Childbirth can trigger a mixture of emotions of joy and happiness, sometimes combined with anxiety or fear. Also, this may lead to something unexpected – depression. So, “How do I know if I have postpartum depression,” you may wonder!
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How Do I Know if I Have Postpartum Depression?
Postnatal depression, also known as PPD, consists from episodes of sadness that come from nowhere, and bring a bitter wave of disappointment mixed with depression and dark thoughts. These feelings can become overwhelming and can even eclipse the beauty of the first weeks of being a mother.
This kind of depression doesn`t mean you have something very serious, but rather that you shouldn`t treated superficially. It occurs at 15% – 20% of women..
Lots of mothers may feel a specific sadness (baby blues) after they given birth, which represents a normal emotional liability after birth. It manifests during the first few days, and includes crying for no apparent reason and sudden mood changes, but disappears relatively fast (around 3 weeks).
Still certain mothers may experience a more severe form of depression that lasts longer, and this is known as postpartum depression. Rarely, it may appear under the form of a depression known as postpartum psychosis. Postnatal depression isn`t a weakness of the mother, but rather a complication of childbirth. If you suffer of postpartum depression, it will be recommended to you a certain treatment so that your symptoms can be controlled and enjoy your newborn.
Causes of Postpartum Depression
This type of depression is mainly determined by significant and sudden hormonal changes that appear immediately after birth. Thus, the levels of female hormones, like estrogen and progesterone, drop strongly in the first few hours after birth. These drops may produce a depressive state, the same way as just small hormonal changes can trigger dysphoric moods and mental tension before a menstrual cycle.
Also, the thyroid hormone levels may decrease a lot after childbirth, developing a thyroid deficiency that can lead to depression. When starting breastfeeding the baby, the pituitary derepression and increase of prolactin level are also made based on the low level of dopamine in certain areas of the brain. The decreased dopamine is linked, as it`s known, with the appearance of depressive symptoms of anxiety and obsessive thoughts.
At the same time, the increased placental level of corticotrophin releasing hormone (CRH), during the week 25 of pregnancy, may be used as a marker of possible development of PPD, as shown in a recent study.
Pastpartum Anxiety Symptoms
Unlike “baby blues,” postpartum depression signs are more intense and last longer, being able to interfere with your ability of taking care of the child or any daily activities.
- Crying crisis.
- Lack of appetite.
- Irritability or anger.
- Extreme fatigue.
- Decreased desire of sex.
- Lack of pleasure.
- Feelings of guilt, shame or worthlessness.
- Severe mood changes.
- Child attachment difficulties.
- Thoughts that you`ll hurt the baby.
Depressive symptom will most often remain at a subclinical intensity, but should be monitored by a medical staff to intervene promptly when a clinic dimension is acquired.
Clinical cases of low intensity of PPD are similar to “baby blues,” but they are present for longer period of time (more than 2 weeks).
Risk Factors of Postnatal Depression
These hormonal changes can cause postnatal depression, especially when they are associated with other risk factors like:
- Previous history of depressive episodes (including bipolar disorder).
- Family history of depression.
- A mother who isn`t naturally breastfeeding.
- Poor socio-economic status.
- Unwanted/unplanned pregnancy.
- African race.
- Lesbian or bisexual mothers.
- No support from the partner, family or friends.
- Excessive postnatal stress.
Some authors deny the etiological importance of hormonal changes, arguing the fact that the PPD incidence is just as high among fathers, but with symptoms of lower intensity. – Check this out!
How Long Does Postpartum Depression Last?
If left untreated, this type of depression can last 1 or 2 years. Sometimes, an untreated depression may become a chronic disease. Even when the depression is treated, it represents a risk for the woman to suffer a future major depressive disorder. Children of mothers with untreated often experience:
- Behavioral problems.
- Eating or sleeping issues.
- They are hyperactive.
- Volcanic temper.
- Speech problems.
How to Treat Postpartum Depression?
Prompt treatment is important for both the mother and baby. The sooner is the treatment started, the faster will the recovery be, reducing the chances of recurrence of depression and the child`s development is less affected by the mother`s condition. Antidepressant medication and cognitive – behavioral therapy have proven equally effective for a lot of women. – More info!
Counseling and supportive therapy are considered a first-line treatment for postpartum depression of low and moderate intensity. Some studies show that the symptoms of this medical condition improve after the first session, and show a significant improvement after the first 6 sessions.
Breastfeeding offers a lot of emotional and physical benefits for both the mother and baby. For this reason, it was identified some safe antidepressants during breastfeeding. Therefore, it`s necessary to stop the process of breastfeeding during treatment with antidepressants for postpartum depression.
Whether the woman is breastfeeding or not, the doctor will most likely recommend a selective serotonin reuptake inhibitor; this class of drugs has proven to be quite efficient in women and with minimal side effects. Most tricyclic antidepressants can also be used during breastfeeding with minimal risk, but they tend to have several side effects. Due to the fact a woman after she`s giving birth tends to have an increased sensitivity to medication side effects, treatment should be started at a low dose.
Therefore, selective serotonin reuptake inhibitors are the first choice in terms of medication for this type of depression.
Usually, it takes a period of 4 to 8 weeks for the treatment to take effect, but some women may feel better sooner.
The treatment and healing time varies depending on the severity of the disease and certain individual features. As already mentioned, when given appropriate treatment, postnatal depression disappears rather soon. It`s important to continue the treatment even if you are feeling better. Stopping the treatment too soon may lead to relapse.
- Treatment with estrogens for postnatal depression has studied very little. Some women who used to take estrogens experienced improvements in health, but some of them used to take antidepressants in between as well, so it`s hard to know if the effect was exclusively due to estrogens. Therapy with estrogens is unlikely to become a common treatment for this type of depression, due to the increased risk of deep vein thrombosis and endometrial cancer. The concomitant addition of progesterone reduces the risk of endometrial cancer, but it`s known as a triggering factor for postnatal depression if is administered after childbirth.
- Therapy by light is another alternative method that exposes the patient to bright light (not the entire light`s spectrum, which also includes ultraviolet rays). Usually, a person who follows this kind of treatment will have to stay in front of a high-intensity fluorescent lamps (from 2.500 to 10.000 lux), increasing gradually the exposure until 1 -2 hours every morning. Although this type of therapy wasn`t yet sufficiently studied, this proven to be benefic for pregnant women and for winter depression (seasonal affective disorder), without serious side effects.
This depression isn`t an illness that you can treat by yourself, but you can do certain things to facilitate the treatment recommended by the doctor:
- Adopt a healthy lifestyle! Include regular physical exercises in your routine, like walking your baby, eating healthy foods and avoiding alcohol.
- Set yourself realistic expectations! Don`t force yourself to do everything on your own. Do what you can and give up on the rest. Ask for help when needed from people close to you.
- Make time for yourself! Dress yourself nice, get out of the house and visit a friend or spend time alone with your partner.
- Don`t isolate yourself! Familial support is important in combating this kind of depression: talk to your partner, family or close friends about what you feel. Ask other mothers about their own experience!