Having a baby is supposed to be one of the happiest times of a woman’s life and for most women, it is. Unfortunately, some women experience the darkness and loneliness of postpartum depression. My personal experience with postpartum depression occurred after I had my first child seven years ago. Through my experience, I am now much more aware of this joy-stealing condition and take care to evaluate and question my patients about concerning symptoms. Like most diseases, early detection and treatment leads to less severe symptoms and less adverse outcomes.
Postpartum depression ranges from mild depressive symptoms that last a short time and resolve without intervention to severe depression that requires treatment. It can occur anytime during the first year after giving birth. It is not well understood why women experience postpartum blues or depression. Hormonal changes may play a role in addition to genetic susceptibility and major life events. Postpartum blues or “baby blues” are very common and are characterized by mild depressive symptoms of sadness, tearfulness, anxiety, irritability, insomnia and decreased concentration. Baby blues peak a few days after delivery and then resolve about two weeks after delivery.
Postpartum depression may be diagnosed when these “blues” persist or symptoms occur after the first two weeks following delivery. Postpartum depression occurs in eight to 15% of women. Symptoms such as fatigue, decreased energy, decreased appetite, weight changes and low libido are common in normal postpartum women to a degree, but when these symptoms interfere with relationships or caring for self or the baby/other children then further evaluation must be undertaken. Postpartum depression symptoms may also include anxiety, panic attacks, irritability, anger, feeling inadequate and overwhelmed, feelings of guilt, shame and failure as a mom. Sometimes, thoughts of harming oneself or baby may occur.
Patients will often describe these as “scary thoughts” recognizing them as unacceptable and are reluctant to admit to having such intrusive thoughts unless directly questioned. Still, in a small number of patients, postpartum depression may lead to suicide, harming others, or psychosis, thus, emphasizing the importance of prompt evaluation by a qualified medical provider. The biggest risk factor for having postpartum depression is having a history of depression. Other risks include lack of support, certain personality traits, stressful life events, complicated pregnancy, abuse, marital discord/living without partner, diabetes, stillbirth /neonatal death and childcare related stressors such as inconsolable crying in addition to several other risk factors. Also, miscarriage appears associated with major depression and typically occurs within four weeks following the miscarriage. The mode of delivery (i.e. vaginal delivery vs. C-section) is not associated with postpartum depression.
Interestingly, postpartum depression may occur in fathers as well as mothers. In fact, paternal postpartum depression in the first 12 months following delivery is not uncommon and is associated with maternal postpartum depression. Postpartum depression can interfere with maternal-infant bonding and adversely affect child development leading to emotional and behavioral problems in the child. Marital discord can be a consequence as well as risk factor. It is well established that depression and marital strain exacerbate each other. Sadly, postpartum depression can lead to suicide or infanticide. Treatment for postpartum depression varies according to severity of symptoms and may include behavioral therapy, counseling, medication, and in the most severe cases, hospitalization. If you or someone you know seems to be showing symptoms of postpartum depression, please do not hesitate to bring it to the attention of a medical provider. You could save a marriage, a child’s well-being, or even a life!
To take charge of your health or if you would like more information, contact me or any of our OB/GYN team at The Jackson Clinic, 731-422-0213 or www.jacksonclinic.com.