Your Guide to Postpartum Depression: Definition, Clinical Presentation, and Treatment

Postpartum depression or post natal depression is seen in women after birth. It is more common than previously thought, and can be debilitating

Baby blues is a common condition that affects new mothers. According to reports, 80% of mothers experience feelings of sadness, worry, and fatigue for 1-2 weeks after giving birth.

Despite the similarities between this condition and postpartum depression (PPD), the latter is more serious and lasts longer.

The incidence of PPD is also significantly lower than baby blues, with approximately 15% of first-time moms affected.

The intensity of the symptoms (e.g., mood swings, exhaustion, hopelessness) can severely impact your ability to take care of yourself and your newborn child.

In this article, we will briefly discuss the causes, common signs and symptoms, and the potential treatment options of PPD.

What are the causes of postpartum depression?

While the exact cause of PPD is not yet clear, researchers managed to pinpoint a few risk factors that include:

Hormonal fluctuation – estrogen and progesterone levels are typically high during pregnancy but drop sharply after a few hours of childbirth. This sudden change may trigger PPD.

Low thyroid hormone levels – also associated with PPD, hypothyroidism may impact your cognition and cause depression.

Sleep deprivation – pregnant women experience so much stress and anxiety during pregnancy, which could negatively impact their sleep quality.

Psychological stress – this is the result of several potential factors, including a recent divorce, health problems in your newborn child, lack of support, and financial burdens.

In one study, researchers identified additional risk factors that precipitate PPD and baby blues, including:

  • Young age
  • Low level of education
  • Certain races (e.g., African-American)
  • Insecurity problems

What are the signs and symptoms of postpartum depression?

Before we discuss the signs and symptoms of postpartum depression, you should keep in mind that it’s completely normal to experience moodiness and fatigue after giving birth.

However, PPD takes these symptoms to another level, mimicking those you’d expect to see in clinical depression (i.e., major depressive disorder).

Additionally, the signs and symptoms are quite diverse, with each patient presenting with different chief complaints that could change after a few days.

With that out of the way, here are the common signs and symptoms of postpartum depression:

  • Extreme feeling of sadness and the urge to cry without an apparent reason
  • Exhaustion associated with insomnia
  • Hypersomnia (i.e., excessive sleep) in a subgroup of patients
  • Anorexia (i.e., loss of appetite)
  • Anxiety, irritability, and sudden mood swings
  • Loss of interest in previously enjoyable activities (e.g., watching TV, jogging)
  • Difficulty concentrating and recalling information
  • Pains and aches all over the body without the notion of trauma
  • Feeling a disconnection with your baby
  • Fear of judgment from other people or getting labelled as a bad mother
  • Intrusive thoughts about harming yourself and/or your baby

As you can see, the clinical presentation (signs and symptoms) of PPD is diverse and could be quite serious. This usually begins within a few weeks of delivery, but some mothers may not experience PPD until months after childbirth.

Moreover, and despite the common belief that postpartum depression occurs uniquely after childbirth, statistics show that up to 60% of PPD cases take place before and during delivery.

Another important characteristic of PPD is the fluctuating presentation. In other words, you could be symptom-free for one week, only to get hit again with all the sadness and depressive mood the very next week.

The treatment of postpartum depression

Similar to other types of mood disorders, PPD gets treated using two approaches:

In general, your doctor will recommend both approaches to increase the effectiveness of the treatment and help you get back to your normal life as soon as possible.

Let’s break down the commonly used treatments:

Medications

The primary drugs used to treat PPD are antidepressants, which alter the chemical composition of the brain and restore the balance of neurotransmitters (e.g., serotonin).

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed drugs due to their rapid effect on depression and lighter side effect profile (compared to older generation antidepressants).

Side effects of SSRIs may include fatigue, decreased libido (i.e., sex drive), obesity, and dizziness.

Make sure to inform your doctor if you’re breastfeeding since some antidepressants may not be safe for your baby.

Aside from antidepressants, hormone replacement therapy (HRT) may be effective in a subgroup of patients with severely low levels of estrogen.

Psychotherapy

Counselling is an effective method that repeatedly proved its positive effects on mental disorders, such as depression and anxiety.

Your therapist may implement numerous techniques (e.g., cognitive-behavioral therapy) to change your perspective about the dark thoughts you’re having. He/she will also provide you with helpful tips during times of extreme feelings of sadness.

Self-care

Most people neglect their personal well-being in order to achieve certain goals or please some people. However, self-care is a must during PPD since it could dramatically improve your symptoms without the treatments mentioned above.

Self-care involves the following:

  • Taking some “me time” without isolating yourself
  • Informing your family about this approach so they can help with the schedule
  • Knowing your limits and avoiding taking more responsibility than you can handle
  • Adopting a healthy, balanced diet
  • Exercising regularly

Dietary supplements

When dealing with dietary supplements that claim to treat postpartum depression, you need to be skeptical about the validity of those claims.

You see, the U.S. Food and Drug Administration (FDA) does not regulate these products like they do with pharmacological drugs. As a result, there isn’t really much scrutiny about which supplement gets released into the market.

Additionally, these supplements may interact with the medications you’re already taking. Therefore, inform your doctor or pharmacist about any intention to take dietary supplements.

With the being said, some evidence advocates for the effectiveness of St. John’s wort and omega-3 fatty acids in improving depression. However, the quality of these studies is poor, which is why we can’t draw any conclusions, especially when dealing with a serious condition such as depression.

Takeaway message

Postpartum depression is a serious psychiatric condition that requires specialized care from a trained physician.

This condition should not be taken lightly since it can lead to dire consequences, such as suicide, self-harm, and even the endangerment of the baby.

We hope that this article managed to clear out some of the confusion that surrounds postpartum depression and baby blues.

If you are dealing with the symptoms we listed above, you may want to speak to your primary care physician or OB/GYN.

Emilie MASI

Registered Nurse, Masters in Advanced Nursing Practice Graduate Diploma of Wound Care Working towards Masters of Wound Care

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