Postpartum depression (PPD)
Postpartum depression(PPD) is not a character flaw or a weakness. The birth of a baby can trigger a jumble of powerful emotions, from excitement and joy to fear and anxiety. But it can also result in something you might not expect – depression.
Most new moms experience postpartum “baby blues” after childbirth, which commonly include mood swings, crying spells, anxiety and difficulty sleeping. Baby blues typically begin within the first two to three days after delivery and may last for up to two weeks.
But some new moms experience a more severe, long lasting form of depression known as postpartum depression. It is the name given to depression that develops between one month and up to one year after the birth ofa baby.
Sometimes it’s simply a complication of giving birth.
It is important to understand that having postpartum depression does not mean that a person does not love their baby, but it is a mental health condition and treatment can resolve it.
Types-
There are three terms used to describe the mood changes women can have after giving birth-
• The “Baby blues” happen to as many as 70% of women in the days right after childbirth. You may have sudden mood swings, such as feeling very happy and then feeling very sad.You may cry for no reason and can feel impatient, cranky, restless, anxious, lovely and sad.The baby blues may last only a few hours or as long as 1 to 2 weeks after delivery. Usually you don’t need treatment from a health care provider for baby blues. Often, joining a support group of new moms or talking with other moms helps.
• Postpartum depression (PPD) can happen a few days or even months after childbirth. PPD can happen after the birth of any child, not just the first child. You can have feelings similar to the baby blues – sadness, despair, anxiety, crankiness – but you feel them much more strongly. When your ability to function is affected, you need to see a health care provider.If you don’t get treatment for PPD, symptoms can get worse. While PPD is a serious condition, it can be treated with medication and counseling.
• Postpartum psychosis is a very serious mental illness that can affect new mothers. This illness can happen quickly, often within the first 3 months after childbirth. Women can lose touch with reality, having auditory hallucinations and delusions. Visual hallucinations are less common. Other symptoms include insomnia, feeling agitated and angry, pacing, restlessness, and strange feelings and behaviors. Women who have postpartum psychosis need treatment right away and almost always need medication.
Symptoms –
Postpartum depression can affect people differently, but below are some common signs and symptoms –
• a low or sad mood
• difficulty thinking or focusing
• low motivation and a lack of interest in activities
• feeling unable to make decisions
• difficulty thinking or focusing
• anxiety and irritability
• feeling guilty, worthless, hopeless or helpless
• fatigue and lethargy
• withdrawing from friends and family
• frequent or long bouts of crying
• a lack of appetite
• pain, such as a headache or stomachache
• difficulty bonding with the baby
• feeling unable to care for the baby
• having no interest in the baby or feeling as if they are another person’s responsibility
Some people experience postpartum psychosis, a severe mental health problem that needs immediate medical attention. Symptoms include hallucinations, delusions, mania, paranoia and confusion.
Other experience baby blues. Mother might feel teary, anxious and moody during that time.This is different from postpartum depression. It affects many new parents and usually disappears after 3-5days.
Causes and Risk factors –
If you have PPD, it is not because you did anything wrong. Experts think it happens for many reasons, and those can be different for different people. Some things that can raise the chances of postpartum depression include –
• A history of depression prior to becoming pregnant or during pregnancy
• Age at time of pregnancy (the younger you are, the higher the chances)
• Family history of mood disorders
• Going through an extremely stressful event, like a job loss or health crisis
• Children (the more you have, the more likely you are to be depressed is a later pregnancy)
• Having a child with special needs or health problems
• Limited social support
• Living alone
• Marital conflict
There’s no single cause of postpartum depression, but these physical and emotional issues may contribute –
• Hormones. The dramatic drop in estrogen and progesterone after you give birth may play a role. An underactive thyroid gland also contribute to PPD.
• Self-image.You may feel less attractive, struggle with your sense of identity, or feel that you have lost control over your life.
• Lack of sleep. when you are sleep-deprived and overwhelmed, you may have trouble handling even minor problems.
• Anxiety. You may be anxious about your ability to care for a newborn.
Complications-
If left untreated, postpartum depression can interfere with mother-child bonding and cause family problems.
• For mothers-
Untreated postpartum, depression can last for months or longer, sometimes becoming a chronic depressive disorder. Even when treated, postpartum depression increases a women’s risk of future episodes of major depression.
• For fathers-
When a new mom is depressed, the risk of depression in the baby’s father may also increase. And new dads are already at increased risk of depression, whether or not their partner is affected.
• For children –
Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying and delays in language development.
Diagnosis-
Your doctor will usually talk with you about your feelings, thoughts and mental health to distinguish between a short-term care of postpartum baby blues and a more severe form of depression.
As a part of your evaluation, Your doctor may –
• Do a depression screening that may include having you fill out a questionnaire
• Order blood tests to determine whether an underactive thyroid is contributing to your signs and symptoms
• Order Other tests, if warranted, to rule out other causes for your symptoms
Treatment-
A range of different treatments can help with postnatal depression, including –
• counselling
• psychotherapy
• group treatment
• support strategies
• medications such as antidepressants
Treatment and recovery time vary, depending on the severity of your depression and your individuals needs.
• Baby blues-
The baby blues usually fade on their own within a few days to one to two weeks.In the meantime-
▪︎Get as much rest as you can
▪︎ Accept help from family and friends
▪︎Connect with other new moms
▪︎ Create time to take care of yourself
▪︎ Avoid alcohol and recreational drugs, which can make moodswings worse
• Postpartum depression-
Postpartum depression is often treated with psychotherapy (Also called talk therapy or mental health counselling),medication or both.
▪︎Psychotherapy. It may help to talk through your concerns with a psychiatrist, psychologist or other mental health professional.Through therapy, you can find better ways to cope with your feeling, solve problems, set realistic goals and respond to situations in a positive way.
▪︎Antidepressants. Your doctor may recommend an antidepressant. However, most antidepressants can be used during breast feeding with little risk of side effects for you baby.
With appropriate treatment, PPD symptoms usually improve. It is important to continue treatment after you begin to feel better. Stopping treatment too early may lead to a relapse.
• Postpartum psychosis-
Postpartum psychosis requires immediate treatment, usually in the hospital. Treatment may include-
▪︎Medication. Treatment may require a combination of medications – such as antipsychotic medications ,mood stabilizers and benzodiazepines – to control your signs and symptoms.
▪︎Electroconvulsive therapy (ECT). If your postpartum depression is severe and you experience postpartum depression is severe ,Ecr may be recommended if symptoms do not respond to medication. ECT is a procedure in which small electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT can reduce the symptoms by causing changes in brain chemistry.
Ayurvedic Perspective –
There are three main forces that control all the physical and mental functions in the body. One, known as Vata, is responsible for the brain activity. After labour, Vata becomes imbalanced and can get even more out of sync due to lack of sleep, worries and anxieties. If a new mom cannot get rest and proper care to overcome the stress of the labour and if she cannot get help with practical innes, breast feeding support and emotional nurturing, she may be prone to postnatal depression.
Postnatal care aims at –
• Agni deepanam
• Yoni sodhanam
• Vata samanam and vata anulomana
• Stanya jananam
New mother must have a wholesome diet, because it’s going to be perfect for you and your baby also. Deficiency of appropriate diet could lead to immense fatigue.
To calm the vata which is vitiated, warm oil massages, termed abhyanga is practiced in Ayurvedic care particularly for postpartum ladies. Ideally you must continue the massage routine for first 40 days to find maximum advantages.
Yoga also help mothers to lessen anxiety and avert postpartum depression.
Beneficial Herbs-
• Ashwagandha –
• Shatavari –
• Brahmi –
• Shankhpushpi –
Useful Medications –
• Dhanwantharam Kashayam
• Dashmoolahista
• Jeerakarhistam
• Ashwagandharhistam
• Bala tailam
• Dhanwantaram tailam
• Medicated ghee
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