Introduction

For new mothers, childbirth is often a joyful experience, however, for many women, the postpartum period can take a toll on not just their physical but also mental health and emotional wellbeing. Let me explain to you with an example. Few days ago, I decided to visit my friend who gave birth to her daughter two months ago. She has always been a joyful and happy to go person, but when I met her, she had completely changed. She looked sad, tired and anxious. She did not have much interest in taking care of the baby. Initially, I thought that it was because of inadequate sleep and tiredness, but later I realized she was suffering from postpartum depression. I spoke to her family members about her condition and none of them were aware of this condition.

Postpartum depression (PPD) is a complex condition affecting millions of new mothers worldwide. Despite its prevalence, many women do not speak about PPD due to social stigma and misinformation, leaving them to suffer in silence. In this article, we will discuss about the causes, risk factors, symptoms, complications and management of PPD.

What is Postpartum Depression?

Postpartum depression is a type of depression that occurs in women after childbirth. It is characterized by feelings of intense sadness and hopelessness, that can interfere with a woman's ability to care for herself and her baby.

Causes of PPD

The exact cause of PPD is not known, but research suggests that it is a multifactorial condition that involves a combination of genetic, physical and emotional issues

1. Genetic: Having a family history of postpartum depression, especially if it was major can increase the risk of experiencing postpartum depression.
2. Physical changes: After childbirth, the sudden decrease in estrogen and progesterone levels after can contribute to mood swings and depression. Other hormones produced by thyroid gland may also /drop which can cause feelings of tiredness and depression
3. Emotional issues: Lack of sleep can exacerbate feelings of anxiety and depression. Also, pressure of caring for a newborn along with stress of adjusting to motherhood can take a toll of mental health of women. Also, women may feel less attractive or have a sense of losing their identity. Any of these issues can contribute to postpartum depression.

Risk factors for PPD

PPD can happen to any new mother and it can develop after the birth of any child, not just the first. The various risk factors for PPD include:

• Prior history of depression, in pregnancy or otherwise.
• Family history of depression.
• Stressful events such as pregnancy complications or illness.
• Health problems in babies or other special needs.
• Twins, triplets or other multiple births.
• Difficulty in breastfeeding.
• Lack of family support including spouse, family and friends.
• Unwanted or unplanned pregnancy.

Symptoms of PPD

The symptoms of PPD can vary from woman to woman, and from mild to severe. The various symptoms include:

• Persistent feelings of sadness and hopelessness.
• Loss of interest in activities that were once enjoyable.
• Fatigue and low energy.
• Depressed mood or mood swings.
• Crying too much.
• Difficulty bonding with your baby.
• Changes in appetite and sleep patterns.
• Irritability and anxiety.
• Physical symptoms such as headaches and stomachaches.
• Withdrawing from family and friends.
• Feelings of worthlessness or guilt.
• Thoughts of harming yourself or your baby.
• Recurring thoughts of death or suicide.

If left untreated, postpartum depression may last for many months or longer.

Complications

Postpartum depression, if left untreated can lead to a chronic depressive disorder. Even if treated, postpartum depression can be a risk for future episodes of major depression. For postpartum mothers, it can also cause disrupted health behaviors, relationships, physiology, and parenting. This results in a risk for the fetus, the partner, and the whole family.

Postpartum depression can also affect children. Children of parents who have untreated depression can develop behavioral and emotional problems, including language development delays, sleeping problems, eating difficulties, excessive crying, and attention-deficit/hyperactivity disorder. The condition can also affect parent-infant bonding. Often, the parent treats the child inappropriately and with a negative attitude, which can significantly impact the child's growth and development.

Diagnosis of PPD

Diagnosing PPD can be difficult, as the symptoms can be similar to those experienced by new mothers who are not depressed. However, by conducting a thorough medical and psychological evaluation, a healthcare provider can diagnose PPD.

Treatment and Management

Though PPD is a serious condition, fortunately, it is a treatable condition. Several effective management strategies available include:

1. Counseling and therapy: Proper counselling and individual and group therapy can help women work through their emotions, cope up with the difficulties and come out of depression.
2. Medication: Antidepressant medications can be effective in managing symptoms of PPD.
3. Social support: Family and friends form a major support for women suffering from PPD. We normally get busy in taking care of the newborn baby, unknowingly ignoring the new mother, however, it is important for the family to understand that the new mother needs love, care and support too. It is important for the family members and friends to understand the behavior and feelings of the new mother and support them so that they don’t feel isolated.
4. Support groups: Joining a support group can help women to connect with others who are experiencing similar struggles and provide women with a sense of community and connection.
5. Self-care: Engaging in activities that promote relaxation and stress reduction, such as yoga and meditation, can help alleviate symptoms of PPD.

Breaking the Silence

Despite the prevalence of PPD, many women find it difficult to speak openly about their experiences of depression. The stigma surrounding mental illness, combined with the pressure to be a "perfect" mother, can leave women feeling ashamed and isolated.

However, it is essential to break the silence surrounding PPD. By speaking and discussing openly and honestly about our experiences, we can help raise awareness and promote understanding of the concept of PPD and ways to manage it . We can also help create a supportive community that encourages women to seek help and prioritizes their mental health.

Conclusion

Postpartum depression is a debilitating condition that affects millions of new mothers worldwide. While it can be difficult to diagnose and manage, multiple effective treatment strategies are available, which can help new mothers come out of depression. By recognizing it, breaking the silence surrounding PPD and promoting awareness and understanding, we can help create a supportive community that prioritizes women's mental health.

Ultimately, it is essential to recognize that PPD is neither a sign of weakness or failure nor a stigma. Rather, it is a common and treatable condition that requires support, and understanding. By working together, we can help ensure that new mothers receive the care and support they need to thrive during this critical period.

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References:

• Carlson K, Mughal S, Azhar Y, Siddiqui W. Postpartum depression. InStatPearls [Internet] 2024 Aug 12. StatPearls Publishing.
• https://www.mayoclinic.org

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