Although it is common for women following the birth of a child to experience a period of “baby blues”, postnatal depression is far more serious and may inhibit a mother’s ability to care for herself and her baby.
Slowly developing postnatal depression can take two forms, the first being postnatal “blues”, which start soon after the birth and becomes worse and more distressing as time passes, and the second which develops more slowly and is not present until several weeks after the birth. When depression is higher during pregnancy than after birth, it is known as perinatal depression. About a third of women with PND have symptoms that started in pregnancy and continued after birth. Very rarely some women experience an extremely severe form of depression, known as puerperal psychosis.
Postnatal depression (PND) affects between 10 to 15% of women after childbirth.
Causes
The causes of PND are not clear; it may be caused by biological, psychological and social factors.
Both hormones oestrogen and progesterone affect emotions and during pregnancy, the levels of progesterone are very high. After giving birth and having the placenta removed, the hormone levels drop back down to normal, triggering a chemical imbalance in the brain and causing postnatal depression. There is some evidence to show that a lack of certain nutrients such as omega 3 oils, magnesium and zinc during pregnancy can lead to depression.
There is probably no single reason but a number of different stressors may lead to PND. A woman is more susceptible to PND if she has had mental health problems before or experienced depression or anxiety during pregnancy and or if she had feelings of isolation. Unresolved issues from a woman’s past can also trigger the condition.
Symptoms
The onset of PND varies but generally starts within one or two months of giving birth and even several months after having a baby. Symptoms vary in severity from woman to woman but the most common signs of postnatal depression are anxiety, panic, tension, depression, obsessive and inappropriate thoughts, irritability, lapsed concentration, difficulty sleeping and loss of interest in sex.
Treatment
Treatment is similar to that of ordinary depression. The best conventional treatment for PND is a combination of practical support and advice, counselling or psychotherapy and, in severe cases, prescribing antidepressants or ultra-brief electroconvulsive therapy (ECT). Questions designed to detect signs of depression should be asked by healthcare professionals to determine a mother’s state of mind before and during pregnancy. Talking therapies are preferred over the use of psychiatric drugs for women who are pregnant or breastfeeding as these can put the baby at risk. Ultra-brief ECT is favoured by some psychiatrists for severe PND because it can produce good results very quickly. Alternative therapies such as osteopathy, herbal remedies and homoeopathy can sometimes be helpful.
Postpartum (puerperal) psychosis
Postpartum (puerperal) psychosis is a rare complication occurring in about one in every thousand women and is more likely to occur in mothers who have a history of mental illness. Mood disturbances, depression, muddled thoughts, delusions and hearing or seeing things that are not there are typical symptoms. These symptoms appear from a couple of days to a couple of weeks after birth. Treatment is imperative.
Sources
http://www.dailymail.co.uk/
http://www.mind.org.uk
http://www.netdoctor.co.uk
https://womensmentalhealth.org
(Revised by M van Deventer)