What is "Postpartum Depression?"
What causes Postpartum Disorders?
How long do Postpartum Disorders last?
How do I get help?
What if my problems are minimalized or trivialized?

What is "Postpartum Depression?"

The Term "Postpartum Depression" is often casually and misleadingly used to describe a wide range of emotional and physical reactions that can occur after childbirth. As a result, normal adjustment and stress are often confused with more serious disorders. It is more important to understand that major depression after childbirth is only one of several major disorders that can occur after childbirth.

Types of Postpartum Depression include:

Baby Blues
This is a mild, short period of depression experienced by approximately 60 - 80% of all women within the first few days after delivery. Due to a sudden drop in hormones, a woman may feel weepy, exhausted, anxious and tense. If this continues beyond the first week or two after childbirth, it's not the "blues."

Normal Postpartum Adjustment
Becoming a new parent is considered a "life crisis" from a developmental perspective, and a certain amount of stress after childbirth is considered normal. Normal postpartum adjustment may involve symptoms similar to the blues, and it is likely that most new mothers experience some of these symptoms during the first few months after childbirth. However, if these symptoms are interfering with mom's normal coping abilities, functioning and parenting, something more serious may be happening.

Postpartum Depression
At least 10-20% of new mothers develop a moderate to severe depression or "postpartum" depression (PPD) that can occur anytime during the first year of postpartum. Many women experience PPD sometime between the 3rd and 9th month postpartum-- not only during the first "six weeks" immediately after childbirth. Some of the symptoms may include sadness and weepiness for no apparent reason, unexpected highs and lows, anxiety, sleep and appetite disturbances, scary thoughts, and a general feeling that something isn't right. PPD can happen to anyone and can be experienced by women with no prior history of psychiatric illness. It is important that a mother experiencing PPD understand that it's not her fault or a "character defect."

Anxiety Disorders
Anxiety seems to be a common symptom among all postpartum disorders and will often be present along with PPD. However, some researchers have found that primary anxiety disorders may develop during the postpartum period or a pre-existing anxiety disorder may worsen at this time. Insomnia, not be able to sleep when the baby is sleeping, can be a sign of an anxiety disorder.

Some researchers have reported that panic disorder can occur for the first time in the postpartum period in the absence of major depression. Postpartum panic disorder involves full-blown panic attacks that occur for the first time during the postpartum period. The symptoms may include heart palpitations, hot or cold flashes, chest pain, shaking, dizziness, and fear of losing control of going crazy. These attacks are marked by sudden increase in anxiety and may include many or some of these symptoms.

The development of postpartum obsessive-compulsive disorder and obsessive-compulsive symptoms can also be common during the postpartum period. These symptoms may occur with or without postpartum depression. However, postpartum obsessive-compulsive disorder is often experienced as a strong visceral sensation (i.e. butterflies), followed by obsessive and intrusive thoughts. These thoughts may include thoughts about harming the baby. In order to cope with these thoughts, many women engage in avoidance behaviors.

Postpartum Psychosis
This is the most severe form of postpartum distress and afflicts approximately 1 - 2 per thousand new mothers. The onset of postpartum psychosis (PPP) is usually early, within the first three weeks after childbirth. The symptoms may include religious or violent hallucinations, delusional thinking with periods of lucidity, and thoughts or attempts to harm the baby. A new mother experiencing these symptoms may be in grave danger, and requires immediate medical care.

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What causes Postpartum Disorders?

Although researchers do not yet understand all of the mechanisms involved, current research indicates that postpartum disorders should more properly be called biochemical and hormonal disorders or "neurotransmitter disorders." The brain's neurotransmitters are directly responsible for the way one feels. They are affected by heredity, hormonal changes, and environment. Situational stressors and psychological factors also play a role.

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How long do Postpartum Disorders last?

The good news is that with appropriate treatment, postpartum disorders are only temporary. Depending on the degree of severity and treatment modality, postpartum depression can last from a few months to up to a year. Long term studies have shown that, without treatment, it can take up to 3 to 4 years to recover. If you don't seek treatment, your child will suffer. Research has shown that a mother's untreated mood disorder will negative affect her child's cognitive, physical and emotional development.

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How do I get help?

If you believe that you may be experiencing a postpartum disorder, it's important to contact your doctor immediately and discuss your symptoms. You should request to have a complete medical evaluation and blood work panel done.

Psychotropic medications are often helpful in treating women with postpartum disorders and women often recover more quickly with their use. A physician who knows what medications will help your symptoms should be consulted. There are medications that are considered safe for nursing mothers. The medications can take up to 2 weeks for you to notice an improvement.

You may feel a great need to talk to others in your situation who can help you sort out your feelings, problems and questions. Support groups can be an important source of help during this difficult time. The counselor should be someone who:

1.) has experience in treating depression

2.) is sensitive to the issues faced by parents around childbirth

Research has shown that accupuncture as well as exercise can be helpful in treating mood disorders.

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What if my problems are minimalized or trivialized?

Unfortunately, some health care providers may not receive adequate training in how to recognize and treat postpartum disorders. If, after any professional guidance, you find yourself still in the same situation, stop and listen to your instincts. You know yourself better than anyone else. Don't give up - The Postpartum Health Alliance can help point you toward resources and professionals that are educated about postpartum disorders in the San Diego area. Call us at (619) 685-7458.

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