DIAGNOSIS, RISK FACTORS AND TREATMENT OF POSTPARTUM DEPRESSION

DIAGNOSIS

Typically, a diagnosis of postpartum depression is considered after signs and symptoms persist for at least two weeks.

A doctor may aim to rule out baby blues by asking the person with suspect PPD to complete a depression screening questionnaire such as the Edinburgh Post Natal Depression Screening Scale.

RISK FACTORS

The risk factors associated with the development of postpartum disorders are:

• Primigravida (first pregnancy);
• unmarried mother;
• young maternal age;
• cesarean sections or other perinatal or natal complications;
• past history of psychotic illness, especially past history of anxiety and depression;
• family history of psychiatric illness, especially mother and sister having postpartum disorder; previous episode of postpartum disorder;
• stressful life events especially during pregnancy and near delivery;
• history of sexual abuse;
• history of drug use disorder;
• vulnerable personality traits;
• low self-esteem and
• social isolation/unsupportive spouse/lack of support.

TREATMENT.

The treatment of PPDs is generally holistic and includes reassurance, familial and social support, psychoeducation, and in some cases, psychotherapy and/or pharmacologic treatment. Individual psychotherapy is an integral part of treatment, especially for females finding it difficult adjusting to motherhood and/or apprehensions about new responsibilities. Psychoeducation and emotional support for the partner and other family members are important. The patient and the family members should be involved in the formulation of the treatment plan. Respite care services should be recommended especially at night to minimize the patient’s sleep disruption. In some cases, interpersonal therapy (IPT) might be beneficial. IPT is shown to result in a greater reduction in depressive symptoms and improvement in social adjustment.

Lifestyle changes can also help to reduce some symptoms of postpartum depression. The following strategies may help you manage the increased stress that accompanies new parenthood:

• Getting enough sleep
• Finding time to exercise
• Surrounding yourself with a supportive network of family and friends
• Eating regular, nourishing meals
• Asking others to watch your child so that you can have a much-needed break.

Postpartum depression shouldn’t be taken lightly. The prognosis of postpartum disorders is generally good if diagnosed early and adequately treated. The chances of recurrence are also very high. The relapse rate in subsequent pregnancies can be as high as 25–40%. Women who sought help within 1 month of delivery had more favourable outcomes and were less likely to suffer a long-term disability as compared to women with late-onset PPD