Postpartum depression:Symptoms, causes, risk factors and treatment

• By Dr Khalid Ur Rehman
• Comments 0
• 15 Oct 2022

Postpartum depression is a mood disorder that may interfere with a mother's ability to care for herself or her child after childbirth. This differs from "baby blues" which generally begin within the first two to three days after delivery and may last up to two weeks. When the depression continues up to one year a point, it classifies as postpartum depression.

The postpartum period is the most vulnerable time for a woman to develop a psychiatric condition, but it is important to remember that symptoms may begin during pregnancy or up to one year after birth. You’ve probably heard of the “baby blues” that’s because it’s quite common for new mothers to feel a little sad, worried, or fatigued. As many as 80 percent of mothers have these feelings for a week or two following childbirth. It’s completely normal and usually fades in a few weeks. While some of the symptoms sound the same, postpartum depression is different from the baby blues.

Postpartum depression is a lot more powerful and lasts longer. It can cause severe mood swings, exhaustion, and a sense of hopelessness. The intensity of those feelings can make it difficult to care for your baby or yourself.

Postpartum depression shouldn’t be taken lightly. It’s a serious disorder, but it can be overcome through treatment.

Symptoms of postpartum depression

Although it’s normal to feel moody or fatigued after having a baby, postpartum depression goes well beyond that. Its symptoms are severe and can interfere with your ability to function. Symptoms of postpartum depression vary person to person and even day to day. If you have postpartum depression, chances are you’re familiar with several of these indicators:

1. You feel sad or cry a lot, even when you don’t know why.
2. You’re exhausted, but you can’t sleep.
3. You can’t stop eating, or you aren’t interested in food at all.
4. You have various unexplained aches, pains, or illnesses.
5. You don’t know why you’re irritable, anxious, or angry.
6. Your moods change suddenly and without warning.
7. You feel out of control.
8. You have difficulty remembering things.
9. You can’t concentrate or make simple decisions.
10. You have no interest in things you used to enjoy.
11. You feel disconnected from your baby and wonder why you’re not filled with joy like you thought you’d be.
12. Everything feels overwhelming and hopeless.
13. You feel worthless and guilty about your feelings.
14. You feel like you can’t open up to anyone because they’ll think you’re a bad mother or take your baby, so you withdraw.
15. You want to escape from everyone and everything.
16. You have intrusive thoughts about harming yourself or your baby.
17. Your friends and family may notice that you’re withdrawing from them and from social activities or that you just don’t seem like yourself. Symptoms are most likely to start within a few weeks of delivery.

Sometimes, postpartum depression doesn’t surface until months later. Symptoms may let up for a day or two and then return. Without treatment, symptoms may continue to worsen.

Treatment for postpartum depression

If you have symptoms of postpartum depression, you should see your doctor as soon as possible so that you can get started on treatment. There are two main treatments for postpartum depression: a) medication and b) therapy. Either one can be used alone, but they may be more effective when used together. It’s also important to make some healthy choices in your daily routine. It may take a few tries to find out what treatment works for you. Keep open communication with your doctor.

1. a)      Medication:Antidepressants have a direct effect on the brain. They alter the chemical that regulate mood. They won’t work right away, though. It can take several weeks of taking the medication before you notice a difference in your mood. Some people have side effects while taking antidepressants. These may include fatigue, decreased sex drive, and dizziness. If side effects seem to be making your symptoms worse, tell your doctor right away. Some antidepressants are safe to take if you’re breastfeeding, but others may not be. Be sure to tell your doctor if you breastfeed. If your estrogen levels are low, your doctor may recommend hormone therapy.
2. b)      Therapy:A psychiatrist, psychologist, or other mental health professional can provide counseling. Therapy can help you make sense of destructive thoughts and offer strategies for working through them. Self-care; This part of treatment may be a little more difficult than it sounds. Practicing self-care means cutting yourself some slack. You shouldn’t attempt to shoulder more responsibility than you can handle. Others may not instinctively know what you need, so it’s important to tell them. Take some “me time,” but don’t isolate yourself. Consider joining a support group for new mothers. Alcohol is a depressant, so you should steer clear of it. Instead, give your body every opportunity to heal. Eat a well-balanced diet and get some exercise each day, even if it’s only a walk around the neighborhood. Treatment helps most women feel better within six months, though it can take longer. 

Natural remedies for postpartum depression

Postpartum depression is serious and not something you should attempt to treat without a doctor’s input. Along with medical treatment, natural remedies such as exercise and getting the right amount of sleep can help improve symptoms. Massage, meditation, and other mindfulness practices may help you feel better. Maintain a diet high in nutrients, but low in processed foods. If you’re not getting the nutrients you need in your diet, ask your doctor to recommend the right dietary supplements.

Causes of postpartum depression

There’s some evidence that a lack of omega-3 fatty acids may be associated with postpartum depression. However, there’s not enough research to know if taking omega-3 supplements would improve symptoms. The exact cause isn’t clear, but there are some factors that may contribute to postpartum depression.

Postpartum depression may be triggered by a combination of physical changes and emotional stressors. Physical factors; One of the biggest physical changes after giving birth involves harmones. While you’re pregnant, your levels of estrogen and progesterone are higher than usual. Within hours of giving birth, hormone levels drop back to their previous state. This abrupt change may lead to depression.

Some other physical factors may include:

1. Low thyroid hormone levels
2. Sleep deprivation
3. Inadequate diet 
4. Underlying medical conditions
5. Drug and alcohol misuse 

Emotional factors: You may be more likely to develop postpartum depression if you’ve had a mood disorder in the past or if mood disorders run in your family. Emotional stressors may include:

1 Recent divorce or death of a loved one

2. You or your child having serious health problems
3. Social isolation
4. Financial burdens
5. Lack of support

Postpartum depression facts and statistics

Depression verses the blues about 80 percent of mothers have the baby blues in the weeks following childbirth. In contrast, a large-scale 2013 study found that just 14 percent of mothers screened positive for depression. Of those women, 19.3 percent thought about harming themselves and 22.6 percent had previously undiagnosed bipolar disorder.

Risk factors

The study found that women who had depression were more likely to be:

1. Younger
2. Less educated
3. Publicly insured

The study authors also found by conducting home visits or phone interviews with 973women that: 26.5percent had onset of depression before pregnancy; 33.4 percent started having symptoms during pregnancy; 40.1 percent noticed symptoms after childbirth Getting help; According to the non-profit Postpartum Progress, only about 15 percent of women with postpartum depression get professional help. In addition, these figures represent only women who had live births. They don’t include postpartum depression in women who miscarried or whose babies were stillborn. That means the actual incidence of postpartum depression might be higher than we think. 

Other statistics:

5. Postpartum anxiety is common, affecting more than 1 in 6 women following childbirth. Among first-time mothers, the rate is 1 in 5.
6. Suicide is said to be the reason for about 20 percent of postpartum deaths. It’s the second most common cause of death in postpartum women. 
7. Postpartum OCD is fairly rare. About 1 to 3 in 100 childbearing women are affected.
8. Postpartum psychosis is rare, affecting 1 to 2 per 1,000 women after childbirth. It’s estimated that up to 25 percent of fathers experience depression in the first year postpartum. Going beyond the first year postpartum, a 2010 study found that 39 percent of mothers and 21 percent of fathers had an episode of depression by the time their child was 12 years old.

How to deal with postpartum depression?

After you consult with your doctor, there are a few other things you can do to deal with postpartum depression.Here are four tips to deal with postpartum depression:

1. Communicate: You may be tempted to keep your feelings to yourself, especially if you’re a naturally reserved person. But it might be helpful to talk things over with someone you trust. You may find out that you’re not alone and that others are willing to listen.
2. Fight isolation remaining in seclusion with your feelings can feed into depression. It’s not necessary to have a whirlwind social life, but do try to maintain your closest relationships. It can help you feel connected. If you’re comfortable in a group setting, you can join a depression support group or a group specifically for new moms. If you’ve stopped participating in previously enjoyable group activities, try them again to see if it helps. Being in a group can help you focus on other things and relieve stress.
3. Cut back on chores: If you’re not up to chores and errands, let them go. Use your energy to take care of basic needs for you and your baby. If at all possible, enlist the help of family and friends.
4. Rest and relax:Both your body and your spirit need a good night’s sleep. If your baby doesn’t sleep for long periods, get someone to take a shift so you can sleep. If you have trouble drifting off, try a hot bath, a good book, or whatever helps you relax. Meditation and massage may help ease tension and help you fall asleep.

Medications for postpartum depression:

Selective serotonin reuptake inhibitors Paroxetine, fluoxetine, and sertraline (are selective serotonin reuptake inhibitors (SSRIs). They’re the most commonly used antidepressants. These drugs affect serotonin, a chemical in the brain that regulates mood. They generally have fewer side effects than other antidepressants. Atypical antidepressants; These newer antidepressants also target several neurotransmitters in the brain. Duloxetine and venlafaxine are examples of atypical antidepressants. Tricyclic antidepressants and monoamine oxidase inhibitors These older antidepressants affect neurotransmitters in the brain. They tend to produce side effects and are not usually prescribed unless all other options haven't worked.