Postpartum or perinatal depression is a type of depression that affects women following childbirth. It is one of the most common but serious medical conditions, which is usually not taken seriously. Postpartum depression can affect people of all age groups, gender, and sexual identities, and all types of parents and their partners, whether they birth, surrogate or adopt a child.
People should not take postpartum depression lightly. It is a severe disorder, but various treatment plans can help people overcome it. If you’re experiencing postpartum depression, you must know you’re not alone and can recover from it.
Birthing a child can trigger powerful emotions, from excitement and joy to fear and anxiety. Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety, and difficulty sleeping within the first two to three days after delivery and may last up to two weeks.
But some new moms experience a more severe, long-lasting form of depression known as postpartum depression. Rarely, an extreme mood disorder called postpartum psychosis also may develop after childbirth.
What leads to Postpartum Depression?
Postpartum depression (PPD) is a complex mix of physical, emotional, and behavioral changes in some women after giving birth. According to the DSM-5, a manual used to diagnose mental disorders, PPD is a form of major depression that begins within four weeks after delivery. Therefore, 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.
Postpartum depression is linked to chemical, social, and psychological changes that happen when having a baby. The term describes a range of physical and emotional changes that many new mothers experience. PPD can be treated with proper medication and counseling.
The chemical changes involve a rapid drop in hormones after delivery. The actual link between this drop and depression is still not clear. But what is known is that estrogen and progesterone, the female reproductive hormones, increase tenfold during pregnancy. Then, they drop sharply after delivery. Then, three days after a woman gives birth, the levels of these hormones drop back to what they were before pregnancy.
About 1 out of every ten women will develop a more severe and longer-lasting depression after delivery. About 1 in 1,000 women develop a more serious condition called postpartum psychosis. Dads aren’t immune. Research shows that about 1 in 10 new fathers get depression during the year their child is born. Postpartum depression isn’t a character flaw or a weakness. Sometimes it’s simply a complication of giving birth. If you have postpartum depression, prompt treatment can help you manage your symptoms and help you bond with your baby.
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Symptoms of Postpartum Depression
Symptoms of postpartum depression can vary from person to person and even from day to day. While symptoms can develop at any point after childbirth, they often start within 1 to 3 weeks after having a baby. But postpartum depression goes well beyond that, lasting for weeks after you give birth. Its symptoms can be severe and interfere with your ability to function. In addition, postpartum depression can make you feel disconnected from your baby.
Other indications of postpartum depression include:
- Feeling sad and hopeless
- Feeling overwhelmed
- Not having an interest in the baby
- Having no energy or motivation
- Sleeping too much or too little
- Having chronic headaches, aches, pains, or stomach problems
- Mood swings and irritability
- Anxiety and restlessness
- Reduced concentration
- Excessive crying
- Difficulty bonding with your baby
- Withdrawing from family and friends
- Loss of appetite
- Inability to sleep
- Too much fatigue or loss of energy
- Feelings of worthlessness, shame, guilt, or inadequacy
- Diminished ability to think clearly
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurrent thoughts of death or suicide
- Symptoms of obsessive-compulsive disorder (OCD) that are new may rarely occur in the postpartum period.
Untreated postpartum depression can be dangerous for a new mom and her baby. A new mom should seek immediate healthcare and help if:
- The symptoms prolong beyond two weeks
- She cannot function normally as before childbirth
- She cannot cope with everyday situations
- She has thoughts of harming herself or the child
- She feels extremely anxious, scared, and panicky all-day
Types of Postpartum Depression
There are three kinds of postpartum depression, depending on the severity of the symptoms.
- Baby blues or mild depression affects about 70% of women after childbirth. The symptoms are the same but mild, such as sudden mood swings, restlessness, anxiety, impatience, loneliness, and sadness. The baby blues may last only a few hours to 2 weeks after delivery. These symptoms disappear in a few days, and getting help from family members is sufficient.
- Postpartum Depression (PPD) may continue longer and affect the woman even months after childbirth. The symptoms are the same but more substantial. PPD affects a woman’s ability to go on with her routine life and childcare. Therefore, seeing a healthcare provider and getting proper treatment is necessary otherwise, symptoms might worsen, leading to psychosis.
- Postpartum psychosis is a severe mental disorder that affects new mothers and happens quickly within the first three months of childbirth. They tend to have hallucinations and become delusional and lose touch with reality. They also have insomnia, restlessness, and strange behaviors. Such a condition should be treated immediately and kept away from the child. They should also be isolated as they might harm themselves or others and medication usually helps to keep them calm and less agitated.
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Postpartum Depression in New Fathers
When a family welcomes a new life into their lives and home, it affects the mother and the whole family. It affects each of them in different ways. As the closest person to the mother and child, the father may also experience postpartum depression. They can also feel exhausted, sad, overwhelmed, and anxious due to many changes the newborn baby brings into his life, such as changes in eating and sleeping habits, financial stress, etc.
New and young fathers with a history of ‘‘depression” and financial and relationship problems are more at risk of developing postpartum depression.
Talking it out with your friends, family, or healthcare professional is essential. In addition, the treatments and support provided to mothers with postpartum depression can also be beneficial in treating postpartum depression in fathers.
Causes
There might be many reasons behind postpartum depression, especially physical changes, and emotional issues may add to the problem. However, some of the causes are:
- The sudden drop in estrogen, progesterone, and thyroid hormones after childbirth may make women depressed and sad.
- The mother may become exhausted and irritable from lack of sleep brought on by pregnancy, prolonged delivery, and constant breastfeeding.
- Anxiety with fear about the child and self-doubts about her ability to handle the newborn is one of the most common causes of depression.
- Image consciousness: childbirth can make you feel less attractive and may lead to a struggle with the sense of identity, or feel that you’ve lost control over your life. Any of these issues can contribute to postpartum depression.
Risk factors
Any woman can experience postpartum depression, which may develop after the birth of any child, not only the first. Not every woman experiences the same symptoms and has the same triggering or risk factors. Some of the common risk factors are:
- A history of depression before becoming pregnant or during pregnancy
- Young mothers are more at risk of developing postpartum depression
- The mother may become exhausted and irritable from lack of sleep brought on by pregnancy, prolonged delivery, and constant breastfeeding.
- A family history of mental disorders
- Under severe stress such as loss of job, marital or financial problems
- Already having a child with special care or health issues
- Multiple births, such as twins or triplets
- Lack of support or living alone
- History of postpartum depression after a previous pregnancy
- A newborn baby with health problems and difficulty breastfeeding
- Unplanned or unwanted pregnancy
Complications
If postpartum depression is left untreated, it may weaken the ability of mother-child bonding and cause many personal issues within the family and friends.
- For mothers: Postpartum depression may become a chronic depressive condition.
- For family: When a mother is depressed after childbirth, the risk of depression in the father may also increase. Likewise, the children, if any, may develop emotional and behavioral problems.
When to seek Medical Help
Feeling depressed after a baby’s birth is nothing to be embarrassed about, and it is wise to seek healthcare and support if you face any stress or other symptoms. However, if the symptoms are getting worse or if you have any extreme thoughts and other signs of postpartum psychosis, it has to be treated as an emergency.
Sometimes women with postpartum depression may not accept, recognize or acknowledge that they are indeed depressed. It is the duty of the family and loved ones to help them with accepting the fact and get immediate help.
Prevention and Management
- Most mild cases of postpartum depression can be managed with support groups, counseling, or other therapies.
- In some cases, if a woman is already depressed or has a history of postpartum depression during a previous pregnancy, antidepressants may be recommended even if she is pregnant.
- It is essential to inform your doctor about your depression if you are pregnant or planning to become pregnant.
- After childbirth, if there are any signs of depression, it should be taken care of immediately.
- The greatest option for the mother and child’s health is to seek treatment as soon as a condition is identified.
- Always ask for help, as it is nothing shameful to be embarrassed about childbirth.
- Try to relax, take short breaks and be realistic about your expectations for the baby.
- You can also try mild exercise, slow walking, yoga, and meditation with your doctor’s advice.
- Eat a healthy, nutritious diet.
- Avoid alcohol and caffeine.
- Make time for your partner, children, and family.
- Try to get a good sleep when your baby sleeps.
- Avoid doing everything by yourself; get help from your partner, family, and friends.
- Take time to visit friends or spend time with your partner.
- Talk about your feelings with your partner, supportive family members, and friends.
- Join a support group or a mothers’ group.
- Avoid making significant life changes right after giving birth, as it will lead to unwanted stress.
Postpartum Depression Treatment
- Postpartum depression is treated depending on the type of symptoms and their severity.
- Treatment options are anti-anxiety or antidepressant medications, psychotherapy, group therapy, etc. The medicines should be taken under the guidance of your doctor if you are breastfeeding.
- Hospitalization and isolation are needed for postpartum psychosis, along with psychotic drugs.
- Hormone therapy can also help to manage postpartum depression.
Homeopathic Medicines for Postpartum Depression
Homeopathic treatment can be an effective alternative to treat postpartum blues and depression or be used as a complementary medicine. It can be taken along with conventional medication and reduce its side effects. Homeopathic medicines are harmless but effective and mild and can be helpful throughout pregnancy and post-childbirth for new mothers and their children. Some of the homeopathic medicines that are useful in treating the symptoms of postpartum depression are:
- Sepia officinalis: Postpartum depression in women who suffer from severe sleeplessness and anxiety and are easily offended. There is sudden prostration with weak, empty, hollow feelings with suicidal thoughts. Aversion to sympathy. Irritability with indifference. Complete detachment from the spouse and baby. She wants to run from it all.
- Natrum muriaticum: One of the most used medicines in cases of postpartum depression in women. She wants to be left alone and refuses to ask for help but tries to manage it independently. Frequent mood swings. She hates sympathy and weeps alone—irritability with no desire to speak.
- Aurum metallicum: It is indicated for postpartum depression with great despair, anxiety, and disappointment. Very anxious about the future. Feel worthless and hopeless with suicidal thoughts.
- Kali carbonicum: It is helpful for postpartum depression with low spirit and anxiety as if they will lose their mind, weak memory, forgetfulness, restlessness, and sleeplessness. Extreme irritability with fear of being alone.
- Arsenicum album: It is indicated for women who are restless, anxious, and fearful. Fear of death is marked. The symptoms are worse at 3 a.m. There is a great flow of thoughts with fear and anxiety.
- Cimicifuga racemosa: Profound gloominess and sadness with a trapped feeling. Speaks incessantly with grief and disappointment, jumping from one topic to another. She may have had a long, exhausting labor with over- sensitiveness to the pain and significant afterpains.
- Pulsatilla nigricans: It is useful where there is great sadness and loss after childbirth. Very sensitive, vulnerable, and fluctuating moods. Craves attention and sympathy.
- Ignatia amara: Postpartum depression with sobbing and sighing, alternate laughing and crying. Grief over disappointed expectations.
- Anacardium orientale: Discouraged about the birth, blames others for her difficulties. Very easily offended. An irresistible urge to curse and swear. Feelings of separation from the world. She has no confidence in her ability to care for the baby. Suspicious of help offered.
- Belladonna: It is indicated for postpartum depression with violent temper and anger that comes and goes suddenly, along with the face turning red. The tantrums are associated with violent acts like biting, striking, or spitting on attendants. It is also of great help for women who want to run away, laugh excessively and tear things in fits of anger.
- Aconitum napellus: It is one of the best remedies for depression and anxiety, with a marked fear of death. The symptoms are worse in crowded places and extreme restlessness, making the person do everything hastily. Acute, sudden, and violent anxiety attacks occur with a marked fear of death. Open air makes the patient feel better.
- Natrum sulphuricum: It is indicated for suicidal thoughts and a feeling of worthlessness with depression in women after childbirth. Women who are very sad with an aversion to talking to others.
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Conclusion
The birth of a child is the most beautiful event in a woman’s life and a proud moment for the new parents. However, not all is well with every woman, new mother, and sometimes father. In some cases, childbirth can be a stressful event for some mothers, affecting the mother and the whole family. Such depression, which sets in after childbirth, is called postpartum depression. There’s no particular cause for this condition, but hormonal changes, physical changes, and emotional issues could be some reasons for postpartum depression.
The symptoms are sadness, weeping, anger, irritability, fatigue, loss of appetite, sleeplessness, anxiety, hopelessness, worthlessness, aversion to the company of family members and friends, thoughts of suicide, and even harming the baby. Depending upon the severity, it can be mild to severe, sometimes leading to chronic depression and psychosis. But the illness can be treated with support and help from family, friends, and the woman herself. Therefore, accepting the condition and getting proper treatment for a healthy mother-child and family bonding is essential!