Post Partum Depression / PPD.
Post partum depression (PPD) is a serious disorder where the
hormonal changes following childbirth combined with psychosocial
stresses such as sleep deprivation may disable some women with an
apparent underlying vulnerability.
The National Women's Health Information Center, a project of the
U.S. Department of Health and Human Services, Office on Women's
Health, prepared a fact sheet relating to pregnancy and PPD. Below is a reprint of that
PPD article;
Why do women get post partum depression?
Having a baby can be one of the biggest and happiest events in a
woman's life. While life with a new baby can be thrilling and
rewarding, it can also be hard and stressful at times. Many
physical and emotional changes can happen to a woman when she is
pregnant and after she gives birth. These changes can leave new
mothers feeling sad, anxious, afraid, or confused. For many women,
these feelings (called the baby blues) go away quickly. But when
these feelings do not go away or get worse, a woman may have post
partum depression. This is a serious condition that requires quick
treatment from a health care provider.
What is post partum depression?
Post partum depression is a condition that describes a range of
physical and emotional changes that many mothers can have after
having a baby. Post partum depression can be treated with
medication and counseling. Talk with your health care provider
right away if you think you have post partum depression.
There are three types of post partum depression women can have
after giving birth:
The "baby blues" happen in many women in the days right after
childbirth. A new mother can have sudden mood swings, such as
feeling very happy and then feeling very sad. She may cry for no
reason and can feel impatient, irritable, restless, anxious,
lonely, and sad. The baby blues may last only a few hours or as
long as 1 to 2 weeks after delivery. The baby blues do not always
require treatment from a health care provider. Often, joining a
support group of new moms or talking with other moms helps.
Post partum depression can happen a few days or even months after
childbirth. Post partum depression can happen after the birth of
any child, not just the first child. A woman can have feelings
similar to the baby blues - sadness, despair, anxiety,
irritability - but she feels them much more strongly than she
would with the baby blues. Post partum depression often keeps a
woman from doing the things she needs to do every day. When a
woman's ability to function is affected, this is a sure sign that
she needs to see her health care provider right away. If a woman
does not get treatment for post partum depression, symptoms can
get worse and last for as long as 1 year. While post partum
depression is a serious condition, it can be treated with
medication and counseling.
Post partum psychosis is a very serious mental illness that can
affect new mothers. This illness can happen quickly, often within
the first 3 months after childbirth. Women can lose touch with
reality, often having auditory hallucinations (hearing things that
aren't actually happening, like a person talking) and delusions
(seeing things differently from what they are). Visual
hallucinations (seeing things that aren't there) are less common.
Other symptoms include insomnia (not being able to sleep), feeling
agitated (unsettled) and angry, and strange feelings and
behaviors. Women who have postpartum psychosis need treatment
right away and almost always need medication. Sometimes women are
put into the hospital because they are at risk for hurting
themselves or someone else.
Who is at risk for getting post partum depression?
Post partum depression affects women of all ages, economic status,
and racial/ethnic backgrounds. Any woman who is pregnant, had a
baby within the past few months, miscarried, or recently weaned a
child from breastfeeding can develop post partum depression. The
number of children a woman has does not change her chances of
getting post partum depression. New mothers and women with more
than one child have equal chances of getting post partum
depression. Research has shown that women who have had problems
with depression are more at risk for post partum depression than
women who have not had a history of depression.
The symptoms of post partum depression include:
- Feeling sad, depressed or crying a lot.
- Feeling restless or irritable.
- Having no energy.
- Not being able to sleep or being very tired, or both.
- Having headaches, chest pains, heart palpitations (the heart
being fast and feeling like it is skipping beats), numbness, or
hyperventilation (fast and shallow breathing).
- Not being able to eat and weight loss.
- Overeating and weight gain.
- Being overly worried about the baby.
- Not having any interest in the baby.
- Trouble focusing, remembering, or making decisions.
- Feeling worthless and guilty.
- No interest or pleasure in activities, including sex.
- Being afraid of hurting the baby or yourself.
A woman may feel anxious after childbirth but not have post partum
depression. She may have what is called post partum anxiety or
panic disorder. Symptoms of this condition include strong anxiety
and fear, rapid breathing, fast heart rate, hot or cold flashes,
chest pain, and feeling shaky or dizzy. Talk with your health care
provider right away if you have any of these symptoms. Medication
and counseling can be used to treat post partum anxiety.
What causes post partum depression?
No one knows for sure what causes post partum depression. Hormonal
changes in a woman's body may trigger its symptoms. During
pregnancy, the amount of two female hormones, estrogen and
progesterone, in a woman's body increase greatly. In the first 24
hours after childbirth, the amount of these hormones rapidly drops
and keeps dropping to the amount they were before the woman became
pregnant. Researchers think these changes in hormones may lead to
depression, just as smaller changes in hormones can affect a
woman's moods before she gets her menstrual period.
Thyroid levels may also drop sharply after giving birth. (The
thyroid is a small gland in the neck that helps to regulate how
your body uses and stores energy from foods eaten.) Low thyroid
levels can cause symptoms that can feel like depression, such as
mood swings, fatigue, agitation, insomnia, and anxiety. A simple
thyroid test can tell if this condition is causing a woman's post
partum depression. If so, thyroid medication can be prescribed by
a health care provider.
Other things can contribute to post partum depression, such as:
- Feeling tired after delivery, broken sleep patterns, and not
enough rest often keeps a new mother from regaining her full
strength for weeks. This is particularly so if she has had a
cesarean (C-section) delivery.
- Having feelings of loss - loss of identity (who you are, or
were, before having the baby), loss of control, loss of a slim
figure, and feeling less attractive.
- Feeling stress from changes in work and home routines. Sometimes
women think they have to be "super mom" or perfect, which is not
realistic and can add stress.
- Feeling overwhelmed with a new, or another, baby to take care
of and doubting your ability to be a good mother.
- Having less free time and less control over time.
- Having to stay
home indoors for longer periods of time and having less time to
spend with the baby's father.
What can I do to take better care of myself if I get post
partum depression?
The good news is that if you have post partum depression, there
are things you can do to take care of yourself.
- Stop putting pressure on yourself to do everything. Do as much as
you can and leave the rest! Ask for help with household chores and
nighttime feedings.
- Get good, old-fashioned rest. Always try to nap when the baby
naps.
- Talk to your husband, partner, family, and friends about how you
are feeling.
- Spend time alone with your husband or partner.
- Do not spend a lot of time alone. Get dressed and leave the
house - run an errand or take a short walk.
- Talk to your health care provider about medical treatment. Do not
be shy about telling them your concerns. Not all health care
providers know how to tell if you have postpartum depression. Ask
for a referral to a mental health professional who specializes in
treating depression.
- Join a support group for women with postpartum depression.
- Call
a local hotline or look in your telephone book for information and
services.
- Talk with other mothers, so you can learn from their experiences.
How is post partum depression treated?
It is important to know that post partum depression is treatable
and that it will go away. The type of treatment will depend on how
severe the post partum depression is. Post partum depression can
be treated with medication (antidepressants) and psychotherapy.
Women with post partum depression are often advised to attend a
support group to talk with other women who are going through the
same thing. If a woman is breastfeeding, she needs to talk with
her health care provider about taking antidepressants. Some of
these drugs affect breast milk and should not be used.
**It is important to note that while antidepressants are often
the first line of treatment for PPD, there are safe alternatives to most
types of depression. Discuss natural alternatives like
Deprex with
your health care provider before using prescription medications
with potentially serious and life-threatening side effects.
