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The Melancholy Mother: Why moms and babies are in jeopardy

by Dr. Pranjal on September 22, 2022 , 5 min read

“Postpartum” refers to the time after delivery in pregnancy. During the process of childbirth, a woman once turned into a mother goes through monumental changes such as in her hormonal physical, emotional, and psychological events. All these many changes can impact this woman tremendously. But what happens after childbirth? Do women go back to being completely normal as they used to be?  Many women wish this is true; they wish to go back to having the same young body as before they were pregnant. Despite pregnancy and motherhood being a wonderful experience and a time of happiness, this is not always seen in families. It is not so sugary sweet with their newborn babies as it may seem. Negative emotions that may or may not be voluntary such as sadness, uncontrollable tears, and general mood-outs are noticed too. 

Postpartum depression (PPD) is a severe psychological rollercoaster of emotions (both positive and negative) and behavioural changes that take place in some women within 4 weeks after delivery. This mental health problem is prevalent amongst all women of all races, putting their offspring at risk.

“According to a national survey of postpartum depression, one in seven women experience postpartum depression (PPD)  which is otherwise infamously confused with the baby blues.”

This depressive state is not a serious condition, many women tend to experience recovery from PPD quicker than other issues. We all know how a mother's influence affects her newborn baby, so whatever the mother feels the baby feels too. This is a natural event and is essentially a healthy bonding and developing stage for the infant. You can imagine how the maternal brain and behavior are compromised due to postpartum depression. 

Postpartum depression is linked to chemical, social, and psychological changes during childbirth. The term refers to a variety of physical and emotional changes that many new mothers go through. Medication and counseling can be used to treat PPD.

 

 

According to a study conducted in 2006, as much as 50% of PPD-affected mothers are left undiagnosed because they feel reluctant to speak out about their symptoms as their privacy may be violated or it might become a burden on the other family members. As most mental health disorders are left unseen, so is postpartum depression, making it more severe as it affects both mother and child. 

 

What causes PPD? And why are some women more prone to it than others?

For starters, postpartum depression deals with a whole array of biological fields such as psychological events, physical living, and internal functioning combining them into what we know and call postpartum depression. Let us evaluate the reasons behind such a disorder in mothers. 

The rapid decline in the levels of reproductive hormones that occurs after delivery is believed to contribute to the development of depression in susceptible women. Although it is tempting to attribute postpartum depression to hormonal decline, several other factors may predispose women to this condition. Stressful life events, past episodes of depression (not necessarily related to childbirth), and a family history of mood disorders, are all recognized predictors of major depression in women. 

 Lifestyle: 

The way you live your life, the sleeping and eating habits, and the daily routine you follow are all linked to the effects of PPD. Out of these, your sleeping cycle is the most influential. So much so that it plays a part in the risk of depression. Oftentimes, newfound mothers lack proper sleep or end up sleeping at unusual times of the day when the brain is supposed to be active. Thus a drastic change or lack of sound sleep is associated with postpartum depression. Adding to that, a sedentary lifestyle is also a leading threat. Make sure you give your body the required amount of sleep and exercise to ensure a proper pregnancy lifestyle. It is a known fact that exercise effectively improves your brain's activity along with other organs such as your heart and lungs. To be healthy is to be happy, so maintain a healthy daily routine to avoid unnecessary problems by avoiding unhealthy habits such as smoking, alcoholism, and so on during pregnancy. 

 Psychological factors: 

A medical history of depression, stress, anxiety, and/or, other related issues such as premenstrual syndrome (PMS), and imbalanced hormonal surges may cause risks. Sometimes new mothers are found negatively impacted by the baby’s gender, or may have experienced sexual or mental abuse, etc are equivalent factors for developing postpartum depression.

 Social factors: 

It is unfortunate when a mother gives birth to a baby without much social or emotional support. This is a problem that most women go through before they develop postpartum depression. Situations such as domestic violence, verbal or sexual abuse, issues in the close family bloodline, etc are causative factors in the development of the disease. 

The time frame for PPD


Postpartum depression most commonly occurs within 4 to 6 weeks after childbirth. Around 6% to 20% of women suffer from this. 

It is also more prevalent in:

  • Teenage or adolescent mothers,
  • Mothers who give birth to premature infants, and 
  • Women who live in urban areas

How exactly does PPD develop?


While we dive into the pathogenesis of postpartum depression, it is suggestive that many factors play a role, as with most other diseases. Genetics, hormonal, psychological, biochemical, and social influences are major factors. 

 

As a woman undergoes her course of pregnancy, her hormones go for a complete turn. She experiences tremendous change from the physical body to her internal organs, all to develop the little cluster of reproductive cells inside of her to a fully grown and healthy fetus. To make such a miracle come alive, reproductive hormones (estradiol, oxytocin, prolactin, and progesterone) are said to be heavy influencers, as they signal various biological processes to the brain. We all know that anything that involves working with the brain will eventually affect our mood and behavior. It is therefore completely natural for mothers to feel this way. But can we let this psychological disorder go untreated? We cannot neglect the obvious so here are a bunch of treatment options available out there to treat postpartum depression. 


 

When we zoom in on hormones prolactin and oxytocin which are noticed in the regulation of breast milk and breast milk production, you can see how it physically affects the feeding infant. In a mother concerned with PPD and depressive-like symptoms, oxytocin levels are particularly low compared to women who are not affected during and after delivery. 

 

Can PPD affect your baby?


The phrase ‘like mother, like baby’ wasn’t invented to fill in for nursery rhymes. In nature, the child takes on whatever the mother faces. It is a simple neural mirroring mechanism much like how yawning is contagious. We can firmly say postpartum depression will affect the infant. This is why it is important to check for the symptoms and get them treated. 

But what happens if PPD is left untreated? The consequences constitute:

  • Difficulty in bonding with your baby
  • Inconvenience in regularly breastfeeding,
  • Breast milk may not be as nutritious for the baby as it should be (breast milk needs to have the appropriate concentration of proteins and fats as it is the best food for the baby during its first year).
  • PPD will make it exhausting to take care of the baby and it ends up being burdensome for the mother. 
  • Health issues that need attention and medical care might be developed by the infant. Oftentimes these health issues will be left unnoticed by the depressed mother. 
  • It may also be hard for the mother to get the baby regularly checked by a pediatrician and render the required vaccination doses. Vaccinations are required to help the baby develop immunity to certain lethal diseases. 
  • In the long run, the baby is prone to grow with behavior, developmental or learning disabilities, and mental health conditions later in life. 
  • By reading all this, you can understand how essential it is to treat postpartum depression so that your baby can live and grow into a healthy child. 

What are the types of postpartum depression?

There are three different types of postpartum mood disorders:

  • Mood swings,
  • Sadness, anxiety, or overwhelming emotions,
  • Crying spells,
  • Loss of appetite,
  • Insomnia, etc. 

However, postpartum depression is a more severe form with long-lasting symptoms that takes more effort to get rid of. 

Postpartum depression (PPD)

Postpartum depression syndrome is a serious mental health issue. It is widespread, and offspring are at risk of developmental problems. Past depression, stressful life events, a poor marital relationship, and a lack of social support are all major risk factors. Public health efforts to detect PPD are growing. For PPD, both standard treatments (such as Interpersonal Psychotherapy) and more tailored treatments have been found to be effective. Prevention efforts have had a less consistent level of success. Studies of epidemiological risk factors and prevalence, interventions aimed at the parenting of PPD mothers, specific diathesis for a subset of PPD, effectiveness trials of psychological interventions, and prevention interventions aimed at addressing mental illness.

 

Postpartum psychosis 

Postpartum psychosis is a rare disorder found in mothers that is on a higher severity scale than postpartum depression. It is a more pressing concern that requires immediate medical intervention as there is a risk to the life of the infant (infanticide) and the mother (suicide). It usually occurs 2 weeks after delivery. Often times mothers who have another mental condition such as bipolar disorder or schizophrenia are more likely to develop postpartum psychosis. Thus it is advised that all PPD patients must be screened for the potential of manifesting postpartum psychosis. 

 

Symptoms include:

  • Seeing or hearing things that are unreal (hallucinations and delusions),
  • A confused state of mind or being disorganized,
  • Rapid mood swing episodes,
  • Paranoia (thinking that others are focused on harming you),
  • Restlessness (sleep disturbances) or agitation (hyperactivity), etc.

Postpartum psychosis may lead to dangerous situations that may be fatal to the life of the infant and mother.

Signs and symptoms of Postpartum Depression


If you come across 5 or more of these symptoms that tend to last longer than 2 weeks, then you may want to consider visiting your doctor. 

In this syndrome, symptoms such as 

  • Weeping, sadness, episodes of crying, feeling helpless,
  • Guilt, shame, and regret,
  • Severe mood swing episodes, irritability, 
  • Anxiety, fear, lack of interest and changes in weight, 
  • Confusion, trouble focusing or making decisions, occur.

    Cropping up around the first month after childbirth up to a year. These constant mood swings cause disturbances in a woman’s mental health but have no effect on her functioning. 

How can you get Postpartum Depression treated?

Here are some common ways to treat postpartum depression depending on the severity or type:

Medications: 

Suitable FDA (Food and Drug Administration) approved drugs prescribed by your doctor or nurse may be taken during the course of illness for adult women suffering from PPD and postpartum psychosis. The most common medications are anti-depressants and anxiolytic (anti-anxiety medications) that aid in relieving symptoms of depression and anxiety most suitable for breastfeeding mothers.

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Therapy (psychotherapy): 

When conversing with a therapist or psychologist, it is known to improve and effectively change the way depression affects a mother by positively influencing the way she thinks, feels, and acts. Thus it is recommended that therapy be the next step in treatment after prescribed drugs. 

Support group participation: 

This type of talk therapy is tremendously helpful for mothers. In a sense, it allows mothers to feel accepted by other women who have experienced the same so that they do not feel left out and can make use of different strategies to combat postpartum depression. 

Electroconvulsive therapy (ECT):

ECT can be used in extreme cases to treat postpartum depression and psychosis.

 


These few treatment methods may be used alone or in combination. However, treatment is mandatory for both the syndrome you and your baby. Seeking help and remedy is always a sign of positive strength. 

References:

Postpartum Depression: What We Know. University of Iowa- https://www.researchgate.net/profile/Michael-Ohara-7/publication/26892699_Postpartum_depression_What_we_know/links/5e85e024a6fdcca789e968d0/Postpartum-depression-What-we-know.pdf

Postpartum depression- https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

Postpartum depression- 

https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

by Dr. Pranjal on September 22, 2022 , 5 min read

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