“Postpartum depression” is not really a separate mood disorder from major depression or bipolar disorder. The word, "postpartum" is a specifier used as additional diagnostic information to describe the onset or occurrence of the depressive episode associated with major depression or bipolar disorder. For instance, a person could receive the following diagnosis— “Major Depressive Disorder, Single Episode, Moderate, With Postpartum Onset”—where "With Postpartum Onset" describes an uncommon depressive episode that begins within four weeks of childbirth and may affect up to 10% of new mothers.
Mothers suffering from PPD will also sometimes exhibit psychotic features. For example, a mother may believe that her child is evil, gifted with magical powers, or other delusional beliefs. She may hear voices telling her to harm the child, or may inadvertently put the child in danger as a result of impaired judgment associated with the psychosis.
Mothers suffering from PPD are often reluctant to disclose their negative or depressive thoughts and feelings. They often feel significant guilt and confusion over their symptoms, and fear how loved ones might perceive their thoughts and feelings. Fortunately, Postpartum depression is very treatable. However, it can be essential that the mother receive support from loved ones to seek out support. Left untreated, PPD can sometimes affect the quality of bonding and relationship between a mother and her child.
Postpartum depression is thought to be triggered by the hormonal changes that follow childbirth. During pregnancy, the levels of the hormones estrogen and progesterone rise greatly. Within about twenty-four hours of giving birth however, estrogen and progesterone levels quickly return to normal. Women who are prone to postpartum depression are thought to have brains which are unusually sensitive to these hormonal changes.
What are the symptoms of postpartum depression? To answer this question we should first distinguish PPD from the “baby blues”. Up to 80% of all new mothers will experience mild baby blues, while only about 10% of women will develop postpartum depression. The baby blues is like a relatively mild type of postpartum depression but one that generally resolves itself within three to ten days. Symptoms include:
• Moodiness
• Anxiety
• Sadness
• Crying spells
• Insomnia
• Fatigue
The symptoms of postpartum depression however, are more severe and last longer. They include:
• Crying spells
• Impaired concentration
• Difficulty making decisions
• Profound sadness
• Feelings of failure and inadequacy
• Suicidal thoughts
• Symptoms of hypothyroidism (fatigue, dry skin, impaired thinking, constipation, cold intolerance, and fluid retention.
Treatment options for postpartum depression include psychotherapy, counseling, and/or anti-depressants. Milder baby blues can often be overcome with good self-care, support from friends and family, and also, possibly, diet. Some women with postpartum depression will have severe or lasting symptoms which require treatment with therapy and/or medication. Many mothers understandably are reluctant to take medication because they are concerned they will not be able to breastfeed or because they are afraid of the side effects associated with anti-depressants. The good news is that non-drug interventions like psychotherapy can often reduce the symptoms of PPD.
While postpartum depression is a modern term, it has long been known that women sometimes experience psychiatric illness following childbirth; today we know much more about PPD and how to treat it.
If you feel that you or someone you care about may be suffering from this condition, feel free to let me know if I may be of assistance.
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