Baby Blues

written by Alison Lingel

Two kids later, one born in the heat of the pandemic and the other costing us a $7,600 pregnancy deductible, I can assert that postpartum can, indeed, be “common, disabling, and treatable” (Stewart et al., 2019).  Though considered the most common of childbirth complications, postpartum mental health challenges are often underdiagnosed and undertreated. So where does that leave your mothers, partners, and selves affected by this debilitating disease?

First, what symptoms constitute postpartum depression (PPD) or non perinatal major depression?  PPD includes depressed mood, loss of interest, anhedonia, sleep and appetite disturbance, decreased concentration, psychomotor disturbance, fatigue, guilt or worthless feelings, and suicidal thoughts.  Each of these symptoms occur during a two-week period and represent different functioning for the individual.  Other symptoms can include mood lability, anxiety, irritability, feeling overwhelmed, and obsessional worries or preoccupation— often related to the baby’s health, feeding, and bathing safety

Suicidal thoughts are unfortunately common, affecting about 20% of women with PPD.  Many women also have thoughts of harming the baby from up to 12 months to more, after the birth.

Measures to evaluate for PPD include the Patient Health Questionnaire–9 (12) or the 10-item Edinburgh Postnatal Depression Scale.  Particular results can lead to a clinical evaluation to determine a proper diagnosis.  

Almost a tenth of partners can also be affected by PPD with many of the same symptoms.  Almost half of women can also relapse with PPD occurring in subsequent pregnancies. 

In terms of treatment, a multidisciplinary approach is often recommended.  Comorbid medical and psychiatric diagnosis occur frequently.  Clinicians suggest that clients enhance their self-care, support systems, and try to lessen the existence of negative life events.  There is evidence to support that aerobic exercise helps to reduce PPD symptoms.  Additionally, interventions are recommended to help with infant sleep and then, consequently maternal sleep increases and PPD symptoms decrease.  For mild symptoms, research advises nondirective counseling and peer support.  Regardless of the severity of the diagnosis, treatment options should be clearly explained and maternal treatment preferences should be implemented into treatment, including preferences for medication or non-medication treatment options, as well as group versus individual interventions. Other barriers should also be discussed such as potential financial or location limitations.  

In other words, there are a multitude of options and resources available!  There is HOPE for us ladies as well as those that love us!

Reference:

Stewart, D. E., & Vigod, S. N. (2019). Postpartum depression: pathophysiology, treatment, and emerging therapeutics. Annual review of medicine, 70, 183-196.