Postpartum
Depression - Beyond Just the "Baby Blues"
Many
new mothers struggle with sadness, anxiety, even crying spells just
after giving birth. For most, these feelings will disappear in a few
days.
However,
for about a half a million American women every year, the feelings do
not go away and will probably get worse.
Those
are the 13 percent of new mothers who suffer from postpartum depression,
says an article in a recent issue of the New England Journal
of Medicine.
Bringing
Awareness to the Problem
"We
wrote this article to make people aware that this is a major health
problem," says lead author Dr. Katherine Wisner, a professor of psychiatry,
pediatrics, obstetrics, and gynecology at the University of Pittsburgh
School of Medicine.
"Women
don't need to suffer with this illness. Treatment is available and effective,"
says Wisner, who worked at the University of Louisville School of Medicine
when the article was written.
A
Need to Educate Expectant Mothers
Wisner
and her colleagues recommend physicians make patients aware of the symptoms
of depression during and after pregnancy, and that they screen the women
for depression using a 10-question test.
The
following are the most common symptoms of postpartum depression. However,
each individual will experience symptoms differently. Symptoms may include:
-
sadness
-
hopelessness
-
fatigue
or exhaustion
-
poor
concentration
-
confusion
-
mood
swings characterized by exaggerated highs and/or lows
-
diminished
libido (sex drive)
-
feelings
of guilt
-
low
self-esteem
-
uncontrolled
crying and with no known cause
-
over
concern/over attentiveness for the newborn and/or a lack of interest
for the newborn
-
appetite
changes
-
sleep
disturbances
-
resentment
-
memory
loss
-
feelings
of isolation
If
depression is diagnosed, Wisner says, there are several treatment options.
One is psychotherapy. Another is medication. Wisner says many of the
newer antidepressants, such as Zoloft and Paxil, can even be used by
breastfeeding women.
Postpartum
Depression and the "Baby Blues" Are Different
Dr.
Boris Petrikovsky, chairman of the department of obstetrics and gynecology
at Nassau University Medical Center in East Meadow, N.Y., says postpartum
depression can go undiagnosed because it is difficult to distinguish
from the more common "baby blues."
Between
40 percent and 85 percent of all women experience the "baby blues,"
which usually lift quickly without intervention, says Ana Rivas-Vazquez,
a psychologist with Baptist Health South Florida in Miami. They cause
feelings of sadness, irritability, confusion, and anxiety, and peak
around the fourth day after delivery.
"If
it's not gone by day 10 postpartum, it's not the blues, it's depression,"
Wisner says.
In
rare cases, postpartum psychosis becomes evident—a very serious
illness that needs immediate treatment. If a new mother shows signs
of hostility toward her baby or has thoughts of harming the baby, Petrikovsky
says he immediately refers her to a psychiatrist. Postpartum psychosis
affects approximately one to two women out of every 1,000 who give
birth.
Be
on the Look Out For Signs of Trouble
Petrikovsky
says it is important for physicians to get to know their patients,
so they can be on the lookout for signs of trouble. He also feels it
would be wise for physicians to have a nurse call patients two weeks
or so after delivery to see how they are feeling.
Those
most at risk for postpartum depression are women who have had previous
episodes of depression and those with poor or abusive relationships
with their spouse, says Rivas-Vazquez.
The
most important thing for women to know is that having postpartum depression
does not mean they are not good mothers, says Rivas-Vazquez. She says
that women often do not seek treatment because they feel guilty about
their depression.
"Postpartum
depression is a frequent condition that is very treatable, and it shouldn't
have any negative connotations," Rivas-Vazquez says.
Always
consult your physician for more information.
|
August
2002
Bringing
Awareness to the Problem
A
Need to Educate Expectant Mothers
Postpartum
Depression and the "Baby Blues" Are Different
Be
on the Look Out For Signs of Trouble
Online
Resources
Lingering
Fatigue Now a Warning Sign for Postpartum Depression
Fatigue
that lingers too long after childbirth could be an early sign of postpartum
depression.
In
research presented recently at the Scientific Session of the Eastern
Nursing Research Society, in University Park, Pa., investigators offered
new evidence that fatigue could, in fact, act as an important marker
for identifying new mothers who are at risk for such depression before
any classic symptoms appear.
"All
women feel fatigue after childbirth and for several weeks afterwards.
But in most women, we see a curve—the fatigue gradually lessens
over time," says study author Elizabeth Corwin, an assistant professor
at the Penn State School of Nursing.
In
women who are prone to postpartum depression, however, Corwin says
that does not happen.
"These
women feel as tired on day 14 as they felt on day 7, indicating the
fatigue isn't letting up," says Corwin. And it is that persistence,
she adds, that could indicate which women may go on to develop postpartum
depression.
Reproductive
psychiatrist Dr. Shari Lusskin agrees that fatigue is an important
risk factor, but she says the study finding is not exactly new.
"We
have long known that fatigue and depression go hand-in-hand. Therefore,
I think if these women were given a standard depression test on day
14, their risk of postpartum depression may have been revealed as
well, and possibly with more accuracy," says Lusskin, an associate
professor of psychiatry at New York University School of Medicine.
Corwin
disagrees: "We found that at the two-week mark, most of the women
who expressed extreme fatigue had no classic signs of depression,
so they may have been overlooked by a classic diagnostic test," she
says.
"I
think the key finding here is that fatigue which either does not begin
to lift within two weeks after childbirth, or increases and actually
grows worse over time, is a good indicator that a woman is heading
for postpartum depression—and it's important that intervention
take place as soon as possible," says Corwin.
Although
sometimes the "six-week postpartum blues" can progress to full-blown
postpartum depression, women who suffer postpartum depression do not
transgress to postpartum psychosis. This, says Corwin, is a completely
different disorder.
To
help ascertain further risk factors for postpartum depression, the
study also looked at breastfeeding vs. bottle-feeding, the presence
of other children in the family, whether the women had partners, and
previous bouts of postpartum depression. The researchers report none
of these factors appeared to make a difference or affect the findings.
Always
consult your physician for more information.
Online
Resources
American
Academy of Pediatrics
American
Board of Obstetrics and Gynecology
American
College of Obstetricians and Gynecologists
American
Medical Association
American
Psychological Association
New
England Journal of Medicine
|
