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POST NATAL DEPRESSION - a patient's guide
Editorial Team
Overview
Postnatal depression affects about 10 percent of new mothers
It usually begins between one month and three months after
giving birth
There is no evidence postnatal depression is related to
hormonal changes
The mother's own psychological and social condition are
believed to be related
Risk factors include a history of depression, lack of
support and birth complications
Symptoms are similar for depression but also involve anxiety
about the baby
Postnatal depression has been linked to developmental
problems in children
The first line of treatment is counselling and support.
Antidepressants may also be very useful.
What is it?
Post-natal depression is a mental illness which affects
about 10 percent of women who have just had a baby.
Postnatal mental disorders are split into three categories.
Baby blues a few days after delivery, post natal depression
which can continue for months, and postnatal psychosis.
The baby blues or postpartum blues start in the first
week after childbirth and usually mothers just have a couple
of tearful days feeling down. This is fairly common with
some studies showing rates of up to 50 percent.
Postnatal depression develops between one and three months
after giving birth. The symptoms are similar to depression
but with the addition of worry about the baby, and guilt
about lack of love for it.
Postnatal psychosis is a serious mental illness with symptoms
of mania, hallucinations, delusions and rapid mood swings.
In rare cases the mother may harm her baby.
Postnatal depression has been linked to developmental
problems with the child. It has been shown to impair the
child's mental and emotional development. One study has
found the children of mothers with postnatal depression
had more difficulty performing mental tasks than others,
with boys at most risk. They were also more likely to be
considered behaviourally disturbed by their teachers.
Children of mothers with postnatal depression may also
have poor emotional adjustment, probably due to problems
with mother-infant bonding.
There is no evidence that the condition is caused by hormonal
changes. Hormone levels stabilise in most women two weeks
after birth. It has been suggested that thyroid problems
could be responsible in some groups of women, but this may
also be a symptom of stress.
It is believed that social factors and the mother's mental
condition before the baby is born are more likely to impact
on the development of postnatal depression.
Risk factors for postnatal depression include baby blues
immediately following delivery, a history of depression,
a previous stillbirth or abortion, unplanned pregnancy,
complications during birth, lack of family support, marital
problems, and unemployment.
Some experts believe that postnatal depression is more
likely if there are problems in the mother's relationship
with her own mother. She may feel dissatisfied with the
care she herself received as a child, and becoming a mother
may bring back these feelings leading her to resent her
partner and baby.
What are the symptoms?
The symptoms for postnatal depression are similar to depression,
but also include anxiety about the baby and mothering skills.
The following symptoms could indicate postnatal depression:
being over anxious
easily upset, tearfulness
poor appetite
being tired but unable to sleep
worry about the baby's health
guilty about inadequate mothering or lack of love for
the baby
problems coping with the baby and domestic routines
loss of interest in sex
fear of harming the baby
thoughts of harming yourself
Postnatal depression usually lasts up to six months, but
some symptoms may remain a year after the baby was born.
Some women may not feel depressed but suffer from an anxiety
disorder or panic disorder instead. They may have symptoms
of intense anxiety, rapid breathing and heart rate, shaking
and dizziness.
Some women also suffer from obsessive compulsive disorder
following birth. Symptoms include repetitive thoughts (possibly
about harming the baby), avoiding the baby, and anxiety.
What can be done to help?
Do not delay seeking professional help.
Treatment may involve a combination of drug treatment
and psychotherapy. Often simple measures like more rest
and time out will be very beneficial.
The initial treatment is counselling and is best carried
out by health professionals visiting the mother at home.
A study of women who received nine visits over 13 weeks
found an improvement in their mood compared to those who
had the standard primary care.
Home visits by trained counsellors has also been shown
to improve bonding between mother and baby. Early intervention
is believed to be the best way to stop developmental problems
in the infant.
Drug treatment can involve hormone therapy. There is debate
over the effectiveness of progesterone but oestrogen has
shown an improvement in some women with severe depression.
One antidepressant, fluoxetine (Prozac) has been proven
to help lift depression among new mothers, in combination
with counselling.
Postnatal depression may be missed by health professionals.
Don't be afraid to ask for help if you think you are suffering
from depression.
Joining a support group for women suffering from postnatal
depression may also be helpful.
Medical assistance is essential for women suffering from
postnatal psychosis.
Future trends
Researchers are looking to develop prevention strategies
to help stop new mothers becoming depressed.
Getting help
Your doctor, Plunket nurse, Family Planning Clinic, or
local mental health team will be able to help.
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