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