Postpartum Depression

Postpartum Depression

Postpartum depression is a common and devastating complication of pregnancy that affects more than 20% of women in the USA within 6 months of their delivery.

    • Lifetime incidence of major depression is 1.7-2.7 timed greater for women than men
    • We believe that hormone fluctuations—associated with menstrual cycle,pregnancy,menopause contribute to the difference
  • During the pp period the range of depressive illnesses includes:
      - Postpartum “Blues”/ “Baby Blues” are characterized by mood instability, tearfulness, anxiety, insomnia, increased sensitivity, fatigue, usually resolves by pp day 10 ( EXPERIENCED BY 50%-80% OF WOMEN)- usually does not need pharmacologic therapy
      - Postpartum Depression: 10-20% of women, increased in teenagers, lower socioeconomic status
      - Depression, +++ obsessive compulsive disorder, panic disorder, phobias
      - obsess over well being of the infant
      - Usually requires psychotherapy and pharmacologic therapy.
      - Postpartum psychosis: 0 .1- 0.2% of ALL women after childbirth
      - requires emergent psychiatric hospitalization and treatment.
      - extreme mood lability, psychotic symptoms like auditory hallucinations and paranoia
      - women with Bipolar disorder are at increased risk.
      - onset usually 2-4 weeks after delivery
      - high risk infanticide and suicide (4%)
      - - may be hereditary
      - treated with antipsychotics, mood stabilizers, antidepressants, electic shock therapy
      - risk of relapse with successive pregnancy is 30-50%
  • SYMPTOMS OF MAJOR DEPRESSION:
      1. sad mood
      2. inability to enjoy activities
      3. changes in sleep
      4. changes in eating habits
      5. decreased energy
      6. inability to concentrate
      7. inability to make decisions
      8. psychomotor agitation or retardation
      9. feeling of worthlessness/guilt
      10. suicidal thought / thoughts of death
  • RISK FACTORS for PPD:
      1. history of PPD
      2. family or personal hx of depressive disorders or psychosis/ other psychiatric disorders
      3. marital dysfunction
      4. inadequate support during pregnancy
      5. depression during pregnancy
      6. negative life events during pregnancy
  • SCREENING:
      EDINBURGH Postnatal Depression SCALE
      - Easy to use
      - Use in third trimester – can predict women who are at risk for PPD
      -estimated 50 % of women with PPD are undetected
      - We can increase our diagnosis rate by 4-10% by using this on a regular basis with EVERYONE!
  • TREATMENT/ Prevention may include:
      - Psychotherapy
      - massage therapy
      - ECT
      - Pharmacotherapy (SSRI’s – watch in pregnancy!)- But sometimes we need to start them in pregnancy or right after delivery
  • Also:
      - Yoga, exercise
      - Marriage counseling
      - establishing more friends—esp. other pregnant women/ new moms
      - support groups
      - Mommy groups
      - Reaching out for help – it takes a village to raise a child!
      -church/ social groups

    • Edited and revised by Sherry VanGoethem, Dr.Christine Brass-Jones OBGYN, and Dr. Denise Quance Grobe N.D.

    For any questions or comments contact True Harmony at (480)539-6646 or through email at info@trueharmonywellness.com