NAME: Mbeng Bessonganyi

Topic: Postpartum Depression

What Is Postpartum Depression?

Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes
that happen in some women after giving birth. According to the DSM-5, a manual used to
diagnose mental disorders, PPD is a form of major depression that begins within 4 weeks after
delivery. The diagnosis of postpartum depression is based not only on the length of time between
delivery and onset, but also on the severity of the depression.

Postpartum depression is linked to chemical, social, and psychological changes that happen when
having a baby. The term describes a range of physical and emotional changes that many new
mothers experience. PPD can be treated with medication and counseling.

The chemical changes involve a rapid drop in hormones after delivery. The actual link between
this drop and depression is still not clear. But what is known is that the levels of estrogen and
progesterone, the female reproductive hormones, increased tenfold during pregnancy. Then, they
drop sharply after delivery. By 3 days after a woman gives birth, the levels of these hormones
drop back to what they were before they got pregnant.

In addition to these chemical changes, the social and psychological changes of having a baby
create an increased risk of depression.

Most new mothers experience the "baby blues" after delivery. About 1 out of every 10 of these
women will develop a more severe and longer-lasting depression after delivery. About 1 in 1,000
women develops a more serious condition called postpartum psychosis.

Postpartum Depression Signs and Symptoms

Symptoms of postpartum depression can be hard to detect. Many women have these symptoms

following childbirth:

 Difficulty sleeping 

 Appetite changes 
  Excessive fatigue 

 Decreased libido 

 Frequent mood changes 

Postpartum Depression Causes and Risk Factors

A number of factors can increase the chances of postpartum depression, including:

 A history of depression prior to becoming pregnant, or during pregnancy

 Age at time of pregnancy -- the younger you are, the higher the chances

 Ambivalence about the pregnancy

 Children -- the more you have, the more likely you are to be depressed in a subsequent
pregnancy

 Having a history of depression or premenstrual dysphoric disorder (PMDD)

 Limited social support

 Living alone

 Marital conflict

There’s no one cause of postpartum depression, but these physical and emotional issues may
contribute:

 Hormones. The dramatic drop in estrogen and progesterone after you give birth may play
a role. Other hormones produced by your thyroid gland also may drop sharply and make
you feel tired, sluggish and depressed.

 Lack of sleep. When you're sleep deprived and overwhelmed, you may have trouble
handling even minor problems. 

 Anxiety. You may be anxious about your ability to care for a newborn. 

 Self-image. You may feel less attractive, struggle with your sense of identity, or feel that
you've lost control over your life. Any of these issues can contribute to postpartum
depression.

Types of Postpartum Depression

There are three terms used to describe the mood changes women can have after giving
birth:

 The "baby blues," which occur in most women in the days right after childbirth, are
common. You may have sudden mood swings, such as feeling very happy and then
feeling very sad. You may cry for no reason and can feel impatient, irritable, restless,
anxious, lonely, and sad. The baby blues may last only a few hours or as long as 1 to 2
weeks after delivery. Usually, you don’t need treatment from a health care provider for
baby blues. Often, joining a support group of new moms or talking with other moms
helps.

 Postpartum depression (PPD) can happen a few days or even months after childbirth.
PPD can happen after the birth of any child, not just the first child. You can have feelings
similar to the baby blues -- sadness, despair, anxiety, irritability -- but you feel them
much more strongly. PPD often keeps you from doing the things you need to do every
day. When your ability to function is affected, you need to see their health care provider,
such as your ob-gyn or primary care doctor. This doctor can screen you for depression
symptoms and develop a treatment plan. If you don’t get treatment for PPD, symptoms
can get worse. While PPD is a serious condition, it can be treated with medication and
counseling.

 Postpartum psychosis is a very serious mental illness that can affect new mothers. This
illness can happen quickly, often within the first 3 months after childbirth. Women can
lose touch with reality, having auditory hallucinations (hearing things that aren't actually
happening, like a person talking) and delusions (strongly believing things that are clearly
irrational). Visual hallucinations (seeing things that aren't there) are less common. Other
symptoms include insomnia (not being able to sleep), feeling agitated and angry, pacing,
restlessness, and strange feelings and behaviors. Women who have postpartum psychosis
need treatment right away and almost always need medication. Sometimes women are
put into the hospital because they are at risk for hurting themselves or someone else.

Postpartum Depression Treatment

Postpartum depression is treated differently depending on the type and severity of a

woman's symptoms. Treatment options include anti-anxiety

 or antidepressant medications, psychotherapy, and participation in a support

group for emotional support and education. For severe cases, intravenous infusion
of a new medication called brexanolone (Zulresso) may be prescribed.
 In the case of postpartum psychosis, drugs used to treat psychosis are usually
added. Hospital admission is also often necessary.
 If you are breastfeeding, don't assume that you can't take medication for
depression, anxiety, or even psychosis. Talk to your doctor. Under a doctor's
supervision, many women take medication while breastfeeding. This is a decision
to be made between you and your doctor.

Postpartum Depression Complications

Postpartum depression that isn’t treated can weaken your ability to bond with your baby,
and affect the whole family:

 You. Postpartum depression that’s not treated can last for months or longer, even
turning into a chronic depressive disorder. Even when treated, postpartum
depression can make you more likely to have episodes of depression in the future.
 The baby’s father. When a new mother has depression, the father may be more
likely to have depression too.
 Children. Children of mothers with postpartum depression are more likely to have
problems with sleeping and eating, crying more than usual, and delays in
language development.

Postpartum Depression Prevention

 If you have a history of depression, tell your doctor as soon as you find out you’re
pregnant, or if you’re planning to become pregnant.

 During pregnancy. Your doctor can monitor you for symptoms. You can manage
mild depression symptoms with support groups, counseling, or other therapies.
Your doctor may prescribe medications, even while you’re pregnant.
 After your baby is born. Your doctor may recommend an early postpartum
checkup to look for symptoms of depression. The earlier you’re diagnosed, the
earlier you can begin treatment. If you have a history of postpartum depression,
your doctor may recommend treatment as soon as you have the baby.

Reference

https://www.webmd.com/depression/guide/postpartum-depression#1

https://www.webmd.com/depression/guide/postpartum-depression#2

https://www.webmd.com/depression/guide/postpartum-depression#3

https://www.webmd.com/depression/guide/postpartum-depression#4