PPD refers to depressive episodes during the postpartum period that persist for more than two weeks. According to the DSM-5, PPD shares the same diagnostic criteria as major depressive disorder, with the onset of pregnancy or within 4 weeks of delivery. The overall prevalence of PPD is thought to be around 17% (Shorey et al., 2018).
The specific cause of PPD is not known but several mechanisms including fluctuations of gonadal hormone and neuroactive steroid levels after delivery, altered cytokines and HPA axis hormones, and altered fatty acid, oxytocin, and arginine vasopressin levels have been proposed.
Risk Factors
As written above a specific cause has not been identified, however, there are multiple risk factors that pertain to getting PPD which are seen below.
Psychological:
Prior history of PPD
History of depression and anxiety,
History of premenstrual dysphoria,
Stressful life events during pregnancy
Stress involved in caring for a new-born.
Social factors
Lack of social or partner support
Domestic violence
Marital conflict
Low income
Lifestyle:
Eating habits,
Disrupted sleep cycle,
Smoking during pregnancy
other risk factors can be Young maternal age, family history of depression or mental illness and first-time motherhood.
Symptoms
In addition to the symptoms of major depression disorder symptoms of PDD include-
Feeling guilty or worthless
Self-blame
Excessive irritability, anger, or agitation
Mood swings
Sadness, crying uncontrollably for very long periods of time
Fear of not being a good mother
Fear of being left alone with the baby
Disinterest in the baby, family, and friends
Misery
Effects
PPD can have detrimental effects on both the mother and the child.
It disrupts maternal-infant bonds, leads to failure of breastfeeding, negative parenting practices, leads to marital discord and It can lead to chronic depressive disorder if not treated on time. It is also the strongest risk factor for paternal depression.
Children of mothers who have untreated depression can develop temperamental difficulties, emotional problems, delay in language and cognitive development, sleeping problems, eating difficulties, excessive crying, and attention deficit/hyperactivity disorder (ADHD).
Treatment
Psychotherapy -Interpersonal psychotherapy (IPT)
Antidepressant medications
Reference list
American Psychological Association (2022). Postpartum depression: Causes, symptoms, risk factors, and treatment options. [online] Apa.org. Available at: https://www.apa.org/topics/women-girls/postpartum-depression [Accessed 27 Jan. 2024].
Mughal, S., Azhar, Y. and Siddiqui, W. (2022). Postpartum Depression. [online] National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/books/NBK519070/.
Pearlstein, T., Howard, M., Salisbury, A. and Zlotnick, C. (2009). Postpartum depression. American Journal of Obstetrics and Gynecology, [online] 200(4), pp.357–364. doi:https://doi.org/10.1016/j.ajog.2008.11.033.
Shorey, S., Chee, C.Y.I., Ng, E.D., Chan, Y.H., Tam, W.W.S. and Chong, Y.S. (2018). Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research, [online] 104, pp.235–248. doi:https://doi.org/10.1016/j.jpsychires.2018.08.001. Assessed and Endorsed by the MedReport Medical Review Board
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