Effects, Symptoms and Treatments of Postpartum Depression
Lori Ramsey

Depression affects an average 19 million Americans, and the vast majority of these are women. According to the World Health Organization (WHO), depression affected 20 % of the world's population in 1990. Included in these statistics, 6 % of those affected were men in the United States, and 12% were US women. Depression can stem from many different reasons - hormonal imbalances, diet, emotional stress, medical conditions, physical ailments, environment and postpartum (the time period after giving birth).

I spoke with Christine Harris, a psychology professor and author of 'The Pregnancy Journal' about post partum depression. Christine says "The vast majority of women, upwards of 85%, experience some kind of postpartum reaction." PPD is one of the ways that women suffer a reaction. Christine goes on to say, "Postpartum reactions have been identified into three categories in order of increasing severity- postpartum blues or baby blues, postpartum depression, and postpartum psychosis. Most commonly, mothers experience these reactions the first week after childbirth. (It should be noted that the symptoms of postpartum blues are typically less severe than the negative symptoms after other surgical procedures, that positive mood ratings after birth tend to be higher than negative mood ratings, and that depression is generally more common in the third trimester of pregnancy than in the first ten days postpartum.)

Baby Blues?

Most women have heard the term postpartum blues or baby blues. Christine says "postpartum blues involves depressed mood, tearfulness, irritability, and appetite disturbances. The best predictor of the postpartum blues is experiencing depression during pregnancy, having a night-time labor, and/or a history of sleep disruption in the latter stages. It tends to be intermittent and usually disappears without medication within 4 weeks."

Or Post Partum Depression?

How many new mothers suffer from PPD? According to Christine, "Postpartum depression affects 7-26% of new mothers and is characterized by feelings of sadness, fearfulness, and uncontrollable crying -- essentially, a clinical depression that follows childbirth."

There are different causes of PPD. "Postpartum depression may be caused by the sudden emotional, physical, and hormonal changes that accompany birth, as well as by emotional or situational factors. For example, unemployed women, those with lower occupational status, poor inner city women, and recent immigrants, particularly those who were not working or who had given birth to a second child, were found to be at higher risk."

The time that PPD lasts also varies. "In 6-10% of women, postpartum depression continues for six weeks; in 4% the depression persists for a year or longer," says Christine.

What about the treatments? According to Christine, "Treatment is generally recommended for persistent postpartum depression. However, only 1/3 of women who were depressed 12-18 months after childbirth reported seeking any form of professional assistance (each woman's case is unique, so medication for breastfeeding moms would need to be evaluated by each health care provider.)"

Symptoms of Post Partum Depression

In post partum depression the first step in recovery is recognizing the symptoms. Post partum depression is not to be confused with its evil counterpart - post partum psychosis. It was post partum psychosis that Andrea Yates, the infamous mother who drowned her five young children in Texas, suffered from. Post partum psychosis requires invasive medical therapy and treatments, while post partum depression can be more easily overcome. Post partum psychosis only affects one or two women for every one thousand who suffer from some type of post partum depression.

Symptoms of PPD include:


Persistent sadness or depressed mood
Loss of interest in ordinary activities, including sex
Decreased energy, fatigue, lethargy
Sleep disturbances - oversleeping or insomnia
Weight gain or loss, associated with eating habits
Lack of concentration
Feelings of guilt, hopelessness, worthlessness
Suicidal thoughts
Irritability and agitation
Excessive crying
Aches and pains that don't respond to treatment
Drug abuse

If you exhibit at least five of these symptoms, you may be suffering from depression. A visit with your doctor will aid in determining the diagnosis.

Traditional Medical Treatments for PPD

Two of the most common treatments for depression are the use of antidepressant medications, and psychological therapy. In the case of depression resulting from a medical condition such as hormonal imbalances, the imbalance is treated, and depression will cease.

Antidepressant medications are given if the depression is caused from emotional stress or chemical imbalances in the brain. These medications can be habit forming, and close monitoring is required. Usually, it's in the more moderate cases that these medications are administered, and therapy is often used in conjunction with antidepressants.

Psychological therapies are used when emotional stress or personal problems are the root of depression. Therapy helps the patient to better cope with situations, allowing the patient feel more control over their life. In mild cases, therapy alone can combat depression.

There are more radical treatments used for the treatment of depression, but these are used in very rare instances. Most often, medications, therapy, or a combination of the two, will successfully release a patient from the grip of depression.

Natural Treatments for PPD

For some women, just recognizing where the depression stems from, post partum hormonal imbalance, can be enough to help them understand why they are experiencing the depression and thus allow it to ebb away on its own. Post partum depression usually hits in spurts or small time frames. For me it was in the evenings and lasted a couple of hours for about two weeks. Knowing when this hits helped me to cope. Finally, one day I experienced it no more.

Other natural remedies can be used to combat the baby blues. Perhaps having Daddy or someone to watch the baby for an hour or two a day will be enough to bring about happy thoughts. Simply being allowed to venture out without baby in tow for a short time of self- pampering can be just what the doctor ordered. Do things that make you feel good, a walk in the park, shopping or shop-looking at the mall, a dessert with a friend, even a movie.

Another way of combating the blues is to go outside for fresh air. Spending a bit of time in the outdoors will help to clear your head and possibly stave off those depressive feelings. If it's winter time, put on a heavy coat and brave the brisk air anyway. Enlist the help of your household members to ease you through this. If Daddy is unavailable, enlist the help of relatives and friends. Even if you don't want to ask, chances are, if you do ask most people are more than willing to help. Sometimes just having company is enough, other times perhaps you need help with the care of the baby, or of older children or with household duties. Don't be afraid to ask for the help if you feel you need it.

There are also herbal and other natural remedies that may help to ease the symptoms of depression. As always, be sure to check with your Doctor first before taking any medications, including herbals.


Bee pollen
Ginseng
Skullcap
Oats
Rosemary
B vitamins, especially vitamin B6
St. John's wort
Breastfeeding your baby
Regular and sustained aerobic excercise

Talk to your Doctor

It's always important to seek the advice of your healthcare provider if you suspect you may be suffering from post partum depression. The advice listed in this article is for informational purposes only and should not replace the advice and care of your physician. If you suspect you may be suffering from depression, make an appointment with your healthcare provider. S/he will better be able to help you understand and diagnose depression, and what you can do to treat it.

Remember that depression is nothing to be embarrassed or ashamed about. It is an illness that needs to be treated-and can be!. In the case of Post Partum Depression (PPD), hormonal imbalances may be the cause, and can be detected and treated by your healthcare provider. Do not, under any circumstances, allow the condition to progress simply because you feel that it is your fault. PPD is a very real, very treatable condition that needs to be brought to your doctor's attention.

Lori Ramsey of Stages in Pregnancy

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