Postpartum Depression: Signs, Symptoms, Causes And Treatment

Postpartum depression, or baby blues, is a depression that occurs during or after pregnancy (1). The condition usually begins during pregnancy and continues after childbirth. Although pregnancy and childbirth are beautiful experiences, women dealing with this condition may find this phase difficult.

Around 50% to 75% of new mothers experience postpartum depression and may experience a range of physical and emotional changes. However, on the brighter side, the condition is treatable with counseling, medication, and emotional and physical support (2).

Read this post to understand the types, signs and symptoms, causes, risk factors, complications, treatments, and prevention of postpartum depression.

Types Of Postpartum Depression

Postpartum depression primarily consists of three types (3).

1. Baby blues: It is also known as postpartum blues and mostly affects women after delivery. It includes frequent bouts of crying, persistent sadness, and anxiety for no apparent reason. This condition usually occurs in the first week after delivery.

2. Postpartum depression (PPD): It is more acute than baby blues. PPD includes signs, such as frequently fluctuating highs and lows, uncontrolled crying, irritability, constant tiredness, anxiety, and guilt, which make the mother drift away from her child, resulting in the inability to take care of the baby or even herself. The condition may appear within days of delivery or may begin gradually.

3. Postpartum psychosis: This is the most severe type of postpartum depression and requires immediate medical attention. Although a rare occurrence, it has severe signs such as agitation, insomnia, paranoia, hallucinations, delusions, and hyperactivity.

Signs And Symptoms Of Postpartum Depression

If you have been experiencing five or more signs or symptoms discussed below, you may have postpartum depression (4).

1. Changes that concern your feelings

• Feeling low or depressed throughout the day
• Looking at yourself as a failure and feeling shame or guilt
• Getting worked up or feeling scared for a prolonged period of time
• Going through major changes in mood

2. Changes that seem to hinder your daily activities

• Lack of interest in the hobbies you previously enjoyed
• Constant feeling of fatigue or loss of energy
• Unusual eating habits such as binging or starving yourself
• Severe fluctuations in body weight
• Oversleeping or dealing with insomnia
• Lack of concentration and decision-making abilities

3. Changes regarding your thoughts on yourself and the baby

• Being unable to bond with the baby
• Having recurring thoughts about hurting yourself or the baby
• Having suicidal tendencies or thoughts

Get in touch with a mental health professional if you think you are going through the symptoms or signs of postpartum depression.

Causes Of Postpartum Depression

Here are some causes and reasons that could account for the onset of postpartum depression.

• Hormones: Physical changes are bound to occur after childbirth. A significant drop in hormones, such as estrogen and progesterone, could contribute to postpartum depression.

• Lack of sleep: Sleep deprivation makes you feel overwhelmed and fatigued. It makes you question your ability to take care of a baby, increasing the risk of postpartum depression.

• Anxiety: Persistently feeling anxious and bothered about your pregnancy and taking care of a baby makes even minor problems appear too severe. This leads to sadness and helplessness.

• Self-image: Since the body goes through significant changes during pregnancy and post-delivery, it is obvious that the mother may feel less attractive. There is a constant struggle with her sense of identity, and it may lead to depression gradually.

Risk Factors For Postpartum Depression

A mother may be at an increased risk of postpartum depression if she experiences the following conditions and scenarios (5).

• History of depression or bipolar disorder
• Lack of support from family and friends
• Depression during pregnancy
• Financial or relationship issues
• Frequent consumption of alcohol or drugs
• Birth of a baby with special needs
• Impediment to breastfeeding due to issues
• Pregnancy was unplanned or unwanted
• Gestational health problems, such as gestational hypertension or preeclampsia

Complications Of Postpartum Depression

Untreated postpartum depression may lead to the following complications among mothers (6).

• Changes in sleep patterns
• Sleep deprivation
• Breastfeeding difficulties
• Emotional and mental breakdown
• Poor bonding with the baby
• Discord with partner or family members over raising the baby

Diagnosis Of Postpartum Depression

The diagnosis of postpartum depression begins with a scheduled visit to your doctor if you think you have the symptoms leading to postpartum depression (7). Keeping an open mind and conveying your thoughts and feelings to the doctor will help them know how long you have been depressed.

Diagnosis includes filling up a questionnaire that the doctor can use later to assess your situation. Sometimes, a blood test may be needed to check your hormone levels and the presence of other problems.

Treatment For Postpartum Depression

The duration of treatment or recovery time from postpartum depression varies depending on the severity of the condition. Below are some of the non-pharmacological treatments for postpartum depression (8).

• Interpersonal therapy: This is a short-term treatment for depression. It is based on addressing the connection between interpersonal issues and moods, which lead to depression. It helps address several factors, including social factors, which lead to depression.

• Cognitive-behavioral therapy: This treatment is based on the belief that perception and behavior are intimately linked to mood. The treatment focuses on modifying distorted patterns of thoughts and improve coping of triggers or factors.

• Electroconvulsive therapy: This treatment is preferred for patients who do not respond to other treatments. It is most commonly used to treat depression and bipolar disorder. It involves a brief electrical stimulation of the brain under the influence of anesthesia.

Medications For Postpartum Depression

Postpartum depression responds in a similar way to antidepressant medication as other types of depression (6). Medications for depression should only be had as per the prescription given by a doctor. The doctor will assess several factors, such as your response to non-pharmacological therapies, the severity of symptoms, and whether you are breastfeeding or not.

The following medications could help control symptoms of postpartum depression.

• Tricyclic antidepressants and monoamine oxidase inhibitors: Cyclic antidepressant medications affect the chemical messengers used to communicate between brain cells, easing depression. They may cause side effects such as loss of appetite, dizziness, headaches, and insomnia in some women.

• Selective serotonin reuptake inhibitors (SSRI): Serotonin is a chemical messenger (neurotransmitter) that carries signals between nerve cells of the brain. SSRIs help in increasing the serotonin levels in the brain to treat depression.

• Hormone therapy: Women experience a drastic drop in estrogen hormone levels after childbirth, leading to the precipitation of postpartum depression. Estrogen could be used to treat depression in such cases.

Management Of Postpartum Depression

Many women may find relief from depression through simple lifestyle changes. The following practices could elevate your mood and help you manage postpartum depression better.

• Communicate: Speak to people around you and open up about what you are going through. It could provide an outlet for your thoughts and a chance to hear from others. You may talk to like-minded moms going through postpartum depression to find the strength and courage to sail through depression better.

• Fight isolation: Do not hesitate to ask for the support and company of a friend or family member. Postpartum could be a stressful phase with you learning to breastfeed and meet the baby’s needs while your body heals from delivery. Thus, stay in touch with your friends and ask for help when needed instead of struggling alone.

• Cut back on chores: Take some time to focus on any activity that you like. Performing an activity that brings you joy is the most therapeutic way to fight postpartum depression.

• Rest and relax: Let your body recover and give it the rest it needs. Taking some time out for yourself just for the sake of getting some sleep is nothing to feel guilty about. Take turns with your spouse to take care of the baby.

• Practice yoga: While any form of extreme exertion is not advised, it is good for the mother to stay physically active and perform yoga and stretches that may also help in hormonal regulation. Remember to consult the doctor first. Do not push yourself too far and do as much exercise and yoga that you feel you can do comfortably.

• Meditation: It is very important for a mother to take some time off and dwell in a peaceful chain of thoughts after having a long tiresome day. It boosts mental and emotional energy and helps to drive away any negative emotions. Meditation is soothing and helps the mother stay calm.

Prevention Of Postpartum Depression

The following methods could help curtail the onset of postpartum depression, preventing its exacerbation (8).

• Psychological interventions: Treatments such as interpersonal therapy, cognitive behavioral therapy, and postnatal psychological debriefing can help control postpartum depression at a nascent stage. You may consider them during pregnancy to avoid postpartum depression after delivery.

• Psychosocial interventions: These interventions include antenatal and postnatal classes and postnatal support from family members and friends. It helps the mother learn efficient techniques to take care of the baby, making her less prone to stress and depression. You may consider these interventions in your third trimester to avoid postpartum depression.

• Regular physical activity: Having a set of interesting physical activities that can be followed on a regular basis could play a major role in preventing the onset of postpartum depression. Staying engaged in any activity such as yoga, meditation, and stretches helps to keep the brain preoccupied.

• Healthy diet: It is very important for the mother to follow a regular diet that boosts her health and energy level naturally. Including more fruits and vegetables is a sensible way to go about it. Alcohol and caffeine intake should be avoided.

• Avoiding isolation: Staying away from everyone may make a mother feel left out and sad. Remember, pregnancy and childbirth do not mean that you must become a recluse. Make sure you have healthy social interactions with friends and other loved ones, even through video calls, at least once a week to boost your mental health.

References

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Reviewer

Dr. Shweta ShahMS, DNB

     

Dr. Shweta is a passionate and skilled gynecologist with over five years of experience in her field. She is a woman who connects and resonates with her patients, like her beloved family. She is a prolific doctor who can be related to women across all walks of life.

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