Postpartum Depression, How Do You Know If You Have It?

Introduction

Bringing a new child into the family can be a joyous experience. Yet, many mothers find themselves feeling depressed for a long time following the birth. This mental illness, called Postpartum Depression, must be understood by any expecting mother. Learn below about what Postpartum Depression (PPD) is, and how it affects mothers and their family members.

      Table of Contents

(click on a question below to be directed quickly)

• How does pregnancy affect mental health?
• What is Postpartum depression (PPD)?
• What is the difference between PPD and “Postpartum blues” or “baby blues”?
• Is PPD the same as Perinatal Depression?
• Is it normal to cry a lot after having a baby?
• What are the causes of PPD?
• What are the symptoms of PPD?
• How soon after pregnancy does a woman get PPD?
• How long does PPD last?
• Does breastfeeding help with postpartum?
• Can you take antidepressants while breastfeeding?
• Does counseling help with PPD?
• Can men/father’s experience PPD?
• References

How does pregnancy affect mental health?

A lot of changes occur when a person is pregnant. Specifically, there are a lot of hormonal changes that occur. A recent study on Prevalence of Antepartum Depression funded by the National Institute of Health found that the changes in hormonal balances can predispose people to experiencing depression during their pregnancy.

What is Postpartum depression (PPD)?

Technically, there is not a separate diagnosis for postpartum depression. Rather, someone would meet the criteria for what is known as major depressive disorder (MDD).

The main difference is that the episode of MDD occurs within a year of giving birth. A researcher at the University of Illinois at Chicago stated that 10% to 20% of women will experience PPD within 6 months of delivery.

What is Postpartum depression (PPD)?

Technically, there is not a separate diagnosis for postpartum depression. Rather, someone would meet the criteria for what is known as major depressive disorder (MDD). The main difference is that the episode of MDD occurs within a year of giving birth.

A researcher at the University of Illinois at Chicago stated that 10% to 20% of women will experience PPD within 6 months of delivery.

What is the difference between PPD and “Postpartum blues” or “baby blues”?

Postpartum blues is not a very accurate term. The Journal of the American Medical Association reports that most people experiencing postpartum blues tend to feel happy overall. Rather, people who experience postpartum blues tend to be more irritable, cry more often, and feel more emotional.

The feelings associated with postpartum blues tend to peak 3 to 5 days after deliver. The development of postpartum blues is unrelated to having a history of depression, stressors, breastfeeding, or culture.

Is Postpartum Depression the same as Perinatal Depression?

Perinatal Depression is described as depressive symptoms that can begin during a pregnancy and last after the pregnancy. Postpartum Depression describes a depressive state that begins following a pregnancy. Aside from this difference, the symptoms and experiences are largely identical.

Is it normal to cry a lot after having a baby?

Yes, it is quite normal to cry after having a baby. It is also normal to feel sad for an unexplained reason. The rapid change in hormones makes it so that many people feeling more emotional and crying more often. However, it is important to notice if these symptoms do not reduce in frequency/intensity.

If they continue for more than 2 weeks you should start to consider seeking help. You should seek immediate medical attention if you have any thoughts of harming yourself or your child.

What are the causes of PPD?

There are a variety of factors thought to contribute to if a person develops PPD after giving birth. For one, the Journal of the American Medical Association states that the time in which PPD is thought to occur (4 weeks after birth) corresponds to the rapid hormonal changes, which they posited to contribute to vulnerability to depression.

Some other risk factors for developing PPD include a history of depression or history of premenstrual dysphoric disorder, high amount psychological/social stress, relationship conflict, and a lack of social support.

What are the symptoms of PPD?

Symptoms of Postpartum Depression are the same as for Major Depressive Disorder, with the additional criteria that the person has given birth in the past year. To meet criteria for MDD a person must experience at least 5 of the following symptoms for more than 2 weeks:

• Depressed mood or mood swings
• Lack of pleasure
• Sleep and appetite disturbance
• Difficulty concentrating
• Psychomotor disturbance (i.e. feeling like your moving through water, or feeling like you can’t sit still)
• Fatigue
• Feelings of guilt or worthlessness
• Suicidal thoughts

A review on PPD by the Journal of American Medical Association also states that people who experience PPD can experience a despondent mood, feeling inadequate as a parent, sleep and appetite disturbances, and impaired concentration.

Sleep disturbances are a regular part of being a new parent, in this situation a sleep disturbance tends to be characterized by difficulty sleeping even when the infant is asleep, and others have offered to care for the infant.

How soon after pregnancy does a woman get PPD?

As mentioned above it is normal to experience postpartum blues for a week or so after having a baby. You may have PPD if these feelings have lasted for more than 2 weeks after delivery.

If you notice you are experiencing any of the symptoms outlined above for more than 2 weeks consider seeking out support from a mental health provider or your primary care.

How long does PPD last?

How long symptoms will last will varies from person to person. An article from the journal of Research and Theory for Nursing Practice shows that there is a significant difference in depression scores from 4-6 weeks postpartum to 10-14 weeks postpartum.

This suggests that a lot of people experience a significant improvement in their symptoms in that timeframe.

Does breastfeeding help with postpartum?

It is always helpful to know if there are things you can do to help prevent PPD. Researchers from Texas Tech University found that people who breastfeeding reported significantly getting more sleep, better physical health, more energy, and lower rates of depression than mixed- or formula-feeding mothers.

However, an important thing to remember is that this does not mean you have to breastfeed to avoid getting PPD. There are a variety of other factors involved. You are the person best able to know what feeding method will work best your family and how to treat depression in your life.

Can you take antidepressants while breastfeeding?

Good news, you can take antidepressants while pregnant or breastfeeding. A researcher from the University of Illinois at Chicago states that there no reasons for a pregnant or lactating person to not take anti-depressants.

Antidepressants are often a significant component of treatment for depression and PPD. To be cautious, most guidelines focus on antidepressants that have been studied extensively, such as tricyclic or selective serotonin reuptake inhibitor (SSRI) antidepressants.

These antidepressants are also a popular option as they tend to have a higher rate of efficacy in women with relatively few side effects. One potential side effect to ask about is a general feeling tired effect.

Does counseling help with PPD?

More good news, counseling can help with PPD. The same article by the Journal of American Medical Association states that both individual and couples therapy are helpful at addressing PPD. If you or your partner are struggling with PPD consider reaching out for help from a licensed mental health professional.

Some have also found support groups for new mothers helpful.

Can men/father’s experience PPD?

It is not uncommon for men to also experience PPD. Researchers at Cornell University report that it is not known exactly how many fathers experience it, but estimate that 4%-25% of fathers experiencing PPD.

These same researchers also report that when partners have PPD fathers are more likely to experience it. The addition of a new member to the family can bring about a lot of feelings for everyone involved. Even if you did not have the baby you may still want to seek out additional support during this moment of transition.

Visit the National Institute of Mental Health for more information and research on Postpartum Depression (PPD). The Department of Health and Human Services also has information about mental health and substance abuse.

For information about Postpartum Psychosis, consider this resource from Postpartum Support International.

References:

Horowitz, J. A., & Goodman, J. (2004). A longitudinal study of maternal postpartum depression symptoms. Research and theory for nursing practice, 18(2/3), 149.

Kendall-Tackett, K., Cong, Z., & Hale, T. W. (2011). The effect of feeding method on sleep duration, maternal well-being, and postpartum depression. Clinical Lactation, 2(2), 22-26.

Kim, P., & Swain, J. E. (2007). Sad dads: paternal postpartum depression. Psychiatry (edgmont), 4(2), 35-47.

Miller, L. J. (2002). Postpartum depression. Jama, 287(6), 762-765.

Okagbue, H. I., Adamu, P. I., Bishop, S. A., Oguntunde, P. E., Opanuga, A. A., & Akhmetshin, E. M. (2019). Systematic review of prevalence of antepartum depression during the trimesters of pregnancy. Open access Macedonian journal of medical sciences, 7(9), 1555.

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