Postpartum Mood Disorders

Postpartum Mood Disorders:

Explain that over half of women giving birth will experience the “baby blues” which happens within 3-14 days of giving birth. Mothers may describe themselves as feeling exhausted, stressed out, crying without apparent reason, and feeling overwhelmed. For the majority of women, these symptoms will pass within 2 weeks and the mother will begin feeling better.

Postpartum depression is generally diagnosed when symptoms last 2 weeks or longer and impair the mother’s ability to function. Symptoms may include: crying spells, feelings of anxiousness, panic attacks, compulsive behavior, excessive worry about the baby, challenges bonding with the baby, feelings of incompetence and feelings of being overwhelmed or lacking support. Medication, additional support, and psychotherapy can be appropriate interventions. Some recent research suggests telephone support is also an acceptable intervention with positive results.

Postpartum Psychosis only occurs in 1-2 out of 1,000 pregnancies. Although rare, the symptoms are severe and require immediate medical intervention. Postpartum Psychosis is believed to be related to bi-polar disorder and women who have a previous diagnosis are particularly at risk. Symptoms include: rapid mood cycling, inability to sleep, thoughts about harming herself or the baby, hallucinations, voices, difficulty putting thoughts together and behaviors such as compulsive overspending. Suicide and infanticide can occur with postpartum psychosis and this is why it is a medical emergency when symptoms are recognized. Hospitalization, medication, and psychotherapy are appropriate interventions. Until medication efficacy is established, the mother should not be left alone with the baby under any circumstances.

Mothers who are breastfeeding are often worried that they will have to stop breastfeeding if they are placed on medication. Research is showing that many of the medications used to treat postpartum mood disorders are compatible with breastfeeding and that a competent and knowledgeable doctor can provide compatible medications.

Untreated mood disorders can lead to neglect and abuse, poor cognitive and motor skill development in infants, and feeding problems for the infant. Mothers who suffer from untreated mood disorders have more disrupted bonding with their babies, and usually wean their infants from breastfeeding much sooner than mothers who are not suffering from postpartum mood disorders. In addition, many mothers feel as though a part of their memories with their new babies has been taken away by postpartum mood disorders. Treatment is effective and mothers need to be encouraged that this is not their fault and they did nothing wrong, and t that treatment can help them feel better about being a new mother.

Edinburgh Postnatal Depression Scale (EPDS):

EPDS is a self-assessment that can help women understand the severity of the symptoms they are feeling. Each question is answered by the woman based upon how she has been feeling over the past 7 days. A score above 10 indicates the possibility of postpartum mood disorders and requires evaluation by a doctor or therapist. Any thoughts of harm to self or others or reports of hallucinations should be reported to a professional for evaluation regardless of the EPDS score. Women should fill this out weekly during the first six weeks postpartum to track progress.