
POSTNATAL DEPRESSION: SYMPTOMS, CAUSES AND RISKS
Written By Caroline Meyer
Postnatal depression aka postpartum depression is a mix of behavioural, emotional and physical changes that can happen to a woman after giving birth. Postnatal depression typically has an onset within 4 weeks of delivery. The diagnosis of PPD is based on when the symptoms manifest and also how severe the depression happens to be.
WHAT IS POSTPARTUM DEPRESSION?
During and after childbirth the body undergoes physical and chemical changes. As a person, you also undergo psychological and social changes as well as emotional upheavals. This can all lead to PPD. Once a woman has given birth there is a massive drop in progesterone and estrogen, the hormones that typically increase dramatically in the body during pregnancy. Within 3 days after delivery, the hormones should be back to a pre-pregnancy level. While the mechanics of it are still unclear, it is suggested that this hormone drop may have a lot to do with PPD in new mothers. Fortunately, PPD can safely be treated with a combination of counselling and medication.
SYMPTOMS OF POSTPARTUM DEPRESSION
Some of the symptoms may appear the same as normal changes due to childbirth such as fatigue, changes in appetite, sleeping problems, mood changes and decreased libido so it can be a little difficult to know the difference. Postpartum Depression is characterised by increased feelings of hopelessness, worthlessness or helplessness. It may also include dark moods and thoughts of death, suicide and possibly doing injury to someone else.
RISK FACTORS FOR POSTPARTUM DEPRESSION
One of the main contributing factors to the risk of getting PPD is a history of depression prior to or during pregnancy. PPD is more prevalent in younger women although the more children you have, the higher your risk of PPD in subsequent pregnancies. If you are ambivalent about having the baby, you may also be at higher risk. Women suffering from premenstrual dysphoric disorder prior to falling pregnant are also more likely to get PPD after the birth of the baby. People who have a small social circle or minimal support from friends and family may also be more likely to get PPD. Stress in the home due to marital conflict or living alone can also lead to a greater chance of becoming depressed after the birth of the baby. While many women suffer from “baby blues” after giving birth, only around 1 in 10 may experience PPD. This can be a mild depression to a long-lasting, more severe condition. Around 1 in 1000 women develop a severe PPD known as postpartum psychosis.
TYPES OF DEPRESSION AFTER CHILDBIRTH
After having a baby, many women experience mood shifts and depression related emotions. Mild conditions are known as “baby blues” and are experienced by most women and considered normal. This can be observed as sudden mood swings which can have intense highs and lows. The new mum can exhibit feelings of restlessness, anxiety, loneliness, sadness, irritability and impatience. The “baby blues” can last from an hour to two to as long as two weeks after giving birth. Talking to other mums or a healthcare provider is the only recommended treatment for this level of depression.
PPD is a more intense depression that can happen from a few days after delivery to months after the birth. PPD is also more likely the more children you have and is not restricted to first time mothers. While the emotions can be similar to those felt with “baby blues”, they are often more intense and affect day to day living. This is quite a serious mental illness and if the depression starts to affect your usual day to day activities, you should consult your care provider. The treatment plan for PPD usually includes medication and counselling.
Postpartum psychosis is a lot more serious and usually occurs within the first 3 months after having given birth, but it can happen even later. This condition is characterised by symptoms such as delusions, auditory and visual hallucinations, agitation, aggression, insomnia, restlessness and unusual behaviours. This mental illness can also include a feeling of needing to hurt yourself or someone else. Treatment includes medication and counselling and in severe cases, hospitalisation. Other mental disorders such as OCD and panic disorder may also occur along with postpartum psychosis or as stand-alone disorders, but this is fairly rare.
If you are suffering from depression from mild to severe after giving birth, get help from your medical practitioner and support from family and friends. Try and relax when you get home with your new baby. Exercise where possible (once your doctor approves), eat a nutrition diet and avoid caffeine and alcohol. Socialise with other people and talk to other parents to help you cope. Don’t be too hard on yourself and realise that not everything will go right all the time. There will be ups and downs. Sleep when you can and take a break where possible. Don’t be scared to ask for help.