Postpartum depression

Description, Causes and Risk Factors: Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth. Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby. Because this syndrome is still poorly defined and under studied, it tends to be under reported. It is estimated that its occurrence range from 3% to 20% of births. The depression can begin at any time between delivery and 6 months post-birth, and may last up to several months or even a year. Types: Baby blues and postpartum psychosis.
  • The `baby blues' is the most minor form of postpartum depression. It usually starts 1 to 3 days after delivery, and is characterized by weeping, irritability, lack of sleep, mood changes and a feeling of vulnerability. These `blues' can last several weeks. It is estimated that between 50% and 80% of mothers experience them.
  • Postpartum psychosis is a relatively rare disorder. The symptoms include extreme confusion, fatigue, agitation, alterations in mood, feelings of hopelessness and shame, hallucinations and rapid speech or mania. Studies indicate that it affects an average of 1% of births.
The exact cause of postpartum depression is not known. One factor may be the changes in hormone levels that occur during pregnancy and immediately after childbirth. Studies have also considered the possible effects of maternal age, expectations of motherhood, birthing practices, and the level of social support for the new mother. But the trigger for postpartum depression remains a mystery. However, it is important to communicate to women with postpartum depression that they did not bring it upon themselves. One certain fact is that women who have experienced depression before becoming pregnant are at higher risk for postpartum depression. Women in this situation should discuss it with their doctor so that they may receive appropriate treatment, if required. In addition, an estimated 10% to 35% of women will experience a recurrence of postpartum depression. The amount of sick leave taken during pregnancy and the frequency of medical consultation may also be warning signs. Women who have the most doctor visits during their pregnancy and who also took the most sick-leave days have been found to be most likely to develop postpartum depression. The risk increases in women who have experienced two or more miscarriages, or women who have a history of obstetric complications. Other factors which increase the risk of postpartum depression are severe premenstrual syndrome (PMS), a difficult relationship, lack of a support network, stressful events during the pregnancy or after delivery. Symptoms: Symptoms may include:
  • Irritability or hypersensitivity.
  • Anxiety and worry.
  • Anger.
  • Difficulty concentrating.
  • Crying or tearfulness.
  • Negative feelings such as sadness, hopelessness, helplessness, or guilt.
  • Loss of interest in activities you usually enjoy.
  • Difficulty sleeping (especially returning to sleep).
  • Fatigue or exhaustion.
  • Changes in appetite or eating habits.
  • Headaches, stomachaches, muscle or backaches.
  • A woman with postpartum depression may have no feelings for her baby or, conversely, be overly concerned for the child. It can have an adverse effect on the bonding between mother and child.
Diagnosis: 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. Your doctor will do a physical exam and ask about your symptoms. Be sure to tell your doctor about any feelings of baby blues at your first checkup after the baby is born. Your doctor will want to follow up with you to see how you are feeling. Treatment: Therapy, support networks and medicines such as antidepressants are used to treat postpartum depression. Psychotherapy has been shown to be an effective treatment, and an acceptable choice for women who wish to avoid taking medications while breastfeeding. Here are some suggestions for coping postpartum depression:
  • Focus on short-term, rather than long-term goals. Build something to look forward to into every day, such as a walk, a bath, a chat with a friend.
  • Look for free or inexpensive activities; check with your local library, community centre or place of worship.
  • Spend time with your partner and/or close friends.
  • Share your feelings and ask for help.
  • Consult your doctor and look for a local support group.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  

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