Diving into Postpartum Depression and more...



On the arrival of a newborn, our society expects the new mom to feel flooded with joy and happiness. What if you don't feel the same? What if, you feel emotionless instead?


Most of the time, moms are embarrassed to share or discuss their emotional turmoil and tend to suffer in silence. They do love their baby, but still feel sad, worried, and lonely all the time. Pregnancy and childbirth is a complex process of physical, emotional, and behavioral changes, which can lead to depression. 

It is important to be vocal, discuss your feelings and experiences. You go through a lot of emotional and physical changes during and childbirth. It is natural to have mixed emotions of happiness and loneliness because you are processing the changes. However, if you feel you are getting trapped in these emotions, and the feeling seems to last longer than a few weeks, you might be dealing with Postpartum depression.


Postpartum Depression 

Postpartum depression is a result of the chemical, social and psychological changes post-childbirth. It describes an array of physical and emotional changes experienced by the new mothers.


Within the first few days and weeks after delivery, a mother goes through a swing of emotions ranging from feeling joyful and bliss to feeling sadness and emptiness. Usually, these feelings go after 3 to 5 days, but if they continue for more than a few weeks, then it's time to get some help.

Postpartum depression is a crippling mood disorder, factually deserted in health care, leaving mothers to suffer alone in distress, confusion, and silence. If left undiagnosed and untreated, it can adversely affect the mother-infant relationship and family dynamics.


Types of depression 

Depression during and after the pregnancy is divided into three categories, these are:

Baby blues (this is the mildest form)
Postpartum depression
Postpartum psychosis (this is the most severe form)

Baby Blues 

Baby blues is a shorter and milder kind of postpartum depression. 30 to 80 percent of the females go through this stage and usually don't last long. The symptoms usually begin within 3 to 10 days of delivery and last for about two to three weeks. During this phase, mothers usually de-value themselves; they feel they are unfit to take care of their child and doubt themselves.


The common symptoms are:

Anxiety
Crying 
Insomnia
Tiredness
Mood swings
Feeling Sad

Note: Postpartum blues is not postpartum depression. Baby Blues does not limit a mother's ability to function on the day to day basis.


Postpartum depression 

Postpartum depression affects almost 1 in 10 new mothers and more severe than baby blues. It tends to develop after three or four weeks after the delivery and can last up to one year. The mood swings are much stronger and long-lasting. 


The common symptoms include:

Crying over small things
Problems in focusing or concentrating
Decision making is difficult
Feeling of inadequacy
Feeling Sad
Some women get suicidal thoughts

At times there are physical symptoms like hyperthyroidism are experienced these are, sensitivity to cold, slow thinking or response, dry or itchy skin, tiredness, lethargy, constipation


Note: If you have experienced any of these symptoms, then it is essential to seek medical help.


Postpartum psychosis

Also referred to as puerperal psychosis or postpartum psychotic depression, it is rare and affects 1 or 2 women out of 1000. The symptoms usually begin within the first few weeks of childbirth. The behavior can be a little extreme and comparable to bipolar disorders. 


The common symptoms associated are: 

Hallucinations
Delusions
Extremely agitated
Hyperactivity
Mostly in a confused state

Note: Mothers suffering from this psychotic behavior are mostly unaware of their actions, and they are at serious risk of suicide or infanticide. With timely diagnosis and help, it is entirely treatable.


Causes

Postpartum depression is quite widespread. However, there are no specific reasons why some moms develop symptoms while others don't. 


There are some interrelated causes and risk factors that contribute to the development of depression. Understanding the correlations can help with identifying mothers who are at high risk of postpartum depression, and able to provide help and support proactively.


Hormonal Changes 

The pregnancy and childbirth process heavily depends on the changes in the level of hormones. After delivery, there is a significant drop in the estrogen and progesterone hormone levels, which leads to chemical changes in the brain and causes mood swings. Apart from these, there is a drop in the thyroid levels that can cause fatigue and depression. Along with the hormonal change, blood pressure, immune system, and metabolism are also affected. All these together act as "a perfect storm" for depression.


Physical Changes

Going through the physical changes from pregnancy, as well as trauma from childbirth, is taxing on the body. After childbirth, instead of focusing on healing, women feel the social pressure of losing baby weight and going back to the pre-pregnancy body. Giving birth leads to several physical and emotional changes. 


Lack of Sleep

Newborns don't sleep through the night, and it is challenging for mothers to wake up every few hours to nurse the baby night and day. New moms are mostly sleep deprived and have a fragmented sleep schedule. Lack of sleep and poor functioning of the brain has been studied for ages. As a matter of fact, lack of sleep has known to be used as a means of torture. Lack of sleep and stress of a new baby can be a substantial contributing factor for postpartum depression.

Note: Being a first-time mom makes all these changes and adjustments even more difficult.



Signs and Symptoms of depression 

It is relatively common to overlook the symptoms of depression as it can be seen as "being a first-time mother" or "haven't been sleeping well." It is vital to pay attention to the symptoms and trust your gut feeling if you think something is not right. It is also crucial for the husbands or partners or family members to speak with the mother if they notice she is struggling or if they notice unusual behavior patterns. 


Some of the common signs and symptoms of postpartum depression are: 

A feeling of sadness, loneliness, or overwhelmed
Crying frequently, with no apparent reasons
Being worried or over-anxious all the time 
Having frequent mood swings like being irritable or restless
Oversleeping or mostly being sleep deprived
Difficulty in focusing or concentrating or making decisions
Losing interest in most of the activities or thing
Overeating or eating too little
Trying to stay aloof 
Finding it difficult to bond or form an emotional attachment with the kid
Getting frequent thoughts of harming herself or the baby
Doubting her abilities to handle the baby

If left untreated, then the postpartum depression can take a toll on the mother and the baby and the loved ones!


Diagnosis

If you are experiencing any of the symptoms, it is best to discuss the symptoms with your healthcare provider immediately.


There are specific common questions that the healthcare provider may ask, some of them are related to:

Sleep pattern or sleep issues
Problems with decision-making
Feeling confused
Appetite changes or dietary issues
Any anxiety
Feeling tired or lethargic all the time
Feeling of guilt or losing self-confidence
Any suicidal thoughts
Depression screening test 
Your doctor may advise a specific diagnostic test like a blood test to check for any hormonal issues.

Treatment

The treatment of postpartum depression is dependent on the individual needs, stage of the depression, and other predisposing factors.

Postpartum blues symptoms can get better with time, within a few days. However, postpartum depression or postpartum psychosis needs professional help. It is better to seek help sooner than later.

The standard treatment plan followed in such cases are:

Rest as much as possible
Medication
Psychotherapy
Combination of drugs and psychotherapy
Participation in a support group helps
Electroconvulsive therapy (ECT) can help in case of severe depression with hallucination
If struggling with postpartum pain, physical therapy can help.

Note: It is always advisable to seek treatment as soon as possible. Sometimes it is hard for mothers to accept that they need help. It gives them the sense that they are weak, and getting help means they are not a good mother. A sound support system, constant reassurance, and professional help can make a huge difference.

FAQS on postpartum depression


Why do women experience postpartum depression?

Having a baby is a life-changer, and this change can be good as well as hard and stressful. A lot of physical and emotionless takes place during this duration; processing through all the changes can make women go through different feelings such as sadness, anxiety, afraid, or even confusion. Usually, this feeling goes away in due time; however, for some, it gets worse and results in depression.



Who is at risk of getting into postpartum depression?

Postpartum depression can affect any woman, irrespective of her age, economic status, and racial or ethnic background. Women with a history of depression are more prone to postpartum depression.

What is anti-natal depression?

Anti-natal depression is a rare condition, and it is a long-lasting sadness, and these females are very much prone to postnatal depression.


What are the risk factors for postnatal depression?

Postpartum mood swings can develop immediately after childbirth, but some of the common risk factors are: 

A history of depression

Having gone through postpartum depression in an earlier pregnancy

Had experienced stressful events during the previous year

Have a poor support system

Are suffering from chronic pain or physical issues

Overwhelm with childcare responsibilities

Hormonal imbalances

Sleep deprivation

What should you discuss with your doctor? 

Discuss if you are at the risk of postpartum depression

Any symptom of depression after two weeks,

The medications list

Any mood swings 

Lack of sleep or insomnia

Any pain after the pregnancy 

Postpartum depression can be prevented and treated. Just talk about how you are feeling. Discuss it with your friend, partner, and doctor. It is the first step to address postpartum depression.

Credit: Dr. Pooja Chaudhary.


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