What is Postpartum Depression?

Having a baby is supposed to be one of the happiest days of a woman’s life. No one talks about the overwhelming sadness and anxiety that can plague some women before and immediately after childbirth. For women with postpartum depression (PDD), this period can become exceedingly difficult and distressing.

The official diagnosis for postpartum depression is called major depressive disorder with peripartum onset.¹ This disorder is a serious, but treatable form of depression that involves feelings of sadness, anxiety, or guilt. Postpartum depression affects a woman’s day-to-day functioning. If not properly treated, this condition carries significant risks for both the mother and child.²

Prevalence, Causes & Risk Factors

Postpartum depression affects up to six percent of women during pregnancy or in the weeks following delivery. About half of the time, symptoms begin in the period preceding or following childbirth, which is known as the peripartum period.²

Researchers have not found a single cause for postpartum depression. However, they do say that postpartum depression is not caused by something the mother does or doesn’t do. The current thinking in the scientific community is that this type of depression stems from a combination of things, including:

Hormonal factors. After childbirth, the levels of two hormones — progesterone and estrogen —  quickly plummet. Researchers speculate that the abrupt withdrawal of these hormones leads to chemical changes in the brain that trigger depression.³

Genetics. Researchers have found that genetics play a role in the development of postpartum depression. Scientists from John Hopkins Medicine isolated alternations in two genes that they say predict postpartum depression with 85 percent certainty. This was a small study and so more research is needed to confirm this finding.⁴

Physical factors. The time right after a baby is born comes with many new responsibilities. Many mothers are physically exhausted. Sleep deprivation and physical discomfort from childbirth are common. These issues may trigger or contribute to the symptoms of postpartum depression.³

Symptoms

Postpartum depression can cause varying symptoms, depending on the person. But common signs include:⁵

• Frequent periods of crying for no reason
• Irritability or agitation
• Changes in appetite
• Feelings of guilt, shame or fear
• Excessive worry or feeling overly anxious
• Frequent, unexplained aches and pains
• Changes in sleep
• Difficulty concentrating
• Social withdrawal and isolation from others
• Lack of interest in normally enjoyable activities
• Extreme difficulty performing daily activities including childcare

In severe cases, postpartum depression can include psychotic symptoms and thoughts of self-harm or harm to others. Without proper treatment, these symptoms can be very dangerous.

Treatment For Postpartum Depression

There are many effective treatments for postpartum depression and new treatments are becoming available all the time.6 Postpartum depression can vary in severity, which affects the type of treatment needed. A combination of treatments is often best.

Psychotherapy. Various types of therapy may be used for postpartum depression, including cognitive behavioral therapy (CBT) and family therapy. CBT can help you identify and change thoughts that contribute to depression and worry. It can also help you identify new ways of coping with symptoms. Family therapy is useful in helping family members learn ways of supporting their loved one with postpartum depression. It can help address things within the family system that may be contributing to symptoms.⁷

Medications. Several types of medications may be used to treat postpartum depression. In some cases, antidepressants are needed to help reduce symptoms of sadness and irritability. If psychosis is present, then antipsychotic medications may be used to treat these symptoms. Mood stabilizers are sometimes prescribed to treat irritability and self-harm behaviors.⁷

Electroconvulsive therapy (ECT). ECT is very effective for severe forms of depression. It is usually prescribed when symptoms do not respond to other forms of treatment. Although the use of ECT has been controversial, this treatment has evolved a lot since its first days and can provide extreme and quick improvements in people who do not otherwise respond to treatment.⁷

Lifestyle Remedies

Along with therapy for postpartum depression, there are many lifestyle changes that can help speed up recovery. Here are a few changes that women with postpartum depression should consider making.⁷

• Reach out for help. Don’t be afraid to ask for help. Pregnancy and childbirth is a time of many new responsibilities. It can be overwhelming — even impossible to try to do everything on your own.
• Exercise. Going for daily walks with your new baby can help you feel better and reduce depression. Try to connect with other new moms who want to exercise, as well.
• Eat healthy foods. It can be hard to eat healthy right after having a baby. It’s easy to let your own diet slide when you are focused on taking care of a little one. Take time to nourish your body just as you are nourishing your baby. Eating healthy will help you maintain a more stable blood sugar levels, which will reduce irritability and other symptoms related to blood sugar fluctuations.
• Get enough rest. During pregnancy and childbirth, your body goes through significant changes. It is important to get enough rest. Give your body the time that it needs to heal.
• Take time for yourself. Most new moms are not focused on themselves. However, it is very important to take time for yourself to do the things that you enjoy. Go to a movie or on a date night with your husband.
• Get Support. Join an online or local support group. It can be very helpful to connect with other new moms who are going through the same things.

Get Help For Postpartum Depression

Postpartum depression is a common medical condition that can get better with treatment. So, if you or someone you love is having symptoms of postpartum depression, use our directory to find a therapist who can help. The sooner you get help, the sooner you’ll be able to cope with the depression and enjoy this critical time of bonding with your new baby.

References

1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
2. National Alliance On Mental Illness. (August 2017). Major Depressive Disorder With Peripartum Onset. Retrieved April 25th from https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Major-Depressive-Disorder-with-Peripartum-Onset.
3. National Institute of Mental Health. (2019). Postpartum Depression Facts. Retrieved April 25th from https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml.
4. John Hopkins Medicine. (May 2013). Genetic Predictors of Postpartum Depression Uncovered by Johns Hopkins Researchers. Retrieved April 25th from https://www.hopkinsmedicine.org/news/media/releases/genetic_predictors_of_postpartum_depression_uncovered_by_johns_hopkins_researchers.
5. Postpartum Depression. (January 2019). Postpartum Depression Symptoms. Retrieved April 25th from https://www.postpartumdepression.org/postpartum-depression/symptoms/.
6. The New York Times. (March 2019) F.D.A. Approves First Drug for Postpartum Depression.  Retrieved April 25th from https://www.nytimes.com/2019/03/19/health/postpartum-depression-drug.html.
7. Mayo Clinic. (September 2018). Postpartum Depression. Retrieved April 26th from https://www.mayoclinic.org/diseases-conditions/postpartum-depression/diagnosis-treatment/drc-20376623.