Postpartum Depression

There is overwhelming pressure on parents to feel intense joy when their child is born. Childbirth, to many, is meant to be the happiest time of their lives. In reality, 1 in 9 mothers.  suffer from postpartum depression (PPD). It is the most prevalent childbirth complication. Many women blame themselves for developing postpartum depression. It’s important to remember that you would not blame someone else for developing a disorder, and so you should not blame yourself either.

Both body and mind experience changes after childbirth, which lead some mothers to develop depressive symptoms. These changes can also affect men, and cause them to develop PPD. There are many factors that correlate with increased susceptibility to postpartum depression, including personal or family history of mood disorders, depression during pregnancy, money or relationship problems, or being younger than 20. Postpartum depression presents itself differently for each person. Seeking professional help will lead you to a happy and healthy life with your baby.

SYMPTOMS OF POSTPARTUM DEPRESSION

Postpartum depression is different from the “baby blues.” Often, postpartum depression’s symptoms mimic those of major depressive disorder. You may experience both psychological and physical symptoms. In order to be diagnosed with postpartum depression, your symptoms must be present for a minimum of two weeks.

PSYCHOLOGICAL SYMPTOMS

• Feeling hopeless, overwhelmed, and/or sad
• Doubting your ability to care for your baby
• Crying often for no apparent reason
• Thoughts of harming yourself or your baby
• Restlessness, changing moods, or irritability
• Rage or inexplicable anger
• Feeling overly worried or anxious
• Having difficulty bonding with baby
• Avoiding friends and family
• Loss of interest in enjoyable activities

PHYSICAL SYMPTOMS

• Difficulty concentrating
• Increased or decreased need for sleep
• Changes in appetite
• Physical aches and pains

OTHER FORMS OF POSTPARTUM DISORDERS

Postpartum depression is the most common of postpartum disorders. However, there are additional diagnoses in the psychiatric diagnostic manual, the DSM-5, that many people are unfamiliar with.

Postpartum anxiety is marked by intrusive, overwhelming worries about yourself or your baby. It’s natural to have anxiety following the birth of a child. But when those anxieties begin to take over your every thought, you may be facing postpartum anxiety. This disorder aligns itself closely with a generalized anxiety disorder.

Postpartum psychosis is a rare, but very severe disorder. Symptoms include hallucinations, delusions, dissociations, and mood swings. For the safety of the mother and baby, postpartum psychosis often requires hospitalization.

Postpartum PTSD can occur following a traumatic event during or following delivery. Unplanned C-sections, emergency health problems with the baby, or the use of forceps are all examples of what can cause postpartum PTSD.  Postpartum PTSD shares many symptoms with traditional PTSD and is treated in much the same way as well.

HOW IS POSTPARTUM DEPRESSION TREATED?

Postpartum depression is commonly treated with therapy or medication. Postpartum treatments are special in that they incorporate both mother and baby. For instance, when taking medication, precautions are taken to ensure no medicine is transferred to the baby during breastfeeding. There are also resources for fathers. Ensuring all members of your family are receiving the proper help makes all the difference.

THERAPY

Current research states that therapy is one of the best forms of treatment. Psychotherapy allows you to talk through your feelings with a professional and create a realistic plan that will help you feel better about being a parent. Your therapist may also teach you techniques to help bond with your baby. In some cases, participating in family or couples therapy is also beneficial. Postpartum depression is a disorder that affects a family as a whole, not just the mother. Having support that encompasses both you, your partner, and anyone else in the house can help speed up the recovery process.

Your doctor may also recommend creating a postpartum care plan that outlines care for both yourself and your baby. Postpartum depression is not treated in one visit, so having an ongoing plan will lead to a smoother recovery. Care plans may include resources for additional psychiatric issues such as anxiety or bipolar disorder, feeding plans for your baby, or a personalized care team.

MEDICATIONS

Postpartum depression is classified as a mood disorder, and as such, is often treated with antidepressants. Selective serotonin reuptake inhibitors (SSRI’s) are the first line of drugs used to treat PPD. These medications offer the least side effects and risks and do not transfer to the baby during breastfeeding. They are also low risk for addiction. Fluoxetine (Prozac), Sertraline (Zoloft), Citalopram (Celexa), and Escitalopram (Lexapro) are among the most common SSRI’s.

A new treatment, called Zulresso (brenaxolone), is the first FDA-approved medication designed specifically to treat PPD. Currently, Zulresso is available only through intravenous administration, but an oral version is in the process of FDA approval. Zulresso works by increasing a hormone called allopregnanolone. Allopregnanolone is naturally produced during pregnancy and dramatically decreases again after childbirth. This sudden hormonal change is thought to cause postpartum depression in some women. An administration of Zulresso over 60 hours has been shown to significantly decrease depression scores, compared to placebo groups.

The downside to Zulresso is that it must be administered in a hospital. This makes it a more expensive treatment than traditional medications like SSRI’s. Also, for safety reasons, the mother may not be the primary caregiver of her child during treatment. This does give the mother a break from the stress of childcare and may serve as another avenue of relief from PPD symptoms. Another benefit is that Zulresso works much quicker than antidepressants; women experience relief in days instead of weeks. As with any medication, there are both pros and cons to Zulresso. Informing yourself about each risk and reward will help you stay active and in control of your treatment process. Talk to your doctor about specific questions you may have about medication to treat PPD.

Postpartum depression can make you feel inadequate and isolated. It may seem too difficult to seek treatment, or you may not think you have the time. But allowing yourself to reach out makes you that much closer to finding relief. Our therapists at New Milford Counseling Center have been specially trained in the treatment of postpartum depression. Contact us by phone at 860-740-2228, or by email at info@nmccct.com, to begin your path to recovery today.