Postpartum Depression
Postpartum Depression
Tiffany Hards
Westminster College of Nursing
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Table of Contents
Abstract................................................................................................................................3
Postpartum Depression........................................................................................................4
What is Postpartum Depression...........................................................................................4
Signs and Symptoms........................................................................................................5
Treatment…….............................................................................................................6
References............................................................................................................................7
Figures.................................................................................................................................9
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Abstract
In this document I cover the topic of Postpartum Depression. How it affects so many women and
families. PPD is a serious problem where many women are not getting the help they need. I
explain some of the reasons why this may be occurring, signs and symptoms to look for, and
different treatment options.
Keywords: Postpartum depression, PPD, signs and symptoms, treatment
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Postpartum Depression
Postpartum depression (PPD) is a serious problem all over the world. This disorder can
cause severe turmoil and upheaval for many families. Women with PPD have difficulty adjusting
to and caring for their new baby. During and after pregnancy a woman’s body has many
fluctuations in hormones, and thus a dramatic drop in estrogen and progesterone may contribute
to PPD.
What is Postpartum Depression
Postpartum depression is a mood disorder that mainly affects women postpartum, but in
some cases can occur during pregnancy. This is a depressive disorder that creates emotional and
psychological turmoil in women who experience it. Postpartum depression is one of the most
underdiagnosed and undertreated obstetric complications, as many obstetricians and pediatricians
do not screen for PPD. A majority of cases happen within the first couple of weeks after birth,
but in some cases it comes much later, as in this instance:
“I never had any symptoms until my daughter was five months old. I went to numerous
doctors because I knew something was “off” but no one mentioned postpartum
depression ever and that is the hardest thing for me to still accept. I finally started doing
my own research and found a website about PPD; I had every symptom listed”. (“7
Postpartum Depression Survivors Share Their Stories of Having More Children |
Postpartum Progress", 2016)
Many women do not seek treatment, but rather try to deal with it on their own. For some
it’s because of the shame attached to PPD. They do not want to feel judged or accused of being
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unfit to care for their child. Many women feel immense guilt for their depression, and feel
ashamed that they are not happy when they should be. They do not understand why they are
feeling this way, and in some severe cases why they feel hostility towards their baby. This
prevents the mom from properly caring for herself and her child. According to
Postpartumprogress.org
“Only 15% of women with postpartum depression ever receive professional treatment.
This means about 850,000 women each year are not getting the help they need. Part of
the reason for lack of treatment is the fact that many physicians, including obstetricians
and pediatricians, do not screen. Another part of the reason is the stigma that exists that
either prevents mothers for asking for help or in following through on treatments like
therapy or psychiatric medication. Whatever the reason, when women are not treated for
PPD, research shows they are less able to bond with their children or care for them
properly. They are more likely to medicate themselves with alcohol or drugs. And they
may end up with lifelong chronic depression or anxiety”.
One in seven women suffer from PPD. (Figure 2), and although the exact causes of PPD
are widely multifactorial, there are many things that can increase the risk for PPD. These include
such things as lack of support system, marital problems, previous depression, mood disorders,
stressful life events, and childcare stressors.
Signs and Symptoms
Many families who are experiencing PPD do not realize that is the problem, and may attribute it
to the baby blues. At this point they may feel like they will eventually get over it, and that they
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are just stressed due to new parental responsibilities. If it is the baby blues, there will be such
things as crying for no reason, irritability, mood swings, sadness, and a general sense of not
feeling like self. In comparison PPD will have many of the same symptoms but also have
feelings of hopelessness, guilt, panic, anger, fear of being alone, as well as scary thoughts about
baby, or over concern for baby’s health. (Figure 1)
Treatment. I believe the first step is to standardize a screening test for all new mothers.
Educate them during prenatal visits and postnatal in the hospital about the signs and symptoms.
If patients are made aware of what to look for and are given resources in case they need them,
they will be more likely to reach out for help. Some resources that are out there are physicians,
support groups, individual therapy, and crisis hotlines. Among many websites out there to help
people, there is Postpartum Support International, this website allows you to click on your state
and it will pull up local resources for you. Another huge part of treatment is to involve the
family, and to establish or strengthen all support systems, with an emphasis on the marriage or
intimate partnership. Medications can also be used to treat PPD, but there is always a higher risk
taking medication while breastfeeding. Some common meds used are SSRI’s, and Tricyclics,
both of which are relatively safe while breastfeeding. “You may start to feel better within 1 to 3
weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more
improvement”. (WebMD n.d.). Letting a patient know the time it takes to feel better, as well as
how long they can expect to be on medication will help with compliance. Pairing the
antidepressants with therapy will have the best outcome.
In conclusion Postpartum Depression is a serious problem, but what is most alarming is
the number of women not getting help. As nurses I feel we are on the frontline to educate the
patient and family about the risks, and when to seek help.
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References
3 Differences Between Postpartum Depression and The Baby Blues. (n.d.). Retrieved December
06, 2016, from http://www.rachelrabinor.com/blog/postpartum/difference-postpartum-
depression-baby-blues
H. (2016). 7 Postpartum Depression Survivors Share Their Stories of Having More
Children | Postpartum Progress. Retrieved December 06, 2016, from
http://www.postpartumprogress.com/7-postpartum-depression-survivors-share-their-stories-of-
having-more-children
@. (n.d.). Home | Postpartum Support - PSI. Retrieved December 08, 2016, from
http://www.postpartum.net/
Dennis, C. (2014). Psychosocial interventions for the treatment of perinatal depression.
Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 97-111.
doi:10.1016/j.bpobgyn.2013.08.008
Postpartum Depression-Medications. (n.d.). Retrieved December 09, 2016, from
http://www.webmd.com/depression/postpartum-depression/postpartum-depression-medications
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Figures
Figure 1
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Figure 2