has Postpartum depression (PPD) is not only a major global health concern but also the most ubiquitous complication associated with childbirth. According to a review published in 2005, 19% of the women in the United States were diagnosed annually with PPD. Another latest study claims that 1 in 7 women experience postpartum depression in the same year after the birth of their child.
Unlike baby blues or postpartum blues in which symptoms appear and resolve quickly (within 2 weeks) after the birth, PPD is more severe and can even last up to one year. The symptoms of PPD include suicidal or self-harming tendencies, reduced interest in activities, abrupt mood swings, thoughts of harming the child, depressed mood, low self-esteem, constant and unexplained fear, insomnia, fatigue, loss of appetite, etc.
Although rare, a more severe illness is the postpartum psychosis which occurs approximately in 0.2-0.3% of the child births. In such cases, the mother suffers a break from the reality and experiences severe psychotic episodes. In fact, the delusions are extremely severe. They only make sense to her, and her beliefs lead to self-harm or even harming the child in some cases. The symptoms include hallucinations, hyperactivity, delusions, paranoia, irritability, rapid mood swings, etc.
Regardless of the severity in symptoms, postpartum depression and psychosis can have long lasting negative consequences on the well-being of both mother and the child. Although the conditions are deeply complex in nature, there are several root causes. These causes can be associated with the development of postpartum depression or psychosis.
During pregnancy, the female body is inundated with Estrogen and Progesterone; two of the most essential hormones associated with gestation. However, there is a rapid fall in the level of these two hormones right after childbirth. Although the relation is still under ongoing research, this rapid and extreme fall in the hormone levels may have a detrimental impact on the mother’s mental health. In addition, social and psychological changes arising from added responsibilities and pressure (financial difficulties, low social support) may surmount to postpartum depression. If unaddressed, this ultimately leads to unfavorable mother-infant interactions, attributing to adverse infant development that may include severe health risks.
When it comes to postpartum psychosis, the most alarming risk factor is either personal or a family history of bipolar disorder. In addition, any previous unreported psychotic episode, rapid fall of estrogen and immune system dysfunction may result in postpartum psychosis. Furthermore, maternal deficiency of the enzyme steroid sulfatase (encoded by X-linked STS gene) is also a culprit. The deficiency is a prime candidate for the development of postpartum psychosis.
The silver lining is, both postpartum depression and psychosis are treatable and quick recovery is possible if addressed immediately. In fact, functional medicine and appropriate psychotherapy can pave the way to efficacious results. However, it is very important that the mother goes through a screening during and after the pregnancy so that she can receive the much-required attention.
Ishtiak Ahmed Chowdhury
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Lara-Cinisomo, Sandraluz Akinbode, Tanitoluwa Demilade (2020). Research Recommendations on the Effects of Postpartum Depression and Pain on Infant Care and Development. Journal of Obstetric, Gynecologic & Neonatal Nursing, 49(5), 416–422. doi:10.1016/j.jogn.2020.05.005
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression—A systematic review of prevalence and incidence. Obstetrics and Gynecology, 106, 1071–1083. https://doi.org/10.1097/01.AOG 0000183597.31630.db