There are three different levels of postpartum depression.
- The Baby Blues: Affect up to 80% of women after they give birth, are considered normal. The symptoms usually appear within the first few days post-birth and normally disappear within a couple of weeks. The Baby Blues do not impact the daily activities of the new mother.
- Postpartum depression: Affects between 10 and 20% of women. It is a more severe form of the Baby Blues and is considered depressive illness. It can appear anytime within the first several months after giving birth and the symptoms usually increase gradually. Women with Postpartum depression should seek help, whether it is from a medical provider or from a support group such as family members or close friends. This “pregnancy depression” can also be accompanied with, but not limited to, lack of interest in your baby, the inability to care for your baby, high levels of anxiety, chest pains, headaches, thoughts of hurting your baby and suicidal thoughts.
- Postpartum psychosis: Is a rare condition that is closely linked to bipolar disorders. It affects about 1 in one 1000 pregnancies, and it is a very serious illness. Symptoms related to postpartum psychosis develop abruptly. Some of the symptoms include; delusions, hallucinations (hearing/seeing things that don’t exist), bizarre behaviour, euphoria, insomnia, mania, acute confusion, agitation. Women who display these symptoms should be treated immediately and in most cases require hospitalization to prevent them from hurting themselves or their babies.
Causes and Risk Factors associated with postpartum depression:
Causes:
Scholars have not yet identified the precise causes for postpartum depression. Contradictory research endeavours indicate different probable reasons why some women go through pregnancy blues and depression. Here are some of the most studied possible causes associated with depression during pregnancy as well as postpartum depression. It is accepted by most that postpartum depression is caused by a combination of factors.
Hormonal Changes:
Although experts have not been able to pinpoint an exact source to postpartum depression, one of the leading causes is associated with the hormonal changes. During and after pregnancy, women experience a significant decrease in their levels of estrogen and progesterone within the first 48 hours after giving birth. This hormonal drop has an impact on the new mother and can generate depression (postpartum syndrome). Although all women go through this hormonal change, the way it affects them determines whether they will experience pregnancy blues or postpartum depression. Some women are more sensitive to these hormonal changes which will heighten their chance of developing postpartum depression. In some cases, the level of thyroid levels may also decrease and cause fatigue which can then open the door to depression. On the other hand, certain scholars contradict this hypothesis (role of hormonal change) claiming that hormonal variations are not to blame since fathers also experience postpartum depression even though they do not experience fluctuations regarding their hormonal levels.
Physical and emotional changes:
Motherhood encompasses physical, emotional and lifestyle changes that can become overpowering. Pregnancy and delivery does not go unnoticed on a woman’s body. For nine months, your body has been changing and preparing itself for birth. These changes (weight gain, diminished muscle tone etc.) may create insecurities. Some women have a difficult time accepting their “new” body and may not feel attractive or sexually desirable. They may have a hard time shedding the pounds they gained during pregnancy. Others may even experience pain and fatigue for a certain period of time after giving birth. All of these examples are common and influence a woman’s mood. Additionally, motherhood is emotionally challenging; there is a newborn to care for, a new set of responsibilities and stress that can be overwhelming. The physical changes, when put together with the emotional challenges that new mothers (especially first time mothers) have to face, can cause depression in some cases.
In short, although every woman goes through similar changes, be it hormonal, physical and emotional, every new mother experiences it differently. Most experts agree that there is not one specific source to blame for postpartum depression but that it is rather the result of a combination of causes, including a lack of social support.
Risk Factors:
Since postpartum depression is considered a depressive illness, women who have a history of depression are more likely to suffer from postpartum depression. Moreover, women who have had postpartum depression in a prior pregnancy increase their chances of being afflicted by it in their subsequent pregnancies by 50%. There is also a link between severe PMS (premenstrual syndrome) and PDD (premenstrual dysphoric disorder) and postpartum depression. In this case, it is the fluctuation in hormonal levels that are more often than not to blame for the onset of depression or postpartum syndrome.
Other factors (when combined or individually) can increase the risk of postpartum depression. These factors include, but are not limited to:
- Unplanned pregnancy
- Pregnancy at a young age (under 20 years of age)
- Single parent
- Unstable relationship with the other parent
- Depression prior to giving birth
- Anxiety
- Having a difficult baby
- Formula-feeding versus Breast-feeding
- Low self-esteem
- Lack of social support
- Low social economic status
- Mother’s sexual orientation
- Substance abuse problem including smoking
In order to prevent postpartum depression, a woman who has been diagnosed with depression, bipolar disorder or any other form of mental illness, should speak to their health care provider regarding treatments available to her. There are some antidepressants which have been found to help lower the risk of pregnancy blues and depression without causing any harm to the breastfeeding child. A new mother’s social support group (family and friends) also has the potential to help lessen the severity of postpartum depression.