, and depressed.
Risk Factors
The risk factors associated with postpartum depression are varied. They include:
- History of depression during previous pregnancies
- Age at the time of pregnancy
- Multiple births (twins or triplets)
- Marital conflict
- Limited social support
Signs and Symptoms of Postpartum Depression
The symptoms and severity of postpartum depression vary between each woman. The following is a list of common symptoms of baby blues, postpartum depression, and postpartum psychosis:
Baby Blues Symptoms
- Restless
- Irritable
- Anxious
- Overwhelmed
- Too exhausted to eat or take care of oneself
- Frequent mood swings
Postpartum Depression Symptoms
- Hopeless, lonely, sad, or worthless
- Unwillingness to do motherly duties
- Cannot bond with baby
- Cannot eat, sleep, or take care of oneself
- Experience anxiety and panic attacks
Postpartum Psychosis Symptoms
- Hallucinations
- Delusions
- Restlessness
- Insomnia
- Risk of suicide
Postpartum Depression Diagnosis
Postpartum depression is often diagnosed through an evaluation that includes a detailed conversation between the patient and the doctor.
The doctor usually enquires about the patient’s feelings and thoughts to help distinguish postpartum depression from similar short-term cases of baby blues. In addition, a blood test could be ordered to determine hormone levels.4
Postpartum Depression Screening Scale
A depression screening questionnaire, regularly referred to as Edinburgh Postnatal Depression Scale (EPDS), is used to diagnose postnatal depression disorders. A score of thirteen is the benchmark to determine a depression diagnosis.
EPDS has its limitations since postnatal depression disorder often exists in a continuum. By adhering rigidly to the score benchmark, we could miss out on women with high levels of postpartum disorder or milder forms of depression.
Complications
Untreated postpartum depression can last for months and hurt the new mother and other parties involved. In addition, it can leave mothers at risk for future bouts of depression.
The strain caused by postpartum depression can also affect fathers due to the ripple effect. Children born of mothers affected by postpartum depression disorder tend to exhibit emotional problems, excessive crying, and delays in language development. Lastly, it can affect mother-child bonding.
Treatment For Postpartum Depression
Postpartum depression disorder is often treated with a combination of talk therapy and medication. Both methods can be deployed alone, but the best results are obtained through utilizing them together. The options for postpartum depression treatment are explained below:5
Medications
Antidepressants are usually recommended due to their highly effective effects of reducing symptoms. Nevertheless, new mothers must carefully decide the type of antidepressant they want to take since some negatively affect breastfeeding.
Psychotherapy
The two recommended forms of psychotherapy, or talk therapy, are cognitive behavioral therapy (CBT) and interpersonal therapy. CBT helps patients understand and change their thoughts and feelings responsible for harmful behaviors, while interpersonal therapy helps patients understand their relationships and work through their problems.
Postpartum Depression Support Groups
New mothers experiencing postpartum depression should seek out support groups. Postpartum depression support groups include women who are experiencing or have experienced this disorder and can provide useful tips and information on how to handle and navigate the symptoms.
Resources
- https://familydoctor.org/condition/postpartum-depression/
- https://www.healthline.com/health/depression/postpartum-depression#symptoms
- https://www.hopkinsmedicine.org/news/media/releases/genetic_predictors_of_postpartum_depression_uncovered_by_johns_hopkins_researchers
- https://www.webmd.com/depression/postpartum-depression/understanding-postpartum-depression-treatment
- https://www.medicalnewstoday.com/articles/237109
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