Introduction 

Postpartum depression is a type of depression that occurs in some women who have given birth recently and affects them physically, emotionally and behaviourally. Typically, this kind of depression begins within 2- 4 weeks after giving birth. 

Postpartum depression symptoms include a broad spectrum of changes that a mother endures. It is important to note that the condition doesn’t happen to all women after pregnancy.

What are some common postpartum depression symptoms?

After giving birth, about 1 in 10 women experience some form of depressive psychological change. In extreme cases, postpartum psychosis may also occur in 1 out of every 1000 women. 

• An interesting side note: many dads too undergo some form of depression within the first year of their child being born!

The most common signs of postpartum depression are easily missed. These are associated with giving birth and may initially not indicate any serious mental health issues:

• Difficulty falling asleep or maintaining a regular sleep schedule
• Frequent appetite and mood changes 
• Severe and long-lasting fatigue (being tired despite getting rest)
• Lower sexual drive or libido 

Along with the above general postpartum symptoms, major clinical depression after giving birth may also be associated with the following: 

• Disinterest in your newborn baby, feeling detached and unconnected to them (lacking any strong sense of bonding)
• Crying frequently (often without any reason) for long periods
• Feeling down/depressed 
• Strong sense of anger
• Inability to feel pleasure (or a decrease in your ability to feel pleasure)
• Feeling hopeless, helpless, insecure, unworthy and similar
• Suicidal thoughts, thoughts of death 
• Thoughts and feelings of causing harm to someone 
• Loss of concentration abilities

Note that, as per most psychological/psychiatric institutions, postpartum depression is a real, serious medical condition. Although it may not affect everyone, it is still common enough that it should be talked about often. 

Panic disorder, obsessive-compulsive disorder and other conditions may also occur simultaneously. 

Postpartum depression causes

There aren’t any confirmed causes of postpartum depression. We do know that it is most probably related to the extreme hormonal changes in the woman’s body during this time. For example, oestrogen, the female hormone associated with reproduction, is ten times higher during pregnancy. But within 3 days of giving birth, this number drops to pre-pregnancy levels. 

This is a rapid hormonal change and it is linked to this postpartum depression, but the exact processes are not understood. Other factors that contribute to this condition include lack of sleep, anxiety over the newborn baby and its care as well as psychological factors like loss of self-image, self-identity, a sense of not being in control or even a perceived loss of attractiveness. 

Apart from these potential symptoms, certain risk factors play a role in postpartum depression:

• A history of depression 
• Having mixed feelings about the pregnancy
• Being younger at the time of giving birth
• Family history of associated mental health issues (particularly mood disorders)
• Stressful life events like health or employment problems 
• Having a child with special needs 
• Personal sociological factors like living alone, lack of support, marriage troubles 
• Multiple birth labour (twins or triplets)

The importance of rest and sleep and the need to avoid hard physical labour. Discussion of normal postpartum bleeding and recovery time is very essential and  how much blood loss they can expect, for how long can help postpartum women navigate through the difficult journey in the postpartum period.

Dr. Ashish, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology

Postpartum depression treatment

Postpartum care will vary depending on how serious your symptoms are. There are several options available to help you, your baby and your family get through this time. Medications can be one part of your treatment. Additional help will be in the form of psychotherapy/counselling as well as participation in support groups. 

Even if you are breastfeeding, you may still be able to take your depression medication prescribed by your doctor. Speak with your doctor and decide with them.

Conclusion

Giving birth can be one of the most joyous occasions in your life. But it is important to be prepared for the good and the bad. Postpartum depression isn’t likely to affect many women, but the ‘baby blues’ as it’s called can affect as many as 70% of women. In the days following your pregnancy, be sure to monitor your mental health and get as much sleep as you need. Speak with your partner, family members, social support and doctor in case you feel you may be experiencing signs of postpartum depression. Consult a psychiatrist without delay if you notice any symptoms of postpartum depression.

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