Postpartum Depression (Also Termed Perinatal Depression): The Journey to Motherhood Can Take a Toll, You Need Medical Help Sometimes

The news of a child being conceived or birthed is usually a cause for jubilation and celebration, but in some cases it becomes a nightmare for the parents involved.

Postpartum Depression (PPD), also referred to as Perinatal Depression (PD), refers to a major depression occurring during pregnancy and/or after childbirth. The National Institute for Mental Health recognizes the onset of depression to mostly begin during pregnancy. It is mostly characterized by extreme feelings of sadness and anxiety, indifference and low energy, and a general loss of interest in hobbies or activities previously enjoyed.

It is estimated that one in every seven women who have had a child experience Postpartum or Perinatal Depression (CDC, 2024). This indicates the wide prevalence of the condition amongst expectant and new mothers.

Hormonal, emotional, social, and financial changes that are commonly associated with pregnancy have been linked to this mental disorder. Certain changes, especially the sharp fall in hormones like estrogen and progesterone after birth, have been connected to PD/PPD. However, it is still unclear in what ways these changes affect mothers, leading to the development of major depressive episodes.

Certain factors have been considered contributors to the development of this condition. Genetics, limited support, socio-economic standards, mental and emotional stress are major factors predisposing to PD. The good news is, as severe as it can be, it is a treatable mental disorder and mostly requires various non-pharmacological approaches to manage and resolve.

Stages of Postpartum Depression

Baby Blues

An estimated 85% of all new mothers experience "baby blues," a condition that does not necessarily affect day-to-day activities. It is usually short-lasting and will generally not require medical attention. It is a short period associated with feelings of general sadness, anxiousness, and mood swings. It commonly occurs a few days after birth, usually peaking at day four. The new changes with a newborn can be overwhelming for mothers and are a major cause of conflicting emotions.

Postpartum Depression

One in seven women that have had a child is estimated to have experienced PPD. It is a severe form of depression that affects the day-to-day function of the mother affected. It is characterized by an overwhelming feeling of sadness and anxiety, feelings of unworthiness, and a general lack of interest. It lasts for a longer period and can last up to two years without meaningful intervention.

Postpartum Psychosis

Postpartum Psychosis, as the name implies, is characterized by major delusions and hallucinations. It is a rare form of PPD but can be extreme to the point of psychosis and poses a major threat to the mother and baby's wellbeing, as some mothers experience suicidal thoughts.

Signs and Symptoms

- Feeling sad, worthless, hopelessness, or gravity.

- Worrying excessively/feeling on edge.

- Loss of interest in hobbies or daily routine/activities.

- Appetite loss/change.

- Trouble sleeping or wanting to sleep all the time.

- Crying excessively.

- Difficulty thinking or focusing.

- Suicidal thoughts.

- Thoughts of hurting oneself or the baby.

Complications

Without timely intervention, PPD/PD can worsen with complications including:

- Chronic or long-term depression.

- Being unable to connect to the baby for a long time.

- Increased risk of suicide or thoughts of hurting oneself.

PPD can also affect the baby in the following ways:

- Behavioural or hearing disorder.

- Sleep or eating problems.

- Developmental delays.

- Underdeveloped language and social skills.

Seeking Help

PPD/PD is a medical condition and should be treated as such. Mothers experiencing this should feel safe to seek help and necessary attention. There is no shame in the experience; it is a mental disorder that should be given the attention it deserves.

It is important for family and friends to take into account the possibility of PPD/PD when the women in their lives suddenly become different after childbirth or during pregnancy, taking into cognizance the above-mentioned signs and symptoms. Healthcare providers also have a crucial role in educating and enlightening the public on PPD/PD and its signs and symptoms to enable timely referrals and intervention.

Treatment and Management

There are several treatment and management strategies, both pharmacological and non-pharmacological.

Many healthcare providers use the Edinburgh Potential Depression Scale to screen for PPD during pregnancy as well as during the PPD period. It is a diagnostic score scale consisting of 10 questions related to symptoms of depression, with higher scores indicating possible PPD.

Pharmacological Management

- Anti-anxiety medications.

- Antidepressant medications.

- Naturaceutical.

Non-Pharmacological Approach

- Psychotherapy or Cognitive Behavioural Therapy.

- Support groups.

In most cases, women suffering from PPD/PD will be managed with the combination of these management strategies. Underlying risk factors that can be modified to improve mothers' quality of life should also be considered.

Sometimes she's not being lazy or uninterested in taking care of her baby; she might need help—a medical one at that.