POST-PARTUM DEPRESSION

The birth of a child is often anticipated and heralded as a joyful occasion. The successful delivery and great health of both mother and child are touted as bliss. And notwithstanding the joy this comes with, having a baby can be stressful irrespective of the anticipation and how much love one has for one’s child.  The changes in routine, sleep deprivation, new responsibilities, lack of personal time for self-care can be overwhelming and many new mothers can feel like they are on an emotional rollercoaster. It is therefore not uncommon that mood swings and mild depression are common in this population and it is termed ‘baby blues’.

Majority of women experience at least some symptoms of the baby blues immediately after childbirth. It is posited to be caused by the sudden change in hormones after delivery, combined with stress, isolation, sleep deprivation, and fatigue. Mothers may find that they 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.  These signs are perfectly normal however if these symptoms do not go away after a few weeks or become worse, there is a high chance that this may be post-partum depression. Post-partum depression is a lot more powerful, lasts longer and the intensity of those feelings can make it difficult to care for your baby or yourself.

According to the Diagnostic and Statistical Manual of Disorders, post-partum depression (PPD) is a mood disorder that can affect women after childbirth. It is touted as the most common psychiatric disorder observed in the post-partum period; being seen in about 10–15% of postpartum women. It is characterized by severe mood swings, exhaustion, and a sense of hopelessness. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others.

PPD is generally difficult to distinguish from depression occurring at any other time in a women’s life. However, in PPD the negative thoughts are mainly related to the newborn. There are feelings of guilt or inadequacy about the new mother’s ability to care for the infant and a preoccupation with the infant’s well-being or safety severe enough to be considered obsessional. Likewise, there could also be a disinterest in the infant, guilt because of dissonance between the mother’s mood and society’s expectation of happiness, and a fearless than optimum development of a mother/infant relationship.

The onset can range from few days to few weeks following delivery, generally in the first 2–3 months following childbirth. History of major depression increases the risk for PPD by 25%, and past history of PPD increases the risk of recurrence by 50%.

SYMPTOMS

Postpartum depression can present different symptoms, depending on the person. But common symptoms include:

• Extreme difficulty in day-to-day functioning.
• Feelings of guilt, anxiety, worry, panic attacks, or racing thoughts and fear.
• Loss of pleasure in life
• Bouts of crying.
• Thoughts of hurting oneself or the infant
• Feeling down or depressed for most of the day for several weeks or more
• Feeling distant and withdrawn from family and friends
• A loss of interest in activities (including sex)
• Changes in eating and sleeping habits
• Feeling tired most of the day
• Feeling angry or irritable
• a feeling of being overwhelmed and trapped, or that it is impossible to cope
• a low mood that lasts for longer than a week
• a sensation of being rejected and feelings of inadequacy.
• headaches, stomach aches, blurred vision
• lack of appetite
• persistent fatigue
• concentration problems
• reduced motivation
• the parent lacks interest in themselves and an unexplained lack of interest in the new baby
• a lack of desire to meet up or stay in touch with friends

CAUSES

PPD is believed to be a result of a combination of physical, emotional, and genetic factors. The following factors may contribute to PPD:

• the physical changes of pregnancy
• excessive worry about the baby and the responsibilities of being a parent
• changes to the sleep cycle/sleep deprivation
• complicated or difficult labor and childbirth
• lack of family support
• worries about relationships
• financial difficulties
• loneliness, not having close friends and family around
• a history of mental health problems
• the health consequences of childbirth, including urinary incontinence, anemia, blood pressure changes, and alterations in metabolism.
• hormonal changes, due to a sudden and severe drop in estrogen and progesterone levels following birth
• Difficulties with breastfeeding.