Postpartum depression (psychology)
Postpartum depression (PPD) is a mood disorder that affects some women after giving birth, characterized by prolonged feelings of sadness, anxiety, fatigue, and guilt. It can develop within days or weeks postpartum, with symptoms that can disrupt daily functioning. PPD is distinct from the more common "baby blues," which typically resolve within a few weeks and are characterized by transient mood swings and emotional instability. The risk factors for PPD include a history of depression, lack of social support, and stressful life events surrounding childbirth. Hormonal changes following delivery and psychosocial stressors are believed to contribute to the onset of PPD, although no single cause is universally accepted.
Treatment options for PPD often involve therapy and, in more severe cases, antidepressant medications. Social support and self-care strategies, such as physical activity and relaxation, are recommended for those experiencing milder symptoms. It is important for women experiencing symptoms of PPD to seek professional help, especially if symptoms persist beyond a few weeks. Awareness of PPD is essential for promoting mental health among new mothers and ensuring that they receive the support they need during this challenging time.
Postpartum depression (psychology)
- TYPE OF PSYCHOLOGY: Psychopathology
Postpartum depression is a type of mood disorder that some women face after giving birth. This disorder is characterized by feelings of sadness, fatigue, anxiety, and guilt. The treatment for postpartum depression includes therapy and, in some cases, antidepressant medications.
Introduction
Postpartum depression (PPD) has been a focus of research since 1970. Approximately 10 percent of mothers suffer from PPD, according to PostpartumDepression.org in 2024, though some studies reported that more than 14 percent of mothers experienced the condition. The disorder is defined as the onset of depression occurring within days or weeks after childbirth. Symptoms include sadness, frequent crying or tearfulness, loss of interest or pleasure in life, loss of appetite, loss of motivation, irritability, fatigue, anxiety, poor sleep, and feelings of hopelessness and guilt. While strong emotions are normal following childbirth, depression is characterized by long-lasting symptoms that are severe enough to be disruptive to one's usual functioning.
PPD can arise days, weeks, or even months after childbirth. The most common onset is within a few days of delivery, perhaps due to the hormonal changes that the body experiences. Some women acquire PPD two to six weeks postpartum due to neuroendocrine changes and lifestyle changes that accompany caring for the infant. No one theory accounts for all cases of PPD, but almost all researchers in this area agree on the importance of biological and psychosocial factors in the development of PPD.
For some people, symptoms of depression may begin during pregnancy and continue after delivery. Therefore, PPD is also known as peripartum depression.
Related Postpartum Emotional Disorders
There are several forms of psychiatric illness that can arise following childbirth. Postpartum blues or “baby blues” are the most common, affecting 50 to 75 percent of mothers after delivery. The symptoms, which generally begin on one to four days after childbirth, can include anxiety, mood swings from joyfulness to tearfulness, irritability, and sleep difficulties. Baby blues typically remit within a few days or weeks, unlike PPD, which is distinguished by being longer lasting and with more severe symptoms.
Another related disorder is postpartum psychosis, a serious psychiatric disorder that occurs two to four weeks postpartum and requires immediate professional attention. Symptoms of postpartum psychosis include hallucinations (such as hearing voices), delusions (bizarre false beliefs), and mania (hyperactivity, increased energy levels, rapid speech, and destructive impulsive behavior). A small number of women with postpartum psychosis experience obsessions having to do with harming themselves or their babies following delivery. In this instance, a differential diagnosis is important to assess the risk of harm to the mother and child.
Other postpartum emotional disorders include postpartum anxiety disorder, postpartum obsessive-compulsive disorder, postpartum panic disorder, and postpartum post-traumatic stress disorder, or postpartum PTSD.
Who Suffers?
The strongest predictor of PPD is any form of depression, especially during pregnancy, but any previous history of mood disorders elevates the risk of PPD. In addition, a lack of social support, mixed feelings about the pregnancy, an unplanned pregnancy, marital problems, or giving birth to a temperamentally difficult child all increase the chances of PPD. Furthermore, pregnant adolescents have a 30 percent chance of developing PPD. The majority of patients with PPD have a family history of mood or anxiety disorders. In general, stressful events that occur during pregnancy or delivery (such as illness during pregnancy, pregnancy complications, or a premature birth) increase the risk for developing postpartum depression. The risk of postpartum psychosis is higher for mothers who have bipolar disorder.
Causes of PPD
Theories about the causes of PPD stress the importance of biological and psychological influences, although no single agreed-on theory has emerged. One biological theory of the cause of PPD is that hormonal changes in the body after childbirth affect mood. Three days after childbirth, the hormones estrogen and progesterone show a sharp drop from their previously high levels during pregnancy, and these changes may induce chemical changes in the brain that play a role in causing depression.
Some psychosocial factors (such as ambivalence about the pregnancy or low social support) can serve to increase stress and undermine coping resources. The fact that a family history of mood disorders is predictive of PPD might suggest that certain people are biologically vulnerable, and the addition of negative psychosocial factors interacts with this vulnerability to produce PPD.
Treatment Options
There are several treatment options for PPD and its variations, which are generally similar to the treatment for other forms of depression. Most women who suffer from baby blues are advised to seek social support from their partners, family, friends, and doctors. Other recommendations for new mothers experiencing the baby blues are to stay physically active, to take time to relax, and to pursue activities that are enjoyable to them. However, because those with maternal blues are at higher risk of developing PPD, physicians should advise and monitor those patients in case their symptoms become more severe or last longer than a few weeks.
If the symptoms persist for an extended period of time, usually more than five weeks following delivery, patients are generally encouraged to seek psychotherapy or counseling. Through therapy, patients can explore their thoughts and feelings, receive help for interpersonal problems, set realistic goals and expectations, and learn strategies for coping with stress. Often, the therapy continues after the PPD is no longer present. With severe cases of postpartum depression, an antidepressant may be used to complement psychotherapy. Nursing mothers should discuss the risks of taking an antidepressant while breastfeeding with their doctor.
Postpartum psychosis requires immediate treatment. If the person with PPD experiences a psychotic reaction, then an antipsychotic medication is often warranted in addition to antidepressant drugs. Electroconvulsive therapy has also been recommended as an effective treatment for severe postpartum psychosis.
Bibliography
Department of Health and Human Services Office on Women's Health. "Postpartum Depression." MedlinePlus, NIH National Library of Medicine, 6 Aug. 2024, medlineplus.gov/postpartumdepression.html. Accessed 17 Dec. 2024.
Dunnewold, Ann, and Diane G. Sanford. Postpartum Survival Guide. New Harbinger, 1994.
Kleiman, Karen. Therapy and the Postpartum Woman: Notes on Healing Postpartum Depression for Clinicians and the Women Who Seek Their Help. Routledge, 2009.
Kleiman, Karen R., and Valerie Davis Raskin. This Isn't What I Expected: Overcoming Postpartum Depression. 2nd ed. De Capo, 2013.
Langdon, Kimberly, and Jenna Carberg. "Postpartum Depression Statistics." PostpartumDepression.org, 2 Apr. 2024, www.postpartumdepression.org/resources/statistics/. Accessed 17 Dec. 2024.
Moran, Rachel Louise. Blue: A History of Postpartum Depression in America. U of Chicago P, 2024. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=4007151&site=ehost-live. Accessed 17 Dec. 2024.
“Postpartum Depression.” Mayo Clinic, 24 Nov. 2022, www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617. Accessed 17 Dec. 2024.
“Postpartum Depression.” The American College of Obstetricians and Gynecologists, Dec. 2021, www.acog.org/womens-health/faqs/postpartum-depression. Accessed 17 Dec. 2024.
“Postpartum Depression.” OASH: Office on Women's Health, US Department of Health and Human Services, 17 Oct. 2023, womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression. Accessed 17 Dec. 2024.
Steiner, Meir, Kimberly A. Yonkers, and E. Eriksson, eds. Mood Disorders in Women. Blackwell Science, 2000.
Twomey, Teresa M. Understanding Postpartum Psychosis: A Temporary Madness. Praeger, 2009.