Post Partum Depression & Other Post Partum
Mental Disorders
"Women who have postpartum depression love their children but may be
convinced that they're not able to be good mothers."
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Postpartum depression is a real, devastating disease. Affecting about 10% of new mothers,
it is different from the "baby blues" and from postpartum psychosis. Women who
have postpartum depression love their children but may be convinced that they're not able to
be good mothers. Women at higher risk for postpartum depression are those who:
- have had depression in the past or have a family history of depression
- have poor social support systems, and
- suffer complications of childbirth.
However, the disease can happen to anyone. Women with depression of any kind can be
treated with medication or with psychotherapy, or, in some cases, a combination of both.
Postpartum depression is different from the "baby blues" in severity, duration and
the debilitating effects of the illness on the mother and her children.
"BABY BLUES"
"Baby Blues" is a common reaction following delivery. It is a state of
heightened emotions that sets in a few days after childbirth and goes away within a week or
so all by itself. It is estimated that up to 70% of all new mothers experience this
emotional letdown, but it usually does not impair functioning. Symptoms can include crying
for no reason, irritability, restlessness and anxiety. It is thought to be caused by the
abrupt decline in the mother's hormone levels that occurs after the baby's birth.
POST PARTUM DEPRESSION
Postpartum Depression usually occurs within just days after the delivery, and can occur
up to a year later. Symptoms include:
- Sluggishness
- Fatigue
- Exhaustion
- Feelings of hopelessness or depression
- Appetite and/or sleep disturbances
- Confusion
- Uncontrollable crying
- Lack of interest in the baby
- Fear of harming the baby or herself
- Mood swings -- highs and lows
A woman experiencing postpartum depression usually has several of these symptoms.
However, the symptoms and their severity may vary from day to day. Usually the woman
experiencing these symptoms feels isolated, guilty and ashamed. She is often afraid to tell
anyone about her symptoms for fear she will be judged a poor mother. It is especially
painful to reveal the symptoms only to be told, "This should be the happiest time of
your life". Sufferers are aware of this but are suffering from a medical disease which
requires appropriate treatment.
POST PARTUM PSYCHOSIS
Postpartum depression can sometimes evolve into psychosis following a dramatic or
traumatic event. Postpartum mood episodes with psychotic features appear to occur in from 1
in 500 to 1 in 1,000 deliveries. Psychosis of Postpartum Depression is often characterized
by hallucinations directing the new mother to kill the infant, or delusions that the infant
might be possessed by evil forces. This may occur even in women without obvious depressive
symptoms. Infanticide is most often associated with postpartum psychotic episodes, but it
can also occur in severe postpartum mood episodes without such specific delusions or
hallucinations. The risk of a postpartum mental disorder with psychotic features is
increased for women with prior postpartum mood episodes. Women who have a history of having
had a non-pregnancy-related mood disorder such as depression or bipolar disorder (manic
depression) are also at a higher risk of having a postpartum mental disorder with psychotic
features. Once a woman has a postpartum mental disorder with psychotic features, the risk of
recurrence is 30-50% with each delivery.
OTHER POSTPARTUM MENTAL DISORDERS
Postpartum Anxiety or Panic Disorder is another example of postpartum psychiatric
illness. There are some women who, after giving birth, experience intense anxiety or
irrational fears. Symptoms can include rapid heart rate, dizziness and a sense of impending
doom. Another subset of women experience Obsessive-Compulsive Disorder after birth. This is
characterized by unwanted, disturbing, obsessive thoughts that may include harming the baby.
Often they may avoid the baby to alleviate these thoughts, and they may feel anxious.
TREATMENT
Treatment for postpartum psychiatric symptoms should include:
- Comprehensive psychiatric evaluation, including a complete medical evaluation to rule
out other, nonpsychiatric, physiological problems
- Psychotherapy
- Medication
- Support group
Many women suffering from postpartum depression require treatment with antidepressant
medication. There is increasing evidence that newer antidepressant medications do not harm
the fetus or the infants of nursing mothers. The possible negative effects of medication
have to be weighed against the real dangers of depression- the suffering of the mother and
her inability to properly bond with her infant-both of which have known long-term effects
for mother and child.
It is imperative that women being treated for postpartum depression or other postpartum
mental disorders continue with treatment even after they feel better, because if they stop
the treatment prematurely, symptoms can recur. In general, she should continue treatment for
at least 6 to 12 months, but should never discontinue treatment until after consulting with
her psychiatrist, because the course varies depending on each woman's unique situation.
Useful web site: Postpartum
Support International
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