When Does Depression Following A Miscarriage Start
The onset of depression after a miscarriage is difficult to give a clear time frame for, as it is different for every mother, though it usually appears fairly rapidly after the end of the pregnancy. Dr. Nisha Chellam, an internal medicine doctor at Parsley Health, says that signs will be seen within one month of the end of pregnancy. The onset will be very acute, she notes.
Shah admits this timeline can be hard to define due to how often depression after an EPL is overlooked. Clinical depression after miscarriage has not been well-defined and hence is often overlooked. These women frequently end up receiving minimal help. It is important that healthcare providers screen every patient who has this unfortunate outcome just like they would any mother after childbirth.
Related Conditions During Pregnancy And After Childbirth
Peripartum anxiety Although estimates vary, a 2013 study found that about 16% of women experience an anxiety disorder during pregnancy and about 17% experience it during the postpartum period.7 After giving birth, some women develop intense anxiety, with rapid heart rate, a sense of impending doom and irrational fears and obsessions. Feeling guilty and blaming oneself when things go wrong, and worrying and feeling panicky for no good reason are signs of anxiety in the peripartum period.8
Treatment may include medication and therapy, alone or in combination.
Peripartum bipolar disorder Bipolar disorder has two phases, the depression phase and the manic phase . When the lows and highs happen at the same time, it is considered a mixed episode. Bipolar illness can emerge during pregnancy or the postpartum period. Risk factors include a previous mood disorder and family history of mood disorders.
Symptoms of depression and mania:
- Severe sadness and irritability
- Rapid speech and racing thoughts
- Little or no sleep and high energy
- Impulsive decisions and poor judgment
- Delusions that can be grandiose or paranoid
- Hallucinations seeing or hearing things that are not present
Treatment can include mood stabilizers and antipsychotic medications9 along with therapy.
Fathers: Pregnancy/childbirth And Depression
New fathers can also experience symptoms of peripartum depression. Symptoms may include fatigue and changes in eating or sleeping. An estimated 4% of fathers experience depression in the first year after their childs birth. Younger fathers, those with a history of depression and fathers with financial difficulties are at increased risk of experiencing depression.1
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What Is Postnatal Depression
Postnatal depression affects up to 15 percent of mothers after they have given birth and up to 9 percent of women during pregnancy. Depression can happen any time during pregnancy or up to a year after ppi is born. It can also occur after a miscarriage.
The symptoms of postnatal depression usually start within a first few months of the birth. You may not seem interested in your ppi or in other members of your whnau, or you may find it difficult to do everyday tasks.
Dads can also experience depression at this time, especially if their partner is depressed. Depression in new fathers is often not recognised and is not usually called ‘postnatal depression’.
The warning signs
Symptoms of postnatal depression are similar to depression at other times. They include feeling sad most of the time and losing interest in things that were once enjoyable. The symptoms might include:
- feeling worthless, hopeless, useless
- feeling so sad that eating and sleeping patterns change
- blaming yourself when things go wrong, even if it’s not your fault
- feeling anxious, panicky or overwhelmed especially regarding your ppi
- having thoughts of suicide that may include hurting your ppi
- not feeling close to your ppi and other whnau members.
When Does Postpartum Depression Start
The onset of postpartum depression is typically seen in parents when their child is between the newborn stage and 6 months of age. The experience, however, is not limited to the first six months after birth.
The American Psychiatric Association and the American College of Obstetricians and Gynecologists use the modifier “postpartum” to note when a person is diagnosed with depression within the first year after the birth of a child.
However, some people feel the effects of postpartum depression longer than a year after giving birth. As more people open up about their experiences with postpartum depression, it’s becoming clear that the condition affects each individual differently.
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Major Depressive Disorder & Generalized Anxiety
Providers will tell you that after the first year postpartum, a mom struggling with her mood is likely to be diagnosed with major depressive disorder or generalized anxiety.
While this is true it doesnt change the need to work through the specific and unique challenges that new moms face. A mom cant be put into a general depression treatment program and get better as quickly as if shes receiving specialized treatment.
Research shows that peer support and having other moms around that can offer a comforting me too is crucial for recovery. Its hard to relate to others that are struggling with depression, but dont also have and infant, toddler or other kids to take care of.
The timing of your diagnosis shouldnt mean that you cant access a new mom support group. Or connect with health care providers that can effectively treat your unique mental health needs.
How To Get Relief
Dont feel as though you need to power through PPD on your own. Receiving help means youll be able to continue loving and caring for your baby to the best of your ability.
There are several options for PPD treatment, and you may need to utilize more than one strategy. There are also lifestyle changes that may make recovery go faster.
Dont stop until you find a combination of treatments that works for you. Relief from PPD is possible with the right interventions.
Here are some options:
- Antidepressants. Your doctor may prescribe a selective serotonin reuptake inhibitor to treat your depression. There are several SSRIs available. Your doctor will work with you to find one that best treats your symptoms with the fewest side effects. Many SSRIs are compatible with breastfeeding or chestfeeding, but make sure your provider knows if youre nursing so they can choose the appropriate medication and dosage.
- Counseling.Cognitive behavioral therapy is a frontline strategy for treating depression, including symptoms of PPD. If you need help locating a provider in your area, you can search for one here.
- Group therapy. It may be helpful for you to share your experiences with other parents who have had PPD. Finding a support group, either in person or online, can be a valuable lifeline. To locate a PPD support group in your area, try searching by state here.
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What Are The Risk Factors For Postpartum Depression
Any new mother can develop postpartum depression regardless of age, ethnicity, or how many children she has.
These things might increase your risk:
- previous depression or other mood disorder
- family history of depression
- drug or alcohol misuse
- sleep deprivation and exhaustion
If you have some of these risk factors, talk to your doctor as soon as you notice symptoms. Postpartum depression can increase your risk of substance abuse or of harming yourself or your baby.
Is It The Baby Blues Or Postpartum Depression
The majority of women experience at least some symptoms of the baby blues immediately after childbirth. Its caused by the sudden change in hormones after delivery, combined with stress, isolation, sleep deprivation, and fatigue. You might feel more tearful, overwhelmed, and emotionally fragile. Generally, this will start within the first couple of days after delivery, peak around one week, and taper off by the end of the second week postpartum.
The baby blues are perfectly normal, but if your symptoms dont go away after a few weeks or get worse, you may be suffering from postpartum depression.
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How Long Does Ppd Last
Your doctor can diagnose postpartum depression as early as 10 to 14 days after giving birth, says Emma Basch, PsyD, a licensed clinical psychologist. At that time, if you are still experiencing mood symptoms on most days, and if those symptoms are impacting your functioning, then your doctor can diagnose postpartum depression.
The sooner postpartum depression is diagnosed, the better. When dealing with postpartum depression, early intervention is critical for the mothers mental health and the childs cognitive development. If the mother’s depression is not treated, it can impact the child’s cognitive development.
How long the depression lasts, however, depends on many factors, including but not limited to: the womans mental health history, hormonal changes, psychological or social distress, or life stressors like a traumatic birth experience or life event.
Upon diagnosis and treatment, symptoms can improve quickly. Dr. Basch says you may feel better within weeks of diagnosis. However, this may not be the case for everyone. Mental health treatment requires an individualized approach because everyone’s needs are different. So while your friend may be feeling better two months after their diagnosis, it may take you longer to feel similarly.
The best way to monitor your postpartum depression, Dr. Basch says, is by paying attention to the reduction in the intensity, severity, and duration of your symptoms.
Can You Get Postpartum Depression After The First Year
by Kate Kripke |
While I cant make a blanket statement about each and every woman who calls me, more times than not these womenone, two, or three years past the birth of their little onesare struggling with a form of maternal distress that dates back, in one way or another, to their pregnancy, postpartum, or even before. While these moms wouldnt technically have postpartum depression any longer, they are often struggling with what I will call here continued postpartum distress that was never adequately supported when they first noticed symptoms.
When we use the terms prenatal/antenatal and postpartum depression, we are really simply talking about an episode of depression or anxiety that occurs sometime during pregnancy or the first year postpartum. We believe that early symptoms, whether mild or severe, are caused by hormonal shifts during pregnancy or following delivery, physiological stressors like sleep deprivation and nutrient depletion, psychological strain including thought patterns that are likely to cause distress , and/or other environmental stressors such as trauma, relationship conflict, or changes in finances, employment, or residence.
However any one or more of the following are usually what we discover when we are together in my office.
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Can Postpartum Depression Be Prevented
Postpartum depression isn’t entirely preventable. It helps to know warning signs of the condition and what factors increase your risk. Here are some tips that can help prevent postpartum depression:
- Be realistic about your expectations for yourself and your baby.
- Limit visitors when you first go home.
- Ask for help â let others know how they can help you.
- Sleep or rest when your baby sleeps.
- Exercise â take a walk and get out of the house for a break.
- Keep in touch with your family and friends â don’t isolate yourself.
- Foster your relationship with your partner â make time for each other.
- Expect some good days and some bad days.
What Is Postpartum Obsessive
Postpartum obsessive-compulsive disorder is one of the newer disorders that is part of the postpartum mood disorders group. It is estimated that about 3-5% of postpartum women will experience some of the symptoms of PPOCD.Symptoms may include:
- Overly occupied with keeping your baby safe
- Compelled to do certain things over and over again to help relieve her anxiety and fearsThis can include counting things, ordering things, listing things, checking and rechecking actions already performed, and cleaning repeatedly. This may manifest itself in cleaning, feeding, or taking care of the baby.
- May recognize these obsessions but feels horror and shame associated with them
- Obsessions or thoughts that are persistent, are repetitive and can include mental images of the baby that are disturbing
- Fear of being alone with the baby
Women who suffer from PPOCD often know that these thoughts, actions, and feelings are not normal and do not act on them. But the obsession can get in the way of a mom taking care of her baby properly or being able to enjoy her baby. With the right treatment, women with PPOCD can experience freedom from being controlled by these obsessions and compulsions.
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What Contributes To Postnatal Depression
Just like other types of depression, there is no simple reason as to why some women experience postnatal depression and others dont.
Experiencing depression at some time in the past, particularly during the pregnancy, is the single biggest risk factor for postnatal depression. But this doesnt mean that if you have a history of depression youll always develop postnatal depression.
Some of the factors that could put you at a higher risk of postnatal depression include:
- depression or persistent distress in this or in a past pregnancy
- family history of depression
- being young
- being unmarried or without partner support
- limited support from parents as a child
- limited support from friends and whnau
- challenging relationship with partner
- worries about money or housing
- low self-esteem.
Treatments For Postnatal Depression
Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available.
- self-help things you can try yourself include talking to your family and friends about your feelings and what they can do to help, making time for yourself to do things you enjoy, resting whenever you get the chance, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet
- psychological therapy a GP may be able to recommend a self-help course or may refer you for a course of therapy, such as cognitive behavioural therapy
- antidepressants these may be recommended if your depression is more severe or other treatments have not helped your doctor can prescribe a medicine that’s safe to take while breastfeeding
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What Medications Can I Take For Postpartum Depression
Your healthcare provider may prescribe antidepressants to manage symptoms of postpartum depression. Antidepressants help balance the chemicals in your brain that affect your mood.
If you’re breastfeeding, talk to your healthcare provider about the risks and benefits of taking an antidepressant. Medications can transfer to your baby through your milk. However, the transfer level is generally low, and many antidepressant medications are considered safe. Your provider can help you decide what medicine is right for you based on your symptoms and if you’re nursing.
Some common antidepressants for postpartum depression are:
- Selective serotonin reuptake inhibitors such as sertraline and fluoxetine .
- Serotonin and norepinephrine reuptake inhibitors such as duloxetine and desvenlafaxine .
- Bupropion .
- Tricyclic antidepressants such as amitriptyline or imipramine .
Keep in mind that it takes at least three or four weeks for antidepressants to work. Talk to your healthcare provider before stopping the medication. Stopping your medication too soon can cause symptoms to return. Most providers will recommend reducing your dose before stopping completely.
If your provider detects postpartum depression while youâre still in the hospital, they may recommend IV medication containing brexanolone.
What Are Ways To Cope With Postpartum Depression
It’s OK to feel overwhelmed. Parenting is full of ups and downs and having a baby isn’t easy. If you have depression, you don’t have to suffer alone. Your healthcare provider can help find a treatment that works for you.
Here are some things you can do to help cope with postpartum depression:
- Find someone to talk to â a therapist, friend, family member or someone who will listen to you and help you.
- Join a support group for new parents.
- Try to eat healthily and find time for exercise.
- Prioritize rest for yourself.
- Go out with friends or talk to them on the phone.
- Find time for self-care and doing things you enjoy, like reading or other hobbies.
- Get help with household chores or errands.
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Risk Factors For Long Term Depression
Researchers have also identified some risk factors for long term postpartum depression, noting that it is often a continuation of preexisting depression, rather than a new set of symptoms that starts at delivery.
Other factors that appeared to play a role include:
- a poor relationship with a partner
- a history of sexual abuse
Some studies suggested that depression was more likely to affect women who are young, on a low income, or from a minority background, but the data were less consistent for these findings.
Ill health in the child did not seem to increase the risk of long term postpartum depression.
The researchers urged doctors to be ready to spot the signs that postpartum depression is becoming chronic and to take into account the wider factors that may contribute to depression.
They also called for further studies on the causes of postpartum depression and its likely duration.
Postpartum Depression: Not Just For Parents With Babies
Its worth remembering that postpartum basically means going back to being not pregnant. So those who have had a miscarriage or abortion can also experience many of the mental and physical effects of being in the postpartum period, including PPD.
Whats more, non-birthing partners can received a PPD diagnosis, too. Even though they may not experience the physical changes brought on by giving birth, they do experience many of the lifestyle ones.
A 2019 review suggests about
- thoughts of suicide
These symptoms may lead to difficulty with breastfeeding or chestfeeding and bonding with baby.
If you feel as though you or someone you know could be experiencing these symptoms, its important to talk with a healthcare professional as soon as possible. PPD is a serious medical condition.
The exact cause of PPD is currently unknown. However, its thought that a combination of factors may play a role in its development. These factors include:
- previous psychological issues
- life stressors that come with a new baby
Dysregulation of reproductive hormones right after childbirth remains one of the key reasons many doctors believe PPD occurs in some individuals.
Your doctor will likely ask you about your current mental and physical health, as well as any medications you may be taking. They may also ask you about your history with other mental health concerns.
If you need immediate support, you can call the National Suicide Prevention Lifeline at 800-273-8255.
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