Monday, March 30, 2015

Postpartum Depression

Postpartum Depression Lot of changes happens to a woman when she becomes pregnant and subsequently gives birth to a child. In addition to physical changes, she also undergoes emotional and mental changes. Ranging from excitement to anxiety she experiences fear also. This might land up in postpartum depression. Depression arising from childbirth is known as postpartum depression. It is quite common for most of the new moms to experience mood swings for some time. But this would not continue for long.


In the case of postpartum depression, it becomes long lasting and may continue for several months or even years after childbirth. It can interrupt her daily activities and many times the mother will not even bother about her new baby due to depression. Postpartum depression has nothing to do with character of mother. It is neither weakness nor “baby blues” but it occurs as a result of bundle of hormonal changes in the brain. It is a rare and severe form of mental illness that occurs after childbirth. In extreme cases, postpartum depression develops into more severe form called postpartum psychosis which is a medical emergency. Postpartum depression can be treated but early intervention is essential for complete recovery.


Symptoms :


Prominent symptom of postpartum depression is feeling hopeless and sad each day and losing interest in pleasurable activities. Intensity of symptoms of PPD may vary from one mother to another, but these are the general signs of this disorder. A mother having “baby blues” might show symptoms of mood swings, sadness, anxiety, irritability and trouble sleeping, but these symptoms would go within few days or weeks after childbirth. The major difference in PPD is the symptoms grow intense day by day and it can significantly interfere with her daily tasks.


Loss of appetite, trouble in sleeping, increased irritation/anger, extreme tiredness, lack of interest in life/sex, severe mood swings, feeling of guilt/shame and withdrawal from family are some of the symptoms of PPD. The mother may have difficulty bonding with the child and she would completely ignore the baby, without caring to feed. Some mothers would harm their baby assuming that it is the reason for their sadness.


In severe cases they get thoughts about suicide/death. They may gain or lose weight and feel restless or sit quietly for hours together. A woman with postpartum psychosis may show symptoms of confusion, delusions and hallucinations (seeing/hearing non-existing things) and severely doubting others. She may not be able to recognize day or night and the place where she lives. Most of these symptoms may develop within few weeks after childbirth.


Causes :


Still experts cannot pinpoint the right cause of PPD and one cannot say why certain mothers develop this disorder and others not. It is believed to occur due to plenty of physical and emotional changes that happen to pregnant woman. Lots of hormonal changes occur in the body of pregnant women and after delivery there will be considerable drop in hormone levels.


It can cause dramatic changes in her metabolism, leaving her extremely tired and weak. It can also cause mood swings leading to postpartum depression. A new mother cannot sleep properly and may have trouble in handling her baby. She may feel that she is worthless and lost control. Such feelings can contribute for postpartum depression. A mother delivering stillborn baby or a child with serious illness can develop PPD.


Who are at risk?


Any woman can develop PPD after childbirth. But there are certain factors that increase the risk. Financial trouble, lack of care/love from spouse, poor support from family, increased stress and sudden death of husband are some of the factors that makes a woman prone to develop PPD.


Having a sick child, undergoing depression during pregnancy and family history of bipolar disorder increases the risk of developing this disorder. A child born for postpartum depression mother can have behavioral problems in life. If left untreated, PPD can develop further to postpartum psychosis.


Tests :


According to DSM, PPD is a kind of major depression. To be classified under PPD, a new mother should have at least 3-4 of the symptoms like depressed mood every day, lack of interest in any activity, loss of appetite, trouble in sleeping, restlessness, fatigue, difficulty to make decisions and think clearly and repeated thoughts about suicide/death.


Treatment :


Medications are given to reduce the symptom of depression and individual counseling and therapy are effective for postpartum depression. Based on your symptoms, your doctor would refer to a psychiatrist or psychologist for counseling. Family counseling is helpful in building relationships. Antidepressant drugs are prescribed with precaution for new mothers. Your psychiatrist would start with low doses since you would be breast-feeding.


If your hormone levels are imbalanced, suitable hormone therapy is given. Often, most of the symptoms of PPD go away with effective treatment, but you should follow the instructions of your doctor in taking medicines to prevent relapse. If you can afford, engage a full-time helper for your baby. Spend quality time for yourself. Eat healthy foods and do regular exercises which can help in regulating your mood.


Prevention :


You can do nothing to prevent PPD since it is not your fault. However if you have a family history of depression you can consult your doctor once you become pregnant. He might give suitable antidepressants to prevent worsening of symptoms.


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