Tuesday, March 26, 2024

Why Do Women Get Postpartum Depression

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How Is Depression Treated

Why we all need to talk about postpartum depression | Auburn Harrison | TEDxUniversityofNevada

There’s no cure for depression. It’s an ongoing disorder, though treatable, with up to 90% of people eventually responding to treatment. Treatment is an ongoing journey, and remission is the goal. Relapses do happen.

Feeling comfortable with your treatment plan and feeling empowered to advocate for yourself when things aren’t working is essential. Depression treatment is a marathon, not a sprint. You should expect treatment to evolve and change as your life does. Even severe depression is treatable. However, seeking treatment as early as possible will often yield the most effective results.

What Are The Baby Blues

About two to three days after giving birth, feelings of depression and anxiety are common. You may experience crying for no reason, having trouble sleeping or questioning your ability to care for your new baby. This is largely due to the shift in levels of progesterone Dr. Stuebe explains. But changes in hormones are unlikely to be the only cause. Beyond these hormonal changes, there are other factors that can lead to these feelings such as extended periods of tiredness or exhaustion, challenges with breastfeeding and other postpartum complications.

Other factors might include:

  • Previous experience of mental health problems
  • Biological causes
  • Stressful living conditions
  • Major life events

With good support from family, loved ones, and friends, these feelings usually go away within about two weeks without any need for treatment.

Signs And Symptoms Of Postpartum Psychosis

Postpartum psychosis is a rare, but extremely serious disorder that can develop after childbirth, characterized by loss of contact with reality. Because of the high risk for suicide or infanticide, hospitalization is usually required to keep the mother and the baby safe.

Postpartum psychosis develops suddenly, usually within the first two weeks after delivery, and sometimes within 48 hours. Symptoms include:

  • Extreme agitation and anxiety
  • Inability or refusal to eat or sleep
  • Thoughts of harming or killing your baby

Postpartum psychosis should be considered a medical emergency requiring immediate medical attention.

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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.

What Is Peripartum Depression

postpartum depression Archives

For most women, having a baby is a very exciting, joyous, and often anxious time. But for women with peripartum depression it can become very distressing and difficult. Peripartum depression refers to depression occurring during pregnancy or after childbirth. The use of the term peripartum recognizes that depression associated with having a baby often begins during pregnancy.

Peripartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child.

An estimated one in seven women experiences peripartum depression.1

Pregnancy and the period after delivery can be a particularly vulnerable time for women. Mothers often experience immense biological, emotional, financial, and social changes during this time. Some women can be at an increased risk for developing mental health problems, particularly depression and anxiety.

Up to 70 percent of all new mothers experience the baby blues, a short-lasting condition that does not interfere with daily activities and does not require medical attention. Symptoms of this emotional condition may include crying for no reason, irritability, restlessness, and anxiety. These symptoms last a week or two and generally resolve on their own without treatment.

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Is It The Baby Blues Or Postpartum Depression

The majority of women experience at least some symptoms of the baby blues immediately after childbirth. It’s 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 don’t go away after a few weeks or get worse, you may be suffering from postpartum depression.

How Do I Know If I Have Baby Blues Or Postpartum Depression

Many people have baby blues after giving birth. Baby blues and postpartum depression have similar symptoms. However, symptoms of baby blues last about 10 days and are less intense. With postpartum depression, the symptoms last weeks or months, and the symptoms are more severe.

You may have the baby blues if you:

  • Have crying spells.
  • Have trouble sleeping.
  • Have sudden mood changes.

Remember, it doesn’t hurt to share your symptoms with your provider. They can assess if you need treatment for your symptoms.

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Why So Many Women Don’t Seek Help For Postpartum Depression

Roughly four months after her first baby was born, Robin Farr noticed herself slipping, slowly, into a funk.

“At the time, I didn’t know what it was,” said Farr, 40, of that period six years ago. “It didn’t occur to me it was postpartum depression I thought I was just tired.”

But months passed, and Farr did not improve. She had bouts of anger that were atypical for her. At times, her pent-up emotions manifested themselves physically — a tingling in her forearms, as though she’d been clenching her fists.

Eight months in, Farr saw a counselor and confided she was unsure that she had it in her to be a mom. The counselor suggested she might have postpartum depression and recommended she see a doctor, but Farr did not want to. Despite her increasingly pronounced distress, she did not want to put a label on her situation.

“I had this feeling of denial. Of, ‘Maybe it will just go away,'” Farr said. “I had a very specific idea of what postpartum depression was, and to me, it was a significant mental health issue. It seemed completely removed from anything I associated with everyday life.”

A new BabyCenter survey of more than 1,400 mothers and pregnant women released on Tuesday calls attention to the significant number of women, like Farr, who do not get prompt treatment for postpartum depression.

Overall, 21 percent of the mothers polled said they had been given a diagnosis of postpartum depression or felt they might have it.

How Is Postnatal Depression Diagnosed

Women help a new mom experiencing postpartum depression | WWYD

If you notice symptoms of postnatal depression, talk to your doctor, midwife or child health nurse. They may ask about how you have been feeling, give you a questionnaire to complete and ask to speak with your partner, if you have one. They may also do a physical examination.

Try to be as honest as you can this will make it easier for the doctor or nurse to give you the treatment and support you need. Remember, postnatal anxiety and depression are extremely common. Theres no need to feel ashamed.

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How Depression Affects Fathers

Some fathers also report symptoms of depression. To better understand the experiences of fathers, PRAMS implemented a PRAMS for Dads pilot project. The pilot projectexternal icon in Georgia found 1 in 10 fathers reported depressive symptoms since the birth of their new baby. Studies such as PRAMS for Dads can help quantify mens health behaviors and service needs.

How Can I Prevent Postpartum Depression

To prevent postpartum depression, try to:

  • Get as much rest as possibly by napping when the baby naps

  • Ask family members and friends for help

  • Talk to your partner, family, or friends about your feelings

  • Take a shower and get dressed every day

  • Get out of the housetake a walk, meet with friends, or run an errand

  • Spend time alone with your partner

  • Join a support group to talk with other mothers

  • Recognize that tiredness, doubts, and trouble concentrating are normal for new mothers and will pass

NOTE:

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Stillbirth And Pregnancy Loss

In the United States, around 1 in 160 pregnancies end in stillbirth, after 20 weeks of pregnancy. This may increase the risk of postpartum depression.

Experts report that 14.8% of people who experience pregnancy loss have postpartum depression, compared with 8.3% of those with regular deliveries.

If symptoms of depression last 2 weeks or longer within 1 year of giving birth, a person should receive medical attention. This is also crucial for anyone who is having trouble caring for themselves or their baby.

The doctor will ask questions about symptoms and medical histories. They may also request blood tests to rule out other causes of depression.

Treatment for postpartum depression is essential for the well-being of the parent and their newborn. The sooner a person receives it, the sooner they are likely to recover. Treatment is effective in most cases.

Once they have identified the issue, the doctor usually prescribes a combination of psychotherapy and medication.

Tips for helping to support recovery include:

  • acknowledging the problem

Support groups can reduce the feelings of isolation and provide tools and helpful strategies.

What Are The Symptoms Of Ppd

Postpartum Depression

The warning signs are different for everyone but may include:

  • A loss of pleasure or interest in things you used to enjoy, including sex

  • Eating much more, or much less, than you usually do

  • Anxietyall or most of the timeor panic attacks

  • Racing, scary thoughts

  • Inability to sleep, sleeping too much, difficulty falling or staying asleep

  • Disinterest in the baby, family, and friends

  • Difficulty concentrating, remembering details, or making decisions

  • Thoughts of hurting yourself or the baby .

If these warning signs or symptoms last longer than 2 weeks, you may need to get help. Whether your symptoms are mild or severe, recovery is possible with proper treatment.

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What Does Treatment For Postpartum Depression Looks Like

You didnt get depressed overnight, so treatment wont quickly get you better. The good news is you will start to see improvement within a few weeks.

Symptoms of PPD can resolve and worsen again, but eventually, you will get to a point where symptoms are managed and dont adversely affect your ability to care for yourself and your children. You may also experience symptom flare-ups during your menstrual period due to hormone fluctuations.

Medications. Your doctor may prescribe an antidepressant. If you are breastfeeding, there are antidepressants available that pose little risk of side effects your baby. Work with your doctor to determine the potential risks and benefits of taking an antidepressant to treat PPD.

Psychotherapy. Also called talk therapy, psychotherapy can help you to talk through your worries and feelings about motherhood. Therapy can help you find ways to cope, solve problems, set goals and learn to respond in positive ways.

Support Groups. If you would like to find a support group for PPD, Postpartum Support International is a good place to start. Support groups can offer helpful information and ideas to coping better and managing your parenting with PPD.

Lifestyle Changes. Lifestyle changes may also help relieve symptoms of PPD. Here are some changes to incorporate daily:

Pearls And Other Issues

Before delivery, many females who are at risk of developing PPD can be identified. These females, along with their families, should be provided with information and education regarding PPD prenatally. The information should be reinforced during postpartum hospitalization and after discharge.

Childbirth education classes teach new mothers to seek help and support that they might need for childbirth. By teaching women and their spouses about the signs and symptoms of PPD, educators can increase the chance that the woman suffering will receive proper management and treatment.

Screening for depressive symptoms can be done during pregnancy. This screening can identify women who are at increased risk for developing PPD.

Exclusive breastfeeding has a positive effect on reducing depressive symptoms from childbirth to 3 months.

Postpartum depression can be prevented when parents are given positive parenting lessons and when the maternal-infant bond is promoted and increased. This can be achieved through social support from family and healthcare providers. Along with this, good maternal sleep can also help in preventing PPD.

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Genetic And Medical History Risk Factors

Women with one or more family members who have suffered from postpartum depression have a greater risk of developing it themselves.

Those who have struggled with mood disorders like depression or anxiety or more significant mental illnesses like bipolar disorder are 30% to 35% more likely to face postpartum depression in their lifetime. Women who have experienced postpartum depression in previous childbirths are also much more likely to experience it again.

Recent studies have discovered a possible genetic factor in developing postpartum depression. According to blood tests performed by Johns Hopkins researchers, there are possibly two different genetic alterations that, when present during pregnancy, may predict whether a woman will develop postpartum depression.

Family history of depression or other mental disorders can also contribute to women developing PPD, especially if the mother already has a diagnosed mental health problem.

Enhancing Healthcare Team Outcomes

Postpartum Depression: What You Need to Know

Because of the high morbidity of postpartum depression, the focus today is now on prevention. Unlike the psychiatrist, the nurse is in a primary position to identify women at high risk for postpartum mood disorders before delivery. During the admission, the nurse may identify the female with a prior history of depression or postpartum blues. Further, any female who develops depression during pregnancy should be identified and closely followed by the postpartum nurse or primary care provider. These women need education and support on available treatments. Some of these women may benefit from a consult with a therapist, and others may need a referral to a psychiatrist for treatment with an antidepressant after delivery. Both pharmacological and nonpharmacological prophylaxis has been used in such settings with variable success. There is also a large body of evidence that postpartum women with depression who are treated have a much better mother-infant bonding experience than those women who forego treatment. More important, infants of mothers who are depressed may also develop a variety of mood and behavior problems, as well as obesity, later in life. Despite awareness of postpartum depression, many women miss out on treatment because they are simply not followed after pregnancy. Thus, the role of the postpartum visiting nurse is critical.

Outcomes

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Postpartum Care For New Moms

Here are some things you can do during pregnancy and after your child is born to reduce your risk for PPD:

Prioritize Your Needs

A well-balanced diet plays a significant role in your emotional well-being. There has also been evidence showing a connection between mood and dehydration, and anyone who is pregnant, postpartum, or breastfeeding has an increased risk of dehydration.

Your baby needs you to be well so taking care of your needs is important. Take breaks and baths, spend time with adults, and do anything that helps your brain and body to feel grounded.

Sleep

Sleep might be in short quantity with a newborn at home, but you should still try to get as much as you can. Studies have shown the quality of sleep in new mothers is the biggest predictor of PPD.

As a general rule, try to sleep anytime you can get a block of sleep. For example, most healthy babies sleep for about four to five hours chucks of time, and if you can get a nap in as well, go for it.

Activity

New mothers who get some mild to moderate exercise throughout their day are less likely to develop PPD.

Obviously, you cannot make time to go to the gym or take a yoga class, but something as simple as taking a walk around the block with your baby in a stroller or a carrier does wonders for increasing feel-good endorphins and reducing stress hormones.

Support

Know Your Risk

Lean on Your Partner

Stress Reduction

How Common Is Ppd

  • Up to 1 in 7 women experience PPD.

  • For half of women diagnosed with PPD, this is their first episode of depression.

  • About half of women who are later diagnosed with PPD may have begun experiencing symptoms during pregnancyso its important to seek help early! Getting the right help can make all the difference for you, your baby and your family.

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Postpartum Depression Does Not Discriminate

Although certain groups of people are at a higher risk for depression, PPD does not discriminate. It does not care if new mothers are rich or poor, healthy or have health issues, have had other pregnancies, or how old new mothers are.

PPD arrives unannounced, bringing with it sadness, hopelessness, and anger, driving a wedge between you and the people you love. And this was the case for celebrity mothers, Brooke Shields, Drew Barrymore and Chrissy Teigen.

Celebrities Affected by Postpartum Depression

  • Brooke Shields: Model and actress, Brooke Shields was one of the first celebrities to speak up about PPD. In her 2005 book, Down Came the Rain: My Journey Through Postpartum Depression, and she shares that after giving birth to her daughter in 2001, she found herself staring out a window thinking that she didnt want to live anymore.
  • Drew Barrymore: In a 2015 interview with People magazine, Drew Barrymore revealed that she struggled with postpartum depression after the birth of her second child. The experience lasted about six months, and she described it as being under the cloud.
  • Chrissy Teigen: Model and wife to the singer, John Legend, is the latest celebrity voice for postpartum depression. In a 2017 essay in Glamour magazine, she shares that PPD does not discriminate and can affect any new mother.

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