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Postpartum Depression: Symptoms & Treatments of Depression After Childbirth

November 21, 2017 - Olusanya Omokorede

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Postpartum depression also known as postnatal depression or depression after childbirth is the depression that can be suffered by a mother following childbirth. It typically arises from a combination of hormonal changes, psychological adjustment to motherhood and fatigue. It can also be experienced by men.

About 15% of women experience depression after childbirth.  Postpartum depression affects about 1-26% of new fathers. In a study done in southwest Nigeria, the prevalence of postpartum depression was found to be about 22.9% of the new mothers.

There is no association between depression and  number of children a woman has (parity) but there an association with the onset of depression within 6 weeks in women with mood disorders (Bipolar depression){1}

 

Risk Factors of Postpartum Depression

The factors that can predispose a woman to have postpartum haemorrhage include;

  • Prenatal depression or anxiety
  • A personal or family history of depression
  • Moderate to severe premenstrual symptoms
  • Maternity blues
  • Preterm delivery
  • Single status
  • Birth-related physical trauma
  • Previous stillbirth or miscarriage
  • Formula-feeding rather than breastfeeding
  • Cigarette smoking
  • Low self-esteem
  • Childcare or life stress
  • Low social support
  • Poor marital relationship or single marital status
  • Low socioeconomic status
  • Infant temperament problems/colic
  • Unplanned/unwanted pregnancy
  • Elevated prolactin levels
  • Oxytocin depletion
  • Race; Studies have also shown a correlation between a mother’s race and postpartum depression. In terms of race, African American mothers have been shown to have the highest risk of PPD at 25%, while Asians had the lowest at 11.5%, after controlling for social factors such as age, income, education, marital status, and baby’s health. The PPD rates for Caucasian and Hispanic women fell in between.

See Also: Depression increases chance of early death by 30%


Signs and Symptoms of Postpartum Depression

Once a woman notices that she has any 5 of the following symptoms during pregnancy or after delivery daily for more than 2 weeks she most likely has postpartum depression. Some of the symptoms include;

  • Extreme sadness, emptiness, or hopelessness
  • Crying all the time
  • Loss of interest or lack of enjoyment in your usual activities and hobbies
  • Trouble falling sleep at night, or trouble staying awake during the day
  • Loss of appetite or eating too much, or unintentional weight loss or weight gain
  • Overwhelming feelings of worthlessness or overpowering guilt
  • Restlessness or sluggishness
  • Difficulty concentrating or making decisions
  • Feeling that life isn’t worth living
  • Being irritable or angry
  • Avoiding friends and family
  • Worrying excessively about your baby
  • Being uninterested in your baby, or unable to care for her
  • Feeling so exhausted that you’re unable to get out of bed for hours
  • In rare cases, some women with PPD experience delusional thoughts or hallucinations and may harm their baby. Postpartum psychosis, a more severe form of postpartum depression occurs in about 1 to 2 per 1,000 women after childbirth. Postpartum psychosis is the leading cause of murder in children under the age of one in the U.S.

 

Treatment of Postpartum Depression

Treatment can be medical and non-medical.

  • Medical form of treatment involves the use of anti-depressants such as selective serotonin reuptake inhibitors like sertraline. They help to regulate the chemicals that control mood in the brain.
  • Electroconvulsive therapy is used in women who are not responsive to treatment and therapy. A small current of electricity is passed through the patient’s brain under general anaesthesia. This also helps to regulate the brain chemicals.
  • Non-medical treatment involves talk therapy which is also called counselling or psychotherapy. It can be one-on-one with your therapist or in a group setting with other women going through a similar experience. It can also be family or couples therapy, where the therapist works with you and your partner or relatives.

Read this: One hour of exercise weekly prevents depression — Study


Some of the adverse effects of postpartum depression  include ;

  • Negative effects on cognitive development and social-emotional development of the child. (These problems may persist and are unlikely to be responsive to intervention over time if the maternal depression remains untreated) (2).
  • increased costs of medical care,
  • inappropriate medical care
  • discontinuation of breastfeeding (3)

The family unit can also be affected leading to;

  • child abuse and neglect,
  • marital discord,
  • divorce and
  • family violence (4)

It is important women with symptoms of postpartum depression seek help as soon as possible. There is a need for spouse and family support. It is also important the woman has enough rest and sleeps well. In addition, she should share her feelings and should seek help when overwhelmed.

 

Sources

(1) Arianna Di Florio, Lisa Jones, Liz Forty, Katherine Gordon-Smith, Emma Robertson Blackmore, Jess Heron, Nick Craddock, Ian Jones. Mood disorders and parity – A clue to the etiology of the postpartum trigger. Journal of affective disorder. 2014 Jan;152(100):334-339. PubMed | Google Scholar

(2) Marian FE. Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice. Pediatrics. 2010;126:1032-1039. PubMed | Google Scholar

(3) Earls MF. Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics: Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010 Oct;126(5):1032-1039. PubMed | Google Scholar

(4) McLennan JD, Kotelchuck M. Parental prevention practices for young children in the context of maternal depression. Pediatrics. 2000 May;105(5):1090-1095. PubMed | Google Scholar

Olusanya Omokorede

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