Postpartum Depression: The Basics
Most people have heard of the “baby blues”, but the lack of awareness about the seriousness and varieties of postpartum depression is alarming. PPD is not a new disorder. Mothers have been experiencing emotional problems postpartum since the time of Hippocrates. The first medically documented case was by Dr. Jean E. Esquirol, a physician in France, all the way back in 18381. Although it is clearly not a new phenomenon, it is very misunderstood. Here I have compiled general facts from multiple sources to help promote general knowledge on the subject.
There are many factors that can play a part in the cause and development of postpartum depression. After birth, a woman’s body is going through drastic physical changes. Lowered immune system, changes in metabolism and blood pressure and volume, can add to fatigue and irritability. Significant decreases in estrogen, progesterone, and other hormones often leave women feeling sluggish and depressed. These physical changes come on top of the emotional upheaval some experience after giving birth which can including feeling overwhelmed or anxious about new responsibilities, sleep deprived, feeling unattractive, and a lost sense of identity. Lifestyle influences can also contribute to the causes of PPD. Some examples of this include: difficulty breastfeeding, financial hardships, lack of support from significant other or family, or a demanding baby2.
While it may not be obvious to those who have not experienced PPD first-hand, there are several characteristics that set it apart from general psychiatric illnesses. Postpartum depression can strike with no personal or family history of mental illness, which is rare for depression or anxiety unrelated to childbirth. The symptoms of PPD also tend to change rapidly and without warning and may include delirium, confusion, and hallucinations which are not typically observed with depression3.
Different sources recognize them with different names, but the five main types of postpartum depression are all broken down into roughly the same groups. Here’s a quick summary of each:
-Not considered a disorder
-Experienced by ~70-80% of mothers, around the first through fourth postpartum weeks
-Symptoms may include: being weepy, sad, anxious, troubles concentrating, feeling dependent
-Treatment: generally goes away with rest, avoiding alcohol, and connecting with other moms
Depression and/or Anxiety
-Experienced by ~15-20% of mothers, within the first year of childbirth
-Symptoms may include: irritability, very anxious, overwhelmed, sad, exhaustion, lack of feeling or emotion toward baby, decreased libido, feeling overwhelmed and guilty for feelings, hopelessness
-Experienced by ~3-5% of new mothers
-Symptoms may include: intrusive and persistent thoughts or mental pictures, thoughts of killing or hurting baby, sense of horror over these thoughts, behaviors to reduce anxiety regarding violent thoughts (such as hiding knives), counting, rechecking, and other repetitive behaviors
-Experienced by ~10% of women
-Symptoms may include: episodes of extreme anxiety, chest pain, shortness of breath, dizziness, hot or cold flashes, palpitations, numbness, restlessness, fear she is going crazy or losing control—all with no identifiable trigger
Treatment for postpartum depression, obsessive-compulsive disorder, and panic disorder often include (one or a combination of): counseling, antidepressants, or hormone therapy
-Affects 1-2 out of every 1000 mothers, about 2 or 3 days after childbirth
-Has a 5% suicide rate and a 4% infanticide rate
-Symptoms may include: visual or auditory hallucinations, delusional thinking (denial of birth, need to kill baby), delirium, mania
-Treatment: postpartum psychosis requires immediate treatment. If you or anyone you know is suffering from this, call 911 or seek medical attention right away.
What is really important to remember is that no one has to go through any form of PPD alone. There are countless resources and support groups available to help you or your loved one through a challenging time and make parenting the joy it ought to be!
Peer Mom Hotline: 1-800-PPD-MOMS
Online support group: http://www.ppdsupportpage.com/
International information and PPD support: http://www.postpartum.net/
1. Sebastian, Linda. Overcoming Postpartum Depression & Anxiety (Nebraska: Addicus Books, 1998), 10.
3. Roan, Sharon. Postpartum Depression (Massachusetts: Adams Media Corporation, 1997), 20-23.
4. Bennett, Shoshana and Pec Indman, Beyond the Blues. California: Moodswings Press, 2003.