Depression During Pregnancy and after Childbirth
For most women, having a baby is a very exciting, joyous, and often anxious time. But for women with peripartum (formerly postpartum) depression it can become very distressing and difficult. Peripartum depression refers to depression occurring during pregnancy or after childbirth. The use of the term peripartum recognizes that depression associated with having a baby often begins during pregnancy.
Peripartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child.
An estimated one in seven women experiences peripartum depression.
Pregnancy and the period after delivery can be a particularly vulnerable time for women. Mothers often experience immense biological, emotional, financial, and social changes during this time. Some women can be at an increased risk for developing mental health problems, particularly depression and anxiety.
Up to 70 percent of all new mothers experience the “baby blues,” a short-lasting condition that does not interfere with daily activities and doesn ot require medical attention. Symptoms of this emotional condition may include crying for no reason, irritability, restlessness, and anxiety. These symptoms last a week or two and generally resolve on their own without treatment.
Peripartum depression is different from the “baby blues” in that it is emotionally and physically debilitating and may continue for months or more. Getting treatment is important for both the mother and the child.
Symptoms Of Peripartum Depression
- Feeling sad or having a depressed mood
- Loss of interest or pleasure in activities once enjoyed
- Changes in appetite
- Trouble sleeping or sleeping too much
- Loss of energy or increased fatigue
- Increase in purposeless physical activity (e.g., inability to still still, pacing, handwringing) or slowed movements or speech [these actions must be severe enough to be observable by others]
- Feeling worthless or guilty
- Difficulty thinking, concentrating, or making decisions
- Thoughts of death or suicide
- Crying for “no reason”
- Lack of interest in the baby, not feeling bonded to the baby, or feeling very anxious about/around the baby
- Feelings of being a bad mother
- Fear of harming the baby or oneself
A woman experiencing peripartum depression usually has several of these symptoms, and the symptoms and their severity may change. These symptoms may cause new mothers to feel isolated, guilty, or ashamed. To be diagnosed with peripartum depression, symptoms must begin during pregnancy or within four weeks following delivery.
Many women with peripartum depression also experience symptoms of anxiety. One study found that nearly two-thirds of women with peripartum depression also had an anxiety disorder. 6
While there is no specific diagnostic test for peripartum depression, it is a real illness that should be taken seriously. Any pregnant woman or new mother who experiences the symptoms of peripartum depression should seek evaluation by a medical professional – an internal medicine doctor or an OB-GYN, who can make referrals to a psychiatrist or other mental health professional. Assessment should include a psychiatric evaluation and a medical evaluation to rule out physical problems that may have symptoms similar to depression (such as thyroid problems or vitamin deficiencies).
You should contact your doctor if
- You are experiencing several of the symptoms above for more than two weeks
- You have thoughts of suicide or thoughts of harming your child
- Your depressed feelings are getting worse
- You are having trouble with daily tasks or taking care of your baby
Who Is at Risk?
Any new mother (or gestational carrier/surrogate) can experience symptoms of peripartum depression or other mood disorder. Women are at increased risk of depression during or after pregnancy if they have previously experienced (or have a family history of) depression or other mood disorders, if they are experiencing particularly stressful life events in addition to the pregnancy, or if they do not have the support of family and friends.
Research suggests that rapid changes in sex and stress hormones and thyroid hormone levels during pregnancy and after delivery have a strong effect on moods and may contribute to peripartum depression. Other factors include physical changes related to pregnancy, changes in relationships and at work, worries about parenting and lack of sleep.
Fathers: Pregnancy/childbirth and Depression
New fathers can also experience symptoms of peripartum depression. Symptoms may include fatigue and changes in eating or sleeping. An estimated 4% of fathers experience depression in the first year after their child’s birth. Younger fathers, those with a history of depression and fathers with financial difficulties are at increased risk of experiencing depression.
With proper treatment, most new mothers find relief from their symptoms. Women who are treated for peripartum depression should continue treatment even after they feel better. If treatment is stopped too soon, symptoms can recur.
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