Postpartum Depression

Have you known someone, or maybe have been that someone who suffered from postpartum depression (PPD)? Studies show that PPD can affect about 10-15% of women. This may not seem like a lot, but with the high amount of births in the US alone (just under 4 million), this percentage equals a staggering high number of women who will have PPD (about 400-600 thousand). Like most things, this is probably under-reported as there are many women who go undiagnosed. As something that can severely impact a child’s life, why are people so opposed to learning about, and getting help for PPD? Those who don’t receive proper care will struggle with many issues, including the neglect and potential abuse of their offspring. It’s very important to be able to understand PPD and diagnose it quickly, know the correlation of parenting and a child’s future, and educate young women before pregnancy so they can spot the symptoms and seek help. 

Understanding Postpartum Depression

Most women aren’t properly educated on this disease because, like most things, we don’t really think it will happen to us. The fact is that PPD can affect women who have never shown signs of any other mental illnesses before. According to The Mayo Clinic, PPD is described as, “experiencing ‘the baby blues’ after childbirth, which includes: mood swings, crying spells, anxiety, and difficulty sleeping”. There is not one particular reason for PPD, but many factors that can play a role. After childbirth, there are so many physical changes with hormone levels, and when those levels drop tremendously, this can cause depressive symptoms. Emotions can also play into the depressive moods. When someone is sleep deprived, stressed, overwhelmed, even minor problems are escalated to become very difficult to manage. PPD can affect not only the mother, but the entire family. Fathers are also known to experience similar symptoms of PPD: irritability, anxiety, sadness, or fatigue. Fathers with a history of depression or who might struggle financially, are more likely to experience paternal PPD. One of the major effects of PPD in new parents during the first 3 months postnatal, is parenting practices. 

Correlation to Parenting Styles

In a study posted in Maternal & Child Health Journal, data is gathered from two separate PPD trials. It focuses on the connection between parenting practices and PPD. This study shows that mothers who were depressed were less likely to use a car seat, feed their infant enough fluids, put them on their back to sleep, or take their child to receive proper health care (Balbierz, Bodnar-Deren, Wang, & Howell, 2015).  Essentially, these children were more likely to be neglected by their mothers. In another study posted in the Online Brazilian Journal of Nursing, 51 postpartum women were gathered to identify potential role performance. Out of those women, it is discovered that 52.9% of them were identified to have ineffective role performance with anxiety, inadequate self-adaptation, and inappropriate self-control being among the top factors (Field, 2010). Some other factors that were associated with the high percentage were the economic status, stress, and lower levels of education. The symptoms that substantially interferes with a relationship between mother and child is anxiety and irritability (Cavalcanti, Marques, Guimarães, de Oliveira Mangueira, da Silva Frazão, and Perrelli, 2014). Both studies focus on the effect PPD has on the parenting style of the mother, but what about when that child grows up? What are the lasting effects on those children? If you read my previous post on ACEs, you will see how adverse childhood experiences can affect long-term health outcomes. Because of the connection to PPD and these adverse experiences, there is a strong correlation to PPD and overall health outcomes for children as well.

A study posted in the Archives of Women’s Mental Health suggests the increase in adverse outcomes in children relating to behavior, cognitive ability, and emotional functioning is linked to mothers with PPD (Sanger, Iles, Andrew, & Ramchandani, 2015). The why behind these risk factors is still being studied, and some studies can be inconsistent because not all children with depressed mothers will see the same results, it is just more common in those who have mothers who have experienced depression postnatal. Another factor could be due to the fact that trauma is subjective, and again, what one person would view as traumatic, may just be an experience that doesn’t affect them as much in the long term. There are so many ways that this disorder can change a child’s future, and if there is any way that future parents can become more educated on the matter before their child’s birth, it will be much easier for their families to recognize symptoms and get the help they need for their child faster. 

Here are some of the most common symptoms of PPD from The Mayo Clinic

Baby blues symptoms

Signs and symptoms of baby blues — which last only a few days to a week or two after your baby is born — may include:

  • Mood swings
  • Anxiety
  • Sadness
  • Irritability
  • Feeling overwhelmed
  • Crying
  • Reduced concentration
  • Appetite problems
  • Trouble sleeping

Postpartum depression symptoms

Postpartum depression may be mistaken for baby blues at first — but the signs and symptoms are more intense and last longer, and may eventually interfere with your ability to care for your baby and handle other daily tasks. Symptoms usually develop within the first few weeks after giving birth, but may begin earlier ― during pregnancy ― or later — up to a year after birth.

Postpartum depression signs and symptoms may include:

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you’re not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Restlessness
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Untreated, postpartum depression may last for many months or longer.

Postpartum psychosis

With postpartum psychosis — a rare condition that typically develops within the first week after delivery — the signs and symptoms are severe. Signs and symptoms may include:

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Excessive energy and agitation
  • Paranoia
  • Attempts to harm yourself or your baby

**Postpartum psychosis may lead to life-threatening thoughts or behaviors and requires immediate treatment.

If you have suicidal thoughts

If at any point you have thoughts of harming yourself or your baby, immediately seek help from your partner or loved ones in taking care of your baby and call 911 or your local emergency assistance number to get help.

Also consider these options if you’re having suicidal thoughts:

  • Seek help from your primary care provider or other health care professional.
  • Call a mental health professional.
  • Call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use their webchat on suicidepreventionlifeline.org/chat.
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone else in your faith community.

Please, if you think you are experiencing these symptoms after having a child, talk to your healthcare provider. This one small act can save your life, and your child from abuse, neglect, or even possible death. 

Additional Resources for PPD: 

  1. Postpartum Support International
  2. National Child & Maternal Health Education Program
  3. Action on Postpartum Psychosis
  4. PPD Info
  5. My Postpartum Voice
  6. Postpartum Progress
  7. Postpartum Depression

References

  1. Balbierz, A., Bodnar-Deren, S., Wang, J., & Howell, E. (2015). Maternal Depressive Symptoms and Parenting Practices 3-Months Postpartum. Maternal & Child Health Journal19(6), 1212-1219. doi:10.1007/s10995-014-1625-6
  2. Cavalcanti, B. C., Marques, D. R., Guimarães, F. J., de Oliveira Mangueira, S., da Silva Frazão, I., & Perrelli, J. A. (2014). “Ineffective role performance” nursing diagnosis in postpartum women: a descriptive study. Online Brazilian Journal Of Nursing13(2), 246-254.
  3. Field, T. (2010). Review: Postpartum depression effects on early interactions, parenting, and safety practices: A review. Infant Behavior And Development331-6. doi:10.1016/j.infbeh.2009.10.005
  4. Sanger, C., Iles, J. E., Andrew, C. S., & Ramchandani, P. G. (2015). Associations between postnatal maternal depression and psychological outcomes in adolescent offspring: A systematic review. Archives Of Women’s Mental Health,18(2), 147-162. doi:10.1007/s00737-014-0463-2
  5. The Mayo Clinic Staff. (2015, August 11). Postpartum depression. Retrieved October 09, 2016, from http://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/definition/con-20029130