Author: Ma. Theresa Hilario-Jimenez, M.D., FPPS

A lot of emotions came to you when you learned you are with a child. When you heard your baby’s first cry and held her for the first time, a new set of emotions came rushing to you with the feeling of joy overpowering you. But as you bring your baby home and start the parenthood phase, the emotions you might feel may range from joy and excitement to fear and anxiety

In this article

What is Postpartum Depression: Meaning and Causes?

Mom-in-postpartum-depression

Photo by jcomp from Freepik

You may have emotions you cannot control and may even cripple your everyday activities as a new mom. Many women experience such a roller coaster of emotions but eventually conquer them without many problems. Others may need more help and support and even medical attention to overcome them. In a study done in a hospital last 2013, about 21.6% of women experienced postpartum depression.1 It is a common condition among postpartum women, making it more relevant to know what to do when it is recognized.

Postpartum depression, on the other hand, is a more severe, long-lasting form of depression.2 It is a complication of giving birth and is not a sign of weakness or character flaw.2 Symptoms of postpartum depression usually develop within the first few weeks after giving birth, but may begin during pregnancy, or later, even up to a year after birth.2 Postpartum depression usually lasts for more than 2 weeks with disturbance of the daily routine.2 But if left untreated, symptoms may last for many months or longer.2

“Baby blues” can be experienced by most moms. These usually begin within the first two to three days after delivery and may last up to two weeks.2 You may experience mood swings, crying spells, anxiety, irritability, feeling overwhelmed, and difficulty sleeping2,3. Some will experience low energy, fatigue, or problems with appetite.

Causes of Postpartum Depression

With no single reason identified, physical and emotional factors may play a role in the development of postpartum depression.3

Physical changes in the mother, such as a drop in the levels of the hormone estrogen and progesterone, can trigger postpartum depression.2 Another hormone that was noted to decrease after giving birth is the thyroid hormone. A drop in thyroid hormone may leave the mother feeling tired, sluggish, and even depressed.2 Being a new mom can be physically and emotionally tiring. Sleep is often lacking and everyday activities to nurture the newborn and do household chores can be overwhelming. Feelings of inadequacy in taking care of the baby can lead to feelings of anxiety. This, together with the feelings of losing control of one’s life and being unattractive, are some emotions that can contribute to postpartum depression as well.

Certain conditions increase the risk of moms developing postpartum depression. These are:2

  • history of depression, either during pregnancy or at other times
  • bipolar disorder
  • postpartum depression after a previous pregnancy
  • family members who've had depression or other mood disorders
  • experienced stressful events during the past year, such as pregnancy complications, illness, or job loss
  • baby has health problems or other special needs
  • With twins, triplets, or other multiple births
  • difficulty breast-feeding
  • problems in your relationship with your spouse or significant others
  • a weak support system
  • financial problems
  • unplanned or unwanted pregnancy

Postpartum Depression Signs and Symptoms

Symptoms of post-partum depression may include any of the following:2

  • Depressed mood or severe mood swings
  • Excessive crying
  • Difficulty bonding with your baby
  • Withdrawing from family and friends
  • Loss of appetite or eating much more than usual
  • Inability to sleep (insomnia) or sleeping too much
  • Overwhelming fatigue or loss of energy
  • Reduced interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Fear that you're not a good mother
  • Hopelessness
  • Feelings of worthlessness, shame, guilt, or inadequacy
  • Diminished ability to think clearly, concentrate or make decisions
  • Restlessness
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurrent thoughts of death or suicide

Related Postpartum Depression Diseases

Postpartum Psychosis

Postpartum psychosis is a rare condition that develops within one week after birth.2 Symptoms of postpartum psychosis are severe and may include the following:2

  • Confusion and disorientation
  • Obsessive thoughts about your baby
  • Hallucinations and delusions
  • Sleep disturbances
  • Excessive energy and agitation
  • Paranoia
  • Attempts to harm yourself or your baby

Paternal Postpartum Depression

Husband in postpartum depression

Photo by pressfoto from Freepik

Fathers may experience postpartum depression as well. They can feel the pressure of fatherhood and can also be overwhelmed by emotions just like anybody else. New fathers can have the same symptoms of postpartum depression just like that of moms.2 Fathers who are most at risk for developing postpartum depression are those who are young, have a history of depression, had experienced relationship problems, or are struggling financially.2 If left untreated, this will produce a strain on the family relationship as well as the growth of the child just like a mom’s postpartum depression.2

Postpartum Depression Prevention and Care Tips

Acknowledging the presence of baby blues or postpartum depression by you, your partner, you’re your support group is the first and most important step for moms experiencing such symptoms. To manage the symptoms, prompt treatment is necessary.

Be sure to call your doctor if you have these symptoms:2

  • Don't fade after two weeks
  • Are getting worse
  • Make it hard for you to care for your baby
  • Make it hard to complete everyday tasks
  • Include thoughts of harming yourself or your baby

It is important to intervene early if symptoms of postpartum depression are recognized. If left untreated this can lead to

  1. Moms experience postpartum depression for months and may even become a chronic depressive disorder.1 Postpartum depression, even if treated, can increase the woman’s risk for future episodes of major depression.2
  2. Paternal postpartum depression causes an emotional strain on everyone close to the baby. Postpartum depression in the mom increases the risk for the dad to experience postpartum depression as well.2
  3. Children have emotional and behavioral problems as well. These children can have sleeping and eating difficulties, excessive crying, and developmental delays such as speech or language development.2

Remember your postpartum wellness plan? Make sure to follow them to lessen the stress and manage the challenges that a new mom face. Take time to do the “mommy time” where you spend time for yourself, doing things that make you relax and happy, guilt-free. The time need not be long, it’s the quality of time spent that is more important. Postpartum is a time for healing and gaining back strength so try to do so.

Prevention

Prevention is an important aspect of wellness. If you have a history of depression, make sure to mention this to your doctor for them to help you prepare and lessen the stress of postpartum. An early postpartum follow-up can be scheduled by your doctor to detect signs or symptoms of depression.2 The earlier it is detected the earlier the intervention and the easier and earlier it is resolved. If you have a previous history of postpartum depression, your doctor may recommend an anti-depressant right after delivery.2

Proper nutrition is an important part of postpartum wellness. Eating a well-balanced diet will help you regain your strength3. Another micronutrient that is needed is the omega-3 fatty acid DHA found in fish oil which may reduce symptoms of postpartum depression when consumed during pregnancy.4,5 However, natural sources of fish oil might be difficult to obtain and might be discouraged because of the mercury content of deep marine fishes that are rich in DHA.

Stress can be a precursor of depression. Managing stress through techniques such as yoga, breathing exercises, meditation, and of course “me time/mommy time” is important.2

Get involved in social activities or activities that make you happy in the past. This will entail the help of your support group to look after your baby while you get the much-needed time out to get recharged. It is important to remember that you are not alone. The support group you have chosen will be at hand to help you through the challenges and difficulties you will face during this period of transition.

Support group to fight postpartum depression

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Talking to other moms can help you realize that you are not alone and that other moms may be experiencing the same things as you are. With the right intervention, you will start to feel the joy and excitement of being a mother again. It’s ok to feel anxious at times. This will help you do better and serves as a reminder of the importance of the new role you have taken.

References:

  1. Prevalence of Postpartum Depression Among Mothers Who Delivered in a Tertiary Hospital, availble at http://pjog.org/article-detail.php?id=15. Accessed on 30 October 2022
  2. Postpartum Depression, available at https://www.mayoclinic.org/diseases-conditions/postpartum-depression/sym... Accessed on 17 October 2022
  3. Postnatal Maternal and Neonatal Care, available at https://www.ncbi.nlm.nih.gov/books Accessed on 15 October 2022
  4. Is there any benefit to taking fish oil supplements for depression? - Mayo Clinic, available at http://www.mayoclinic.org/diseases-conditions/depression/expert-answers. Accessed on 15 October 2022
  5. Pilot trial evaluating maternal docosahexaenoic acid consumption during pregnancy: Decreased postpartum depressive symptomatology. International Journal of Nursing Sciences, available at .https://www.sciencedirect.com/science/article/pii/S2352013214000982 Accessed on 15 October 2022