{Professional Insight} Knowing the Signs of Postpartum Depression

May 2, 2012

Having a baby and experiencing parenthood is supposed to be one of the most exciting and rewarding transitions that we, as humans, can experience.  While this is typically the case, there are some women who will have an experience much the opposite.  They find themselves reeling in a flood of what they consider unacceptable emotions and stressors.

Postpartum depression (PPD) occurs in 1 out of every 9-10 women.  Generally, we see some emotional lability in all new moms within the first three days to two weeks, affectionately termed “baby blues.”  PPD, however, generally peaks at 3-4 weeks post delivery to about three months post-delivery.  Technically, PPD can occur up to one year after delivery of the child.  While the “blues” can have you laughing and crying in the same sentence are fleeting, depression generally encompasses multiple symptoms that occur most of the day, every day, for at least two weeks.

PPD symptoms include:

  • Insomnia or extreme fatigue (unable to get out of bed)
  • Decreased or complete lack of appetite
  • Feelings of guilt and/or hopelessness
  • Anger or irritability
  • Anxiety
  • Inability (or perceived inability) to care for your child
  • Decreased bonding with your child

Women can often have intermittent thoughts of hurting herself or her baby, this is not uncommon in PPD.  If these thoughts become intrusive and common, postpartum psychosis may be occuring, which is much more serious and needs the attention of a doctor immediately.

Certain women and situations increase the risk of developing PPD:

  • Personal or family history of depression, bipolar disorder, anxiety, OCD or panic disorder
  • Stressful life events within the last twelve months
  • Unplanned pregnancy
  • Lack of social or financial support
  • Living alone
  • Previous miscarriage
  • Marital discord
  • Difficulties within the pregnancy itself (i.e., preterm birth, difficult delivery, birth defects, hyperemesis)
  • Pre-gestational or gestational diabetes
  • Breastfeeding difficulties

If you experience symptoms that are concerning for PPD, see your doctor immediately.  They can often administer standardized test to help determine what may be happening.  There are multiple options for treatment, which include light therapy, cognitive or psychotherapy and/or medications.  Sometimes, just setting up a system of reliable help and giving mom and opportunity to sleep more will make a big difference.  Whatever the therapy choice, a treatment plan can be created and put into place immediately which allows patients to begin improving very quickly.  For patients who choose to use medications, improvements can often be seen within 2-6 weeks.  Generally, patients won’t have to be maintained on medication for more than six months, but there are patients who will need this treatment for several years, depending upon their situation and personal history of depression.

I think being proactive can be such a help in deterring potential problems with PPD.  If you have risk factors for PPD, it is important to bring up your concerns with your medical provider during the pregnancy.  That way, you can make a plan to be preventative in the postpartum period.  This will include enlisting the help of friends and family to share as much of the workload as possible and to help alert you when they feel you might be headed in the direction of PPD.  Sometimes, it means that your doctor will recommend starting medication immediately after delivery, especially if there is a history of previous depression that responded well to medical therapy.

Preventing PPD, or treating it quickly, will go a long way in helping create the bond that you so desire with your child and allowing you to truly enjoy the most precious gift of children!

Guest Blogger

Dr. Felicia Nash is a successful OB/GYN with Austin Women Partners in Health.  Her medical focus is on infertility and mental health, with special interest in postpartum depression. She graduated cum laude from Texas A&M University with a B.S. in Nutritional Science.  Dr. Nash’s medical training was done at the University of Texas Houston Medical School.  She completed her residency training at Wake Forest University in Winston-Salem, North Carolina.  Dr. Nash lives in Austin with her husband, an ER doctor, with their three children.  Dr. Nash also had a pregnancy which ended with the birth of her son just prior to 18 weeks. She was shocked and saddened having previously experienced a healthy pregnancy with his big sister.  While Dr. Nash embraces her fulfilling professional opportunities, she absolutely cherishes her family and time spent with them. She is honored to serve as a board member for Hand to Hold, having seen the struggles of patients, as well as her own experience with preterm birth.