by Kimberly Allen, RN
Most expectant parents are somewhat prepared for the excitement and joy as well as the anxiety and fear that come with the birth of a new baby. Few, however are prepared for depression. Postpartum (PPD) is a type of clinical depression that can affect both men and women, though it is more common in women. PPD has been determined to be the most common problem related to childbirth. Studies indicate that at least 10%-20% of new mothers as well as approximately 10% of new fathers, especially first time fathers, develop PPD worldwide. In the US, in 1 out of 8 births the mother develops PPD which is approximately half a million women every year. A more severe form of PPD called postpartum psychosis affects approximately 1 out of every 1,000 new mothers. However, most experts believe these figures to be deceiving as they believe many cases, up to 50%, are not detected or reported.
Postpartum depression is not a weakness or character flaw, it is considered a complication related to childbirth. Many people think PPD only occurs after the birth of the first child but that is not true, it can develop after the birth of any child. Like other conditions there are certain things that can increase your risk of developing PPD. Anyone that has a history of depression whether during pregnancy or before and if you have had PPD after previous deliveries. Stressful events like complications with the pregnancy or the loss of a job can also trigger PPD. Other factors include problems in the relationship between the prospective parents, or if the pregnancy was unplanned and/or unwanted as well as financial problems can all increase your risk of developing PPD whether you’re a new mom or dad.
Drs have not been able to determine an exact cause for PPD but they do believe that in addition to the factors that increase your risk of developing PPD there are other changes that may contribute to PPD. After delivery there is a dramatic drop in the estrogen and progesterone as well as other hormones needed during pregnancy that are produced by the thyroid gland in a woman’s body. In addition to the sudden changes in the blood volume and blood pressure as well as in metabolism and the immune system. These changes can leave the new mother feeling very fatigued and depressed as well as having mood swings. In addition to the physical changes having a new baby brings other challenges, getting enough sleep for one. New babies just naturally bring anxiety, especially the first which can at times feel overwhelming, combine that with sleep deprivation and even minor problems can be difficult to handle. Drs believe that it is a combination of all these factors that cause PPD.
The symptoms of PPD can seem like a case of the “baby blues” in the beginning with anxiety and mood swings, irritability, sadness and crying but instead of resolving in a week or two they become more intense and don’t go away. In time the symptoms can prevent you from caring for your baby as well as coping with other activities of daily living. People with PPD have difficulty bonding with their new baby, some are even unable to hold their new baby. Many hve thoughts of harming either themselves or their baby. Some experience feelings of anger, guilt, shame, or inadequacy and withdraw from family and friends.
Treatment varies depending on the severity of symptoms as well as the individual needs of the new parent. It is most frequently treated with a combination if medications and counseling. Antidepressants have been shown to effectively treat PPD, however if you’re a new mother that is breastfeeding be sure to inform your Dr as there are medications that can be used while breastfeeding without putting your baby at risk. Some Drs may also give estrogen replacement therapy to counter act the sudden drop in estrogen that comes after childbirth. Counseling is recommended for all new parents suffering from PPD. Counseling can help new parents set realistic goals. PPD will usually resolve with in a few months when properly treated. It’s important that you continue your treatment even after you start feeling better because stopping treatment too early usually leads to a relapse.