POST PARTUM DEPRESSION

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POST PARTUM DEPRESSION

• INFORMATION AND PREVENTION

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Training Objectives

• Define Baby Blues
• Identify causes and symptoms of Baby Blues
• Recognize ways mothers can cope with Baby Blues
• Define Postpartum Depression
• Identify causes and symptoms of Postpartum
  Depression
• Identify the differences between Baby Blues and
  Postpartum Depression

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• Identify the risk factors of Postpartum
  Depression
• Identify the symptoms of Postpartum Psychosis
• Identify the forms of treatment for women with
  Postpartum Depression and Postpartum Psychosis
• Identify ways women with Postpartum Depression
  can help themselves
• Identify ways loved ones can help women who have
  Postpartum Depression
• Identify Preventative Steps women can take

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Depression and New Mothers

• Having a baby can be both an exciting and
  thrilling time for any mother. However, it can
  also be a time when many new mothers feel
  overwhelmed.
• Nearly 10 percent of new mothers experience a
  distress known as postpartum depression.

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Baby Blues

• According to Kids Health, Baby Blues are
  feelings of sadness and surges of emotions that
  may occur in the first few days after child
  birth. A woman may feel happy one minute and then
  tearful the next. Baby Blues normally only last a
  few days, but can last up to two weeks.

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Signs and Symptoms of Baby Blues

• Crying
• Mood swings
• Anxiety
• Sadness
• Trouble sleeping
• Difficulty concentrating
• Irritability
• (Mayo Clinic)

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Causes of Baby Blues

• Baby Blues are believed to be caused by hormonal
  changes.
• Levels of estrogen and progesterone that have
  increased during pregnancy drop suddenly after
  delivery, and this can affect mood.
• These female hormones return to their
  pre-pregnancy levels within a week or so. Baby
  Blues usually resolve on their own without
  medical treatment.
• (Kids Health)

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Coping with Baby Blues

• According to Kids Health, new moms should try to
  accept help from family and friends in the first
  few weeks after labor and delivery. Family
  members can run errands, prepare meals, or watch
  the baby.
• Good nutrition and plenty of rest is important.
• Talking to other new moms or family and friends
  can help a new mom feel supported.
• If baby blues last longer than a week or two, a
  new mom should call her doctor to rule out
  postpartum depression.

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Postpartum Depression

• According the Mayo Clinic, Postpartum Depression
  may seem like Baby Blues at first however, the
  symptoms are more intense and longer lasting,
  eventually impacting a mothers ability to care
  for her baby.
• Women experiencing Postpartum Depression often
  feel much pain during a time that should be
  joyful. Many are reluctant to tell someone when
  they feel this way. Postpartum depression is a
  medical condition that requires attention and
  treatment.

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Signs and Symptoms of Postpartum Depression

• ?Insomnia
• ?Overwhelming fatigue
• ?Intense anger and irritability
• ?Severe mood swings
• ?Difficulty bonding with baby
• ?Lack of joy in life

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• ?Loss of appetite
• ?Feelings of shame, guilt, or
• inadequacy
• ?Withdrawal from family and
• friends
• ?Loss of interest in sex
• ?Thoughts of harming self or baby
• (Mayo Clinic)

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Causes of Postpartum Depression

• According to the Mayo Clinic, there may be a
  number of causes of Postpartum Depression.
• One such cause are physical changes. After
  childbirth, a dramatic drop in estrogen and
  progesterone may contribute to postpartum
  depression. The hormones produced by the thyroid
  gland may also drop sharply resulting in tired
  and depressed feelings. Changes in blood volume,
  blood pressure, immune systems and metabolism can
  lead to fatigue and mood swings.

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• Emotional changes can also cause Postpartum
  Depression. Many new moms are sleep deprived and
  overwhelmed, and may have trouble handling even
  minor problems. Moms may be anxious about their
  ability to care for a newborn. They may feel
  less attractive and feel they have lost control
  over their life. Any of these factors can
  contribute to postpartum depression.

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• Lifestyle influences can also be a cause of
  Postpartum Depression. These include
• A demanding baby
• Older siblings
• Difficulty breast-feeding
• Exhaustion
• Financial problems
• A lack of support from loved ones

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Risk Factors of Postpartum Depression

• Postpartum Depression can occur after the second
  or third child, not just the first. A woman may
  experience Postpartum Depression after the birth
  of each child.
• According to the Mayo Clinic, the following may
  be risk factors
• A history of depression, either during
  pregnancy or at other times

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• Postpartum Depression has been experienced
  after a previous pregnancy
• Marital problems
• Lack of a support system
• Stressful events have occurred in the past
  year, including illnesses, a difficult pregnancy,
  or loss of a job
• The pregnancy was unplanned or unwanted

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Postpartum Psychosis

• According to the Mayo Clinic, some women can
  develop a rare condition that develops within two
  weeks of delivery called Postpartum Psychosis.
• According to Kids Health, Postpartum Psychosis
  affects 1 in 1,000 women who give birth. It
  occurs within the first month after labor and
  delivery.

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Signs and Symptoms of Postpartum Psychosis

• Hallucinations and delusions
• Confusion and disorientation
• Paranoia
• Attempts to harm self and the baby
• The risk for Postpartum Psychosis is higher for
  those women with Bipolar Disorder.
• (Mayo Clinic)

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When to Seek Medical Advice

• If signs and symptoms of depression do not fade
  after a couple weeks, it is important for women
  to tell their doctors. If the depression is
  impeding them from doing every day tasks, it is
  very important to alert a physician.
• If a woman thinks she is developing Postpartum
  Psychosis, she must call a doctor immediately.
  This can lead to life-threatening behaviors or
  thoughts.
• (Mayo Clinic)

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The Importance of Seeking Treatment

• Without medical treatment, Postpartum Depression
  can interfere with mother and child bonding, as
  well as lead to family stress.
• According to the Mayo Clinic, children of mothers
  who have untreated Postpartum Depression are more
  likely to have behavioral problems, such as
  sleeping and eating difficulties, temper tantrums
  and hyperactivity. Another common problem are
  delays in language development.

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• Untreated Postpartum Depression can last for a
  year or longer. If left untreated, it can some
  times become a chronic depressive disorder.
• Even when Postpartum Depression is treated, it
  increases a womans chances of having future
  episodes of major depression.

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Treatment for Postpartum Depression

• According to the Mayo Clinic, Postpartum
  Depression is often treated with medication and
  counseling.
• Counseling can provide better ways to cope with
  feelings, solve problems, and set realistic
  goals. Talking to a psychiatrist, psychologist
  or other mental health professional can be
  helpful. Family or marital therapy may also be
  helpful.

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• Anti-depressants are a proven treatment for
  Postpartum Depression. Some anti-depressants can
  be taken with little risk of side effects to the
  baby if a mother is breastfeeding. A doctor can
  give the mother potential risks and benefits of
  specific anti-depressants.
• Hormone therapy may be used to treat Postpartum
  Depression as well. Estrogen replacement may
  help counteract the rapid drop in estrogen that
  accompanies childbirth. This may ease the signs
  and symptoms of postpartum depression in some
  women.

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Treatment for Postpartum Psychosis

• Treatment for Postpartum Psychosis must be
  immediate and often done in a hospital.
• According to the Mayo Clinic, when safety is
  assured, a combination of medications, including
  antidepressants, antipsychotic medications and
  mood stabilizers may be used to control signs and
  symptoms.

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• The Mayo Clinic lists electroconvulsive therapy
  (ECT) as being recommended as well. During ECT,
  a small amount of electrical current is applied
  to the brain to produce brain waves similar to
  those that occur during a seizure. The chemical
  changes triggered by the electrical currents can
  reduce the symptoms of depression, especially
  when other treatments have failed or when
  immediate results are needed.

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• A mothers ability to breast-feed can be
  challenged while being treated for Postpartum
  Psychosis. Mothers are separated from their
  babies and some medications used to treat
  postpartum psychosis are not recommended for
  women who are breast-feeding. However, a team of
  health care providers will help a mother work
  through these challenges.

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Helping Yourself

• According to Kids Health, there are small things
  women can do along with getting medical treatment
  for Postpartum Depression. These activities can
  include
• ?Read something uplifting and positive that
  can be read a bit at a time.
• ?Focus on things to look forward to during the
  day such as a hot shower, relaxing bath, or a
  visit with a friend.

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• ?Schedule a babysitter so that moms can have
  some planned time for themselves.
• ?Indulge in simple pleasures such as reading a
  magazine, sipping a cup of tea, etc.
• ?Spend time with family and friends for
  comfort and company.
• ?Ask for help whether it is for emotional
  support or help in caring for the baby.
• ?Accept help when it is offered.
• ?Rest when the baby sleeps.

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• ?Be optimistic and think of things to be
  grateful for.
• ?Be patient as it will take time to feel
  better.
• ?Join a support group. Doctors and womens
  centers should be able to put moms in touch with
  groups in their area.
• ?A daily walk can help to lift moods, but any
  new exercise program should be approved by a
  doctor.

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Helping Someone with Postpartum Depression

• Kids Health lists ways people can help their
  loved ones affected by Postpartum Depression.
  These activities can include
• Offer to go with her to the doctor, if she
  wants you to.
• Listen to her when she wants to talk.
• Check in with her regularly to see how shes
  doing.

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• Give her some breaks from child care and
  household responsibilities.
• Let her nap or take a relaxing bath, while
  you care for the baby.
• Make her a nutritious meal.
• Go on a walk with her.
• Be patient and believe in her. She will need
  to be reminded of her strengths and good
  qualities.

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Preventative Steps

• According to the Mayo Clinic, women with a
  history of depression, especially postpartum
  depression, should mention it to their doctor as
  soon as they find out they are pregnant. Doctors
  will monitor closely for signs and symptoms of
  depression. Sometimes mild depression can be
  managed with support groups, counseling or other
  therapies. In other cases, antidepressants are
  recommended (even during pregnancy).

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• After a baby is born, doctors may recommend an
  early postpartum checkup to screen for signs and
  symptoms of postpartum depression. The earlier
  postpartum depression is detected, the earlier
  treatment can begin. If there is a history of
  postpartum depression, a womans doctor may
  recommend antidepressant treatment immediately
  after delivery.

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For More Information, Visit these Websites

• Kids Health, http//kidshealth.org/parent/emotions
  /feelings/ppd.html
• The Mayo Clinic, http//www.mayoclinic.com/health/
  postpartum-depression/DS00546
• Medicine Net, http//www.medicinenet.com/postpartu
  m_depression/article.htm
• Family Doctor, http//familydoctor.org/online/famd
  ocen/home/women/pregnancy/ppd/general/379.html

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Missouri Department of Social Services State
Technical Assistance Team

• Address
• PO Box 208Jefferson City, MO 65102-0208
• Telephone [phone](800) 487-1626(8 a.m.
  to 5 p.m. CST, Monday Friday)
• Email
•  dls.stat_at_dss.mo.gov