Postnatal Depression - Types, Causes, Prevention & Management

Postnatal Depression or Postpartum Depression is the feeling of sadness or acute hopelessness following the birth of a child. The condition often presents itself within a year of giving birth and needs immediate care and treatment for effective recovery. The heightened emotions that come from the excitement of childbirth also trigger severe depression in some new moms calling for treatment and counselling.About 15% of the mothers may experience severe emotional upheaval with symptoms starting after child birth (even later in some cases) and lasting up to two weeks or more.

Signs & Symptoms of Postpartum Depression

The first step to recovery starts with recognizing the various manifestations which include but are not limited to -

  • Severe Mood Swings
  • Excessive Crying
  • Isolation
  • Trouble Bonding with the Baby
  • Loss of Appetite or Binge Eating
  • Insomnia or Excessive Sleeping
  • Extreme Fatigue
  • Constant Irritability
  • Anxiety and Hopelessness
  • Feeling of Inadequacy
  • Panic Attacks
  • Thoughts of Harming Self or the Baby
  • Persistent thoughts of Suicide or Death

Types of Postpartum Depression

Postpartum Depression can present itself differently to different individuals. There are different types based on their severity, risk factors, symptoms, and treatments. Treatment for each type may vary and it is extremely important to have a candid discussion with your Gynaecologist and get the help you need.1. Postpartum BluesPostpartum blues are commonly known as Baby Blues.  Baby blues may cause the mother to feel fatigued, sad, and worried. This is very common with almost 85 percent of new moms experiencing it. This usually fades within two weeks of childbirth and is considered normal given how common it is.2. Postpartum AnxietyPostpartum Anxiety often goes undiagnosed as new moms are expected to be anxious for their babies. However, the condition is characterized by fears and worries that are persistent, extreme stress, and an inability to relax. While the symptoms usually only last a few weeks, it may vary depending on the individual.3. Postpartum Obsessive-Compulsive DisorderAbout 3 to 5 percent of new moms may experience Postpartum OCD where they have intrusive thoughts that are persistent. Repetitive cleaning or changing the baby are common symptoms of postpartum OCD. Some may even have persistent thoughts of harming or even killing the baby. Mothers are aware of and usually do not act upon these thoughts. But since disclosing these thoughts can be embarrassing for most, the condition often goes unreported.4. Postpartum Panic DisorderThis mood disorder is seen in about 10 percent of new mothers and can bring bouts of anxiety and panic attacks. Symptoms include chest tightening, shortness of breath, heart palpitations, and excessive worry about losing control. Women with a history of panic attacks or thyroid dysfunction are at risk of Postpartum Panic Disorder.5. Postpartum Post-Traumatic Stress DisorderPostpartum PTSD may be a result of a real or perceived threat to the mother. Incidents such as birth complications, emergency C-sections, baby being admitted in the NICU, and other delivery injuries can be traumatic. Reliving these traumas through memories and flashbacks, panic attacks, and other symptoms can be noticed in women with Postpartum PTSD.6. Postpartum PsychosisIn extremely rare cases, new moms may develop postpartum psychosis which is characterized by extreme mood disorders. It can include hallucinations, confusion, poor judgement, delusional thoughts, and hyperactivity. This manic behaviour may resemble bipolar disorder and women with a history of bipolar disorder are at a greater risk of developing Postpartum Psychosis.

Causes & Risk Factors for Postpartum Depression

The Causes of Postpartum Depression are almost always linked to physical or emotional issues and the dramatic change and fluctuation of hormones that occur after childbirth, triggering fatigue and depression. Since the infant is totally dependent on the mother to thrive and survive, caring for a baby and fulfilling related tasks and requirements can be very overwhelming leading to sleep deprivation and anxiety which manifests as Postpartum Depression.Some of the Risk Factors that have been traced back to Postpartum Depression include -

  • History of Depression
  • Prior Instance of Bipolar Disorder
  • Postpartum Depression during a previous Pregnancy
  • Trauma or Extreme Stress in the past
  • Difficulty in Breastfeeding
  • Baby With Health Problems or Special Needs
  • Multiple Births
  • Weak Support System
  • Financial Trouble
  • Relationship Issues

Treatments for Postpartum Depression

The treatment is decided based on the severity of the condition and your individual needs. It is imperative that you see your doctor as soon as you notice or observe any Signs or Symptoms.1. MedicationAntidepressants are often used to treat the condition to regulate your mood by altering chemicals, but often take time to show effects. It may be weeks before you see improvement through medication. Certain medications may also have side effects like increased fatigue, dizziness, and decreased sex drive.

No Treatment should be started without a prior discussion with your Gynaecologist about its side-effects.

Not all antidepressants are safe for breastfeeding mothers. Make sure that your doctor knows if you are breastfeeding. If your Postpartum Depression is caused by low levels of estrogen, your doctor may prescribe hormone therapy.2. CounsellingCounselling can help keep you develop practical strategies to handle your moods and emotions. A certified mental health professional like a Psychiatrist or a Mind therapist can provide dedicated counselling for Postpartum Depression. A combination of Medication & Counselling when used together  is very effective in managing Postpartum Depression. 3. Self-CareSelf-care requires a careful balance of time by yourself and support systems. It is important to have an open and honest conversation with your family or friends about what you’re going through and what you need to get better. Be sure to ask for help when you need it rather than taking on more responsibility than you can handle.Some of the essential aspects of self-care include eating a healthy diet, exercising regularly, and getting adequate sleep. You can also join a support group for new mothers to talk to women who are experiencing similar conditions.

Can Postpartum Depression be prevented?

Although there are no concrete or sure-shot ways to prevent Postpartum Depression, there are a few things you can do or steps you can take, like maintaining a healthy physical and mental lifestyle, to minimize, manage and abate any triggers causing it.1. Before ChildbirthIf you have a history of mental health conditions or trauma or anyone in your family has had a history, you should talk to your doctor when you know you’re pregnant or if you’re trying to get pregnant. Your doctor can carefully watch out for any signs and symptoms through regular monitoring. You may even be required to fill in a depression-screening questionnaire during your pregnancy and after your delivery.If any signs are noticed, antidepressants may be prescribed during pregnancy along with a recommendation to join and be a part of support groups to manage the condition.2. After ChildbirthA postpartum check-up or screening may be conducted to detect signs of Postpartum Depression. This is done so as to start treatment as early as possible to reduce symptoms. If you’ve had a history of Postpartum Depression in your earlier pregnancies, you may be started on antidepressant treatment or recommended therapy as soon as you deliver.Postpartum Depression is a serious condition, but can be managed when treated promptly. The ideal management for Postpartum Depression is a combination of practicing self-care along with seeking professional help from your Gynaecologist and a Mind Therapy expert. Postpartum Depression is not a reflection of who you are. Do not be embarrassed to talk about it or seek help when you see the signs and symptoms. Getting the right treatment at the right time is important for you and the baby's health. Schedule an online consult with a professional and credentialed Psychiatrist or Therapist to make it through this difficult stage and experience the joy of motherhood.

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