Most people have, at least once, heard of mothers getting depressed after giving birth, getting suicidal or harming their loved ones. Postpartum depression (PPD) affects up to 10-15% of birthing people with onset in the 1st month after childbirth, without this being a strict rule. Researches show that PPD is usually under-recognized and under-treated and this can lead to Postpartum Psychosis. This article is here to provide all the basic information that parents, future parents, families and health professionals need to know in order to be prepared for the possibility.
Disclaimer: Midwifery is a very inclusive and safe space for everyone, where your identity and your needs are valid and important to us. Thus, the terms used in this article aim towards making everyone feel comfortable and included.
Uterus owner (person with a uterus, uterus having person) <--> Woman
Parent <--> father (dad), mother (mom)
Birthing person <--> mother (mom)
Pregnant (pregnant person) <--> mother (mom)
Breastfeeding (Breast) <--> Chestfeeding (Chest)
[if you feel that you are not included at any point, please contact us and help us change that]
© KAMPERI PARASKEVI, SOME RIGHTS RESERVED, 20/12/2020
Disclaimer: This article may trigger some unwanted emotions, so, if you find the topics of depression troubling, please do not continue reading.
Symptoms of PPD and
Symptoms should be present for more than 2 weeks in order for the disorder to get characterized as Postpartum Depression (PPD) and not to subside, but to worsen. Those could be:
Less Serious
Ø Severe fear
Ø Severe anger
Ø Diminished concentration
Ø Obsessive need for deserts and alcohol
Ø Irrational reactions
Ø Disturbance of sleep and appetite
Ø Loss of interest and energy
Ø Severe anxiety
Ø Depressed mood
Ø Loss of pleasure in activities
Ø Obsessive feeling of guilt
Ø Crying episodes
Ø Excessive fatigue
Ø Severe irritability
Ø Feelings of worthlessness
Ø Hyperactivity
Ø Confusion
Ø Suspiciousness
Ø Poor care of the baby
More Serious (mostly related to Postpartum Psychosis)
Ø Persecution mania
Ø Obsessive thoughts of harming the baby or the partner
Ø Suicidal thoughts and attempts
Ø Panic attacks
Ø Emotional rejection of the baby
Ø Pathological jealousy of the baby
Postpartum Blues (PB) are not PPD
Postpartum Blues (PB) or Postpartum Melancholia is sometimes getting confused with PPD, due to the likeliness of their early symptoms. Although, PB usually appears during the first 4 postpartum days, it can get vanished during the day and it usually stops after 1 to 2 weeks. Its symptoms are self-limiting with the supporting care and reassurance of the birthing parent. PB happens to 70-80% of birthing cis women (assigned women at birth and identifying as women) and there is no information yet about birthing transgender men. PPD is a disorder that needs proper treatment and psychiatric evaluation, when PB does not. Therefore, it is very important not to get them confused.
Causes of PPD
The exact causes of PPD are not known for sure yet, but there are several risk factors that have been correlated. These are:
Ø Marital conflicts during pregnancy and postpartum period
Ø Personal of family history of PPD
Ø Young maternal age (even more likely and worse during teenage pregnancies)
Ø Anxiety during pregnancy
Ø Poor nutrition
Ø Crowded living conditions
Ø Previous untreated or mistreated Major Depressive Disorder (MDD)
Ø Previous premenstrual dysphoria
Ø Sensitivity to hormonal fluctuations
Ø Stressful events during pregnancy and puerperium period
Ø Poor social and marital support
Ø Older child with difficulty of adaption or health problems
Ø Immigration or refugee status
Ø MDD during pregnancy
Ø Sleep disturbance during pregnancy and postpartum period
Treatment of PPD
Treatment of PPD includes psychiatric evaluation and counseling, medication and hospitalization if needed. Psychotherapy may be needed in some cases. Cognitive, behavioral and interpersonal therapy is proved to be very effective when we are treating PPD. Alternative therapies with medical herbs, nutritional supplements, massage, aromatherapy, chromotherapy and acupuncture can, also, be helpful. Antipsychotic medicines and lithium must be avoided during the breastfeeding period, because they pass through breast milk and can be harmful to the baby’s organism.
Conclusion
We have to acknowledge the fact that Postpartum Depression affects a lot of birthing parents and realize that it is not the monster with green eyes some of us think. We can all agree it can be dangerous for both the parents and the baby if not diagnosed and properly treated, but this can be the warning sign for correctly evaluating unusual behaviours during the postpartum period and not let them escalate.
We truly hope that this article helped you get informed about Postpartum Depression and Postpartum Psychosis, and realize the difference between them and Postpartum Blues. We strongly encourage you to contact us in whatever way suits you and discuss the article, suggest ideas for upcoming content, tell us your strong and emotional stories or for any other reason you would like.
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The “Being a Midwife” team
Bibliography
·Obstetrics and Gynecology, Beckmann, Ling, Herbert, Laube, Smith, Casanova, Chuang, Goepfert, Hueppchen, Weiss, Lippincott Williams & Wilkins Publications, 2018
·Maternity Nursing, 8th Edition, Lowdermilk, Perry, Cashion, Elsevier Publications, 2010
·Gynecology and Obstetrics, 3rd Edition, Dimitrios Lolis, Parisianou Scientific Publications, 2010
·Postpartum Depression, Pearlstein, Howard, Salisbury, Zlotnick, The American Journal of Obstetrics & Gynecology, 2009
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