For most women, having a baby is a very exciting, joyous, and often anxious time. But for women with postpartum 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.
Postpartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference ,anxiety, as well as changes in energy, sleep, and appetite.
An estimated one in seven women experiences postpartum depression.Pregnancy and the period after delivery can be a particularly vulnerable time for women. Mothers often experience immense biological, emotional and social changes during this time. Some women can be at an increased risk for developing mental health problems, particularly depression, anxiety and psychotic features as well.
Up to 70 % 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. Postpartum depression is different from the “baby blues” in that it is emotionally and physically debilitating and may continue for months or more. Getting treatment is important for both the mother and the child.
Symptoms of Postpartum depression
• Feeling sad or having a depressed mood.
• Loss of interest or pleasure in activities once enjoyed.
• Changes in appetite.
• Trouble sleeping or sleeping too much.
• Loss of energy or increased fatigue.
• Increase in purposeless physical activity (e.g., slowed movements or speech).
• Feeling worthless or guilty.
• Difficulty thinking, concentrating, or making decisions.
• Thoughts of death or suicide .
• Crying for “no reason”.
• Lack of interest in the baby, not feeling bonded to the baby, or feeling very anxious about/around the baby.
• Feelings of being a bad mother.
• Fear of harming the baby or oneself.
Untreated postpartum depression is not only a problem for the mother’s health and quality of life, but can affect the well-being of the baby who can be born prematurely, with low birth weight. Postpartum depression can cause bonding issues with the baby and can contribute to sleeping and feeding problems for the baby. In the longer-term, children of mothers with peripartum depression are at greater risk for cognitive, emotional, development and verbal deficits and impaired social skills. It should not be ignored that gestational carriers and surrogates are also at risk of developing postpartum depression.
While there is no specific diagnostic test for postpartum depression, it is a real illness that should be taken seriously. Any pregnant woman or new mother who experiences the symptoms of postpartum depression should seek evaluation by her Gynecologist, who can make referral to a Psychiatrist. Assessment should include a psychiatric evaluation and a medical evaluation to rule out physical problems that may have symptoms similar to depression (such as thyroid problems or vitamin deficiencies).
When to contact your Psychiatrist?
• When you are experiencing several of the symptoms mentioned above for more than two weeks.
• When you have thoughts of suicide or thoughts of harming your child.
• When your depressed feelings are getting worse.
• When you are having trouble with daily tasks or taking care of your baby.
Many women may suffer in silence, dismissing their struggles as a normal part of pregnancy and childbirth and fail to seek care. Treatment for depression during pregnancy is essential. Greater awareness and understanding can lead to better outcomes for women and their babies.
Like other types of depression, postpartum depression can be managed with psychotherapy , medication, lifestyle changes and supportive environment or a combination of these. Women who are pregnant or nursing should discuss the risks and benefits of medication with their doctors. In general, the risk of birth defects to the unborn baby are low. The decision should be made based on careful consideration of the potential risk-benefit ratio of treatment vs. no treatment affecting the health of the mother, the unborn child, and/or the nursing newborn.
With proper treatment, most new mothers find relief from their symptoms. Women who are treated for postpartum depression should continue treatment even after they feel better. If treatment is stopped too soon, symptoms can recur.
How partners, family and friends can help?
Strong support from partners, family and friends is very important. Here are some suggestions for how loved ones can help:
• Know the signs: Learn to recognize the symptoms of depression and anxiety and if you see signs, urge her to see a Psychiatrist.
• Listen to Her: Let her know you want to hear her concerns. For example, "I notice you are having trouble sleeping, even when the baby sleeps. What's on your mind?"
• Give her support: Let her know she's not alone and you are here to help. Try offering to help with household tasks or watching the baby while she gets some rest or visits friends.
• Encourage her to seek help if needed: She may feel uncomfortable and not want to seek help. Encourage her to talk with a health care provider. Share some information on peripartum conditions. Offer to make an appointment for her talk with someone.