Prenatal & Postpartum Depression
Before you read on, please understand that prenatal and postpartum disorders are very treatable. Most women experience a full recovery if they receive the proper treatment from healthcare professionals that have experience and understanding of the specific nature of these disorders.
Did you know that the most common complication following the birth of a baby is Postpartum Depression (PPD)? There is no female who is immune to this. Women of any age, race, culture or income level can develop prenatal or postpartum depression. Symptoms may appear any time during pregnancy or the first year postpartum and can last up to two years after the birth of a child.
We are taught and believe that pregnancy is supposed to be a happy, wonderful experience. However, about 15-20% of pregnant women experience a depressive episode. It is sometimes difficult to know whether the pregnant woman is just experiencing symptoms of pregnancy, i.e., irritability due to discomfort, fatigue, etc. The main way to assess mood and anxiety issues is related to functioning. Do the symptoms interfere with the woman’s typical day-to-day functioning? If so, assessment is important for the health and well being of the mother and the baby.
Baby blues are experienced by 80% of women. Symptoms include: sadness, crying easily, moodiness, anxiety and worrying, loss of confidence, feelings of inadequacy and dependence. These symptoms usually remit by the third week postpartum. If symptoms continue past this time, the women may be experiencing the onset of Postpartum Depression. PPD is typically slow and insidious with peak intensity between the second and third month.
What women may not know is that 70% of PPD cases involve some type of anxiety or agitation. Many times PPD is not a vegetative, flat depression. That is why many women will say “I’m not depressed” but they feel as if they are jumping out of their skin or that they want to punch a wall. Although the term “Postpartum Depression” is typically used, there are actually several forms of illnesses that can occur during pregnancy or postpartum including: Anxiety, Panic Disorder, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder and Psychosis. These disorders may also overlap. Symptoms of prenatal or postpartum disorders may include: changes in appetite, insomnia or fragmented sleep, frequent crying, mood swings, fatigue, irritability, loss of sexual interest, negative, scary or intrusive thoughts, physical agitation, intense anxiety or panic attacks, loss of concentration, feelings of inadequacy and worthlessness, feelings of anger, shame or guilt, thoughts of harming self or baby. Postpartum psychosis occurs in 1-2 per 1000 births and is very serious. Symptoms can include hallucinations, delusions, inappropriate emotions and disturbance of consciousness. Onset of symptoms are usually two to three days postpartum.
It is important that women understand the risk factors associated with prenatal and postpartum depression so that they may be informed and prepared. Risk factors related to Postpartum Depression include:
- A previous postpartum episode
- Unstable relationship or marriage
- History of mood or anxiety disorders
- Hormonal difficulties such as; PMS, PMDD, fertility issues, thyroid problems
- Family history of PPD
- Family history of anxiety, depression, bipolar disorder, psychosis, alcohol or drug abuse
- Unwanted pregnancy
- Difficult pregnancy and/or birth including c-section
- Premature or compromised baby
- Baby with difficult temperament or colic
- Victim of abuse or assault
- Major stressful events in two years prior to birth
- Multiples (5x more likely)
- Lack of familial or social support
- Perfectionistic, high control, self-critical or rigid personality style
- Older than 30 or career woman
- History of miscarriage or abortion
If you or anyone you know is experiencing any of these symptoms, please seek the advice of your physician, healthcare professional and a mental health professional familiar with these disorders. It is very possible to prevent PPD or further suffering if we identify symptoms as soon as possible.