Postpartum Depression: Causes, Risks and Treatment at UPMC in Central Pa.

Approximately 1 in every 7 women will get a perinatal mood or anxiety disorder like postpartum depression or anxiety. These illnesses are not normal, but they are very common. Seventy to 80 percent of new moms may feel depressed, anxious or even angry a few days after giving birth. These “baby blues,” as they are called, are normal and they usually go away within a week or so without treatment.

For some women – more than 10 percent of mothers -- postpartum depression (PPD) is a serious disease that can last a year after childbirth. It can interfere with a mother's ability to take care of and bond with her baby, as well as harm the child’s development and safety. In rare cases, new mothers have harmed themselves and/or their babies.

For the good of the mother and her new baby, it is crucial to identify and treat PPD as quickly as possible.

What Causes Postpartum Depression?

No one knows what triggers postpartum depression (PPD). It probably does not have a single cause. It likely results from a combination of physical and emotional factors. It’s important to know, though, that postpartum depression does not occur because of something a mother does or does not do.

According to the National Institute of Mental Health, after childbirth, the levels of hormones (estrogen and progesterone) in a woman’s body quickly drop. This leads to chemical changes in her brain that may trigger mood swings.

Also, many new moms find it difficult to get the rest they need after giving birth. Sleep deprivation can lead to body pain and exhaustion, which may also contribute to the symptoms of postpartum depression.

Know the Risk Factors of Postpartum Depression

All pregnant women are at risk for PDD, regardless of age, race, ethnicity, or economic status. But you are more likely to develop it if you or someone in your family has had depression or if you previously suffered from postpartum depression.

According to the National Institute for Mental Health, other risk factors include:

• A stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness.
• Medical complications during childbirth, including premature delivery or having a baby with medical problems.
• Mixed feelings about the pregnancy, whether it was planned or unplanned.
• A lack of strong emotional support from your spouse, partner, family, or friends.
• Alcohol or other drug abuse problems.

Baby Blues vs Postpartum Depression

As noted before, many women suffer from temporary “baby blues.” But it’s important to know the difference between "baby blues" and postpartum depression so you can seek appropriate treatment.

The baby blues last from a few days up to two weeks with milder symptoms like:

• Mood swings
• Sadness and/or crying
• Feeling anxious and irritable
• Difficulty concentrating
• Difficulty sleeping

You may not have all the symptoms listed or even most of them. Postpartum Depression and anxiety are not “one size fits all” illnesses.

PDD last longer than few days. The symptoms are also more intense and may include:

• Severe change in appetite
• Extreme fatigue yet not sleeping
• Severe mood swings, including feeling irritable, angry and sad, but no joy
• No interest in pleasurable activities
• Low self-worth
• Withdrawing from loved ones, including baby, along with feelings of guilt or shame
• Having thoughts about hurting yourself or your baby
• Feelings of sadness, restlessness, anxiety, or hopelessness
• Trouble concentrating or remembering
• Changes in eating or sleeping habits
• Low energy
• Loss of interest in favorite activities
• Detachment from family and friends
• Persistent physical problems, such as headaches or an upset stomach

Many women experience significant postpartum symptoms. It is important to realize that these disorders are not self-induced. A woman cannot “pull herself together” any more than she could if she had the flu, diabetes, or any other physical illness. Some women experience these symptoms during pregnancy, following a miscarriage, or termination of a pregnancy. A woman experiencing any of these symptoms described should have a complete medical evaluation, including thyroid screening.

Figure Out Your Risk for Postpartum Depression

For high risk patients, treatment before giving birth can help lessen the negative effects or head off postpartum depression. If you are expecting or you already delivered your child, this assessment asks you questions to help you figure out your risk for postpartum depression.

Treatment of Postpartum Depression Is Critical

If you or someone you know is showing signs of postpartum depression (PDD), seek help right away. Left untreated, PDD can seriously harm a mother’s health. She may not eat well or lack the energy to care for her child. She may even start to think about hurting herself or her baby. Experts have also noted behavioral problems and developmental delays in infants whose mothers have PDD.

Some women, though, are too embarrassed to seek treatment. After giving birth, they think they should be feel joy, not sadness. But, as noted, postpartum depression is a common condition affecting more than 10 percent of mothers. You are not alone.

Treatment for postpartum depression is counseling, antidepressant medicine, or both:

• Counseling/Talk Therapy involves talking one-on-one with a mental health professional. The goal is to help the patient understand their feelings and to develop coping skills. Groups sessions are also a possible form of treatment.
• Antidepressant medications act on the chemicals in the brain that affect mood and its regulation. These medications are generally considered safe to use during breastfeeding, but a woman should talk to her health care provider about the risks and benefits to both herself and her baby.

In addition, support from the new mother’s spouse, friends and family are also very important. They can encourage her to talk with a health professional, offer emotional support, and help with caring for the baby or the home.

The professional, compassionate help for PPD is available at UPMC Central Pa. Psychological Associates. Call them at (717) 231-8360.

Postpartum Depression Resources

Postpartum Support International helps women suffering from postpartum depression find help and local services. Visit their website at www.postpartum.net or call their toll-free hotline at 800-944-4PPD (4773).

American Academy of Family Physicians offers a wide range of information on postpartum depression at this website.

U.S. Department of Health and Human Services, Office on Women’s Health has an excellent FAQ on postpartum depression on their website.

Dads Get Postpartum Depression Too

New research is finding that postpartum depression may affect up to one-quarter of dads, yet it goes unnoticed. A recent study reviewed the latest research to better explain how it affects men.

The researchers found that some men are more likely to develop postpartum depression. The risk factors include:

• A history of depression or anxiety.
• Having a partner who has a mood disorder.
• Lack of social support.
• Financial worries.
• Age – older men are more likely to be affected.
• Marital discord.

Men suffer from the same symptom of postpartum depression as women. However, it may not be as obvious as men are more likely to conceal their feelings. Additionally, postpartum depression in men may also start later, often after his partner already has it.

Treating Postpartum Depression in Men

Untreated, postpartum depression can cause marital and family problems. It can even affect the child’s growth and development. Fortunately, it can be treated.

Treatment for men is the same as for women: medicine, such as an antidepressant, and/or counseling. Treatment may focus on the cause of a man’s depression. For some, being a parent may feel overwhelming and they wonder if they are up to the task. Teaching parenting skills may boost dads’ confidence and reduce their depression.

New dads can also seek help at UPMC Central Pa. behavioral health. Call them at 717-231-8360.