Eda Leshan once said, “A new baby is like the beginning of all things — wonder, hope and a dream of possibilities”. Nurturing a new life inside our bodies is the closest thing to a miracle.
Childbirth is the hardest and most rewarding experience of a woman’s life. As you bring your newest family member to your home, you bring joy, love and new excitement into your life. You fill your lives with happiness as you see the little one grow.
But did you know that the changes of motherhood can take a toll on your mental health? You must have heard about baby blues which are mild mood swings that occur for a few days after childbirth. However, some mothers can experience severe mood disturbances that are called postpartum depression (PPD) or postnatal depression (PND).
Because of the stigmas that surround mental health, postpartum depression is often considered an indicator of being an unfit mother, rather than a genuine problem. But it is so real that it is one of the most common complications of childbirth, affecting around 10–20% of mothers.
In this blog, we will learn about postpartum depression in detail starting with some of the basic questions like what is postpartum depression and why it happens.
We will also address some of the common questions like is postpartum depression a disability? Is there any treatment for it? etc, in an attempt to counter the stigma and start a larger conversation about the importance of the mental health of new mothers.
What are the common mood disorders in mothers after childbirth?
Childbirth represents a time when women undergo changes in their bodies, emotions and hormones that can take a toll on their mental health.
During the postnatal period, that is the time after childbirth, there is an increased risk of developing serious mood disorders. There are broadly three common types of postpartum mood disorders:
- Postpartum Blues, also known as maternity blues or baby blues.
- Postpartum Depression (PPD) or Postnatal Depression (PND)
- Postpartum Psychosis also known as Postnatal Psychosis or Puerperal Psychosis
Baby blues are common but not of much concern unless they develop into something serious. Sometimes, there may be a period of well being after which the symptoms worsen and gradually develop into postpartum depression. Postpartum psychosis is a rare but serious mental health condition that requires hospitalization.
Let us now examine what exactly postpartum depression is!
What is postpartum depression?
As we have already learned, postpartum depression is a mood disorder that affects women after childbirth. The symptoms usually start showing within four weeks of delivery and can go on for a year, unless treated properly.
It has an impact on the health of both mother and baby. Postpartum depression can be physically and emotionally weakening and lead to serious complications if left untreated which causes people to wonder, is postpartum depression a disability?…
Let us look at how PPD can present itself in mothers…
Postpartum depression symptoms
Postpartum depression symptoms gradually develop with time and commonly manifest as:
- Loss of energy or fatigue
- Loss of appetite
- Sleep disturbances
- Feelings of guilt, worthlessness or hopelessness
- Feeling like crying all the time
- Poor concentration and memory
- Withdrawal from society and family
- Thoughts of harming yourself or your baby
Women who are suffering from PPD feel like they are inadequate, ‘bad’ or unloving mothers. They worry excessively about their baby’s health or feeding habits. In extreme cases, postpartum depression symptoms can include suicidal tendencies, where mothers may want to harm themselves or even their babies.
By now, it is evident that PPD can be harmful if it is not diagnosed and treated properly. PPD can contribute to bonding issues and lead to sleeping and feeding problems for the baby.
Did you know?
Although women are mostly affected by this, sometimes even fathers can suffer from PPD! Some studies suggest that low vitamin D levels are linked to depression. Read our blog, “Keeping Vitamin D under check for a healthy conception“ to know more…
In case you have any of the above symptoms or any other concerning health condition, you can download the Zyla app or visit our website- Zyla.in. Zyla provides personalised treatment for your overall health management.
Before learning the diagnosis and treatment, let’s explore the scientific causes and factors that contribute to the development of this disorder.
Causes of postpartum depression
The exact causes of postpartum depression are still unclear but there are many possible theories. Any mood disorder is a very complex disease, and there are multiple factors affecting it: biological, genetic, environmental and experiential. Therefore, it’s likely that all these factors play a role in the development of PPD.
1. Hormonal changes
The most widely believed cause of postpartum depression is the hormonal changes that occur after pregnancy. There is a rapid decline of reproductive hormones like progesterone and estrogen, returning to prepregnancy levels within 3 days. The usual monthly cycle of hormones is absent during pregnancy and lactation.
In addition to that, thyroid function also returns to prepregnancy levels approximately 4 weeks after delivery. To know more about thyroid disorders during pregnancy, read our blog, “Thyroid disease: Development during pregnancy, it’s impact on pregnancy and how to treat it”.
Because of these significant hormonal changes, it is only natural that mood disturbances can happen which in some cases may develop into PPD.
However, it is important to understand that these changes are normal and cannot be prevented.
2. Prior history of depression or mood disorders
Having a previous history of clinical depression or other mood disorders could be one of the causes of postpartum depression.
3. Stressful events
Dealing with stressful events in addition to dealing with pregnancy can increase the risk of developing postpartum depression. The mother might start questioning herself, is postpartum depression a disability?
4. Lack of sleep
The lack of sleep for a new mother, coupled with a lack of social or family support has been observed as one of the possible causes of postpartum depression.
Did you know?
A study found that two-thirds of women with postpartum depression also had an anxiety disorder.
What are the complications of PPD?
Now that we have discussed the causes of postpartum depression, we should know why it is so important to seek professional help without any delay.
- For the mother, this episode of PPD can be the beginning of chronic recurrent depression which can become very serious in later stages.
- The baby can have trouble sleeping, eating and learning to speak. A mother’s ongoing depression can contribute to the child’s emotional, behavioural, cognitive and interpersonal problems in later life.
If the mother is suffering from depression, the other family members like the father are also likely to suffer from depression.
Postpartum depression risks
All women are capable of developing depression after childbirth. Having any of these factors can significantly increase the postpartum depression risks:
- A past history of clinical depression before or during pregnancy
- Excessive anxiety during pregnancy
- Past history of PPD in previous pregnancies
- Family history of depression and mood disorders
- Age of the mother. Research has shown younger the age of the mother, the higher is the risk of developing PPD.
- Lack of social support
- Marital conflict
- Recent stressful life events or socioeconomic status can also affect the mother.
Identifying the postpartum depression risks is essential because identifying a trigger can help us better address the problem and seek treatment on time.
If you’re seeking help to improve your mental health, you can download the Zyla app or visit our website Zyla.in and check out the health program which is suitable for you.
Let us now look at some of the ways how postpartum depression diagnosis is done!
Postpartum depression diagnosis
The process of postpartum depression diagnosis can be a challenge in itself and there are many reasons for that.
Firstly, because of the stigma and shame associated with mental illnesses, women are usually unwilling to disclose these symptoms to their physicians. They are indirectly and eventually forced to think, “is postpartum depression a disability”?
Many women will ignore these signs or internalise their struggles due to the lack of awareness of the severity of PPD.
The other reason is how similar the symptoms of postpartum depression are to that of postpartum blues, which can be difficult to differentiate. Unless the symptoms are very severe, it is often undetected and considered as natural mood swings that occur after childbirth.
For the postpartum depression diagnosis, there are two main classification systems used within psychiatry:
- The American Psychiatric Association’s Diagnostic & Statistical Manual of Mental Disorders, in its current fifth edition (DSM-5, 2013) and
- The 10th edition of the International Classification of Diseases, (ICD-10), published by the World Health Organization (World Health Organization, 2019).
Apart from the unnecessary medical details, DSM-5 and ICD-10 contain standard criteria for the diagnosis of known mental illnesses, like postpartum depression.
Your doctor with the help of standardized interviews, self-report questionnaires, and clinician-rated scales will screen you for the diagnostic symptoms of PPD. PPD is diagnosed after a psychiatric evaluation and medical evaluation.
Now let us learn how PPD can be treated in new mothers!
Postpartum depression treatment
If PPD is not diagnosed and treated early, it can lead to many long-term adverse effects not only on the mother’s health but also on her child and family. The following lines of postpartum depression treatment can be adopted by your doctor:
- Antidepressant medications can be effective. The commonly used drug is fluoxetine or paroxetine which is effective and has fewer side effects. Since this drug is safe for breastfeeding, make sure you do not self medicate. Discuss with your doctor about the safety and side effects of all the antidepressants before starting with any of them.
- Hormonal patches (estrogen or progesterone) can also be recommended for postpartum depression treatment.
- Continuous reassurance and psychological support by your family members can go a long way. In an interview with mothers who have recovered from PPD, the first suggestion they gave was to “find someone to talk to.” For this reason, peer support groups can be very helpful.
- If there is no improvement of symptoms, psychiatric consultation is looked for. The two widely used therapies are Interpersonal Psychotherapy and Cognitive Behavioural Therapy which can improve your mental health.
If you are wondering how to prevent PPD, the next section will be helpful as we take a closer look at some preventative measures.
How can you prevent PPD?
There is no hard and fast rule on how to prevent PPD but if you take care of yourself by following the given points, you might be able to stop PPD from getting worse.
- Have an open discussion with your doctor about your mental health. If you had any depressive episodes during pregnancy or before, make sure to share this with your doctor so that a care plan can be made to watch for signs of postpartum depression after delivery.
- Look for the risk factors and if you have any of them, look out for any symptoms. Do not dismiss them as mere mood swings and seek medical help.
- Lastly, education and awareness about PPD not only to you but also to your family members can enhance a positive attitude towards mental health. Have a healthy relationship with others so that you can have a strong support system when you feel low. This way, the question, “is postpartum depression a disability?” won’t arise.
No doubt, post-delivery, it becomes extremely important for a mother to take care of her mental and physical health. One such concern is taking care of the genital region. Read our blog, “Wound healing post-delivery” so that you can take more care of your body.
Before concluding this blog, let us take a brief look into the other two kinds of postpartum mood disorders that I have mentioned in the beginning.
What are postpartum blues and postpartum psychosis?
Postpartum blues
Blues is the most common mood disturbance occurring in almost 30–75% of mothers. The symptoms begin within a few days of delivery, usually on day 3 or 4, and persist for hours up to several days.
The symptoms include:
- Mood swings
- Irritability
- Tearfulness
- Generalized anxiety
- Sleep and appetite disturbance
As you can see, the symptoms are similar to PPD but in a much less severe form. Postpartum blues are by definition time-limited, mild and do not require any treatment other than reassurance.
Postpartum psychosis
Very severe depressive episodes which are characterized by the presence of psychotic features are classed as postpartum psychosis. This is different from postpartum depression in cause, severity, symptoms, treatment and outcome.
It is the most severe and uncommon form of postpartum mood disorders and can affect 1- 2 women per 1000 deliveries. The symptoms develop rapidly within the first two weeks after childbirth.
The symptoms include:
- A depressed or elated mood that can change rapidly
- Disorganized behaviour
- Sleep disturbances
- Feeling restless and having strange feelings
- Delusions, where women lose their touch with reality and start having false beliefs
- Hallucinations that can be auditory or visual where they hear or see things that aren’t happening in real life. The other forms of hallucinations of taste, smell and touch are quite less common.
Because of the severity and the chances of harming others, postpartum psychosis requires constant monitoring and hospitalization.
If you develop any symptoms of these mood disorders, you might feel isolated and that nobody can understand what you are going through. You might be scared, so you might not even open up to your loved ones. However, as a part of recovery, you must seek help because you are not alone in this.
The ignorance of mental health remains a major problem in our culture, but postpartum depression is just another complication that can occur after pregnancy and needs treatment just like any other disease.
And the answer to “is postpartum depression a disability?” is obviously a big NO! When we normalise this, only then can we give proper care to these mothers who are in no way less than superheroes!
If you are experiencing any such symptoms, Zyla can help you. You can enrol in our Ova Pentacare Pregnancy Program where Zyla’s team of 50+ medical experts guide you through pre-conception to post-delivery management and counselling.
Zyla has doctors, nutritionists, psychologists and physiologists to provide you with a holistic approach through personalised care and treatment. Feel free to download the Zyla app or visit our website-Zyla.in.
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