What you Need to Know about Postpartum Depression among Breast-Feeding Mothers

Childbirth is, most times, associated with a happy feeling and a cheerful mood. We do not know that society could be the happy set while the mother who just delivered is experiencing anxiety and fear, suffering, and slowly draining into depression. Various negative experiences are linked to childbirth, including baby blues, postpartum psychosis, and postpartum depression (PPD). These disorders after childbirth are not a weakness or bad character. They can affect mothers, fathers, surrogates, and adoptive parents. Anyone experiencing them should know they are not alone; it is not their fault, and many people are willing to help.

Causes of Postpartum Depression

There is no single lead to postpartum depression. It is mainly linked to a combination of factors. The factors can be genetics, hormonal changes, and emotional issues.

1. Genetics. According to past studies, being a member of a family with a history of PPD, especially a major one, increases your chance of being a victim.
2. Hormonal changes. The drop in estrogen and progesterone hormones in your body can lead to PPD. A sharp drop in hormones produced by the thyroid gland could leave one sluggish, tired, and depressed.
3. Emotional issues. Anxiety about your ability to care for your child and feeling overwhelmed may make you have difficulty handling minor issues. Feeling less attractive, like you have lost control over your life, and struggling with your sense of identity could also lead to PPD.

Risk Factors of Postpartum Depression

In as much as any woman can experience postpartum depression, the most likely are;

• Those with a history of depression during pregnancy (prenatal depression) or other times or that have had premenstrual syndrome
• Those with bipolar disorder
• Those with low self-esteem mainly caused by body changes during pregnancy
• Those that have experienced postpartum depression in previous pregnancies
• Those with family members that have experienced depression or other mood disorders
• Those reluctant to accept the baby’s gender
• Those that have experienced stressful events such as job loss, pregnancy complications, or illness during the past year
• Those with medical complications during childbirth, e.g., umbilical cord prolapses, low hemoglobin, meconium passage, or delivered a baby that has a health problem or other special needs
• Those that have multiple births, such as twins, triplets
• Those with difficulty in breastfeeding
• Those with relationship problems with their spouses and lack enough emotional support from them
• Those that have experienced domestic violence, physical, sexual, verbal, and emotional.
• Those with a weak support system, such as family, friends
• Those with financial constraints
• Those with poor eating and sleeping habits
• Those whose pregnancy was unplanned or unwanted
• Those with alcohol or other drug abuse problems
• It has similar adverse effects on child development and partner relationship.

Differences Between Postpartum Dysphoria, Postpartum Depression, And Postpartum Psychosis

Postpartum Dysphoria (baby blues) is the most common. If they fail to subside after mainly two weeks or about, the symptoms graduate to postpartum depression. Postpartum psychosis is rarer than postpartum depression; its onset is often sudden and linked to paranoia and confusion. It is more severe than postpartum depression.

Baby Blues/ Postpartum Dysphoria

According to specialists, baby blues are seen 2-5 days after the baby is born and lasts for about two weeks. Up to 70% of new mothers experience baby blues. It is caused mainly by the change in estrogen and other hormones after childbirth. Common symptoms of baby blues are;

• Crying
• Anxiety
• Feeling overwhelmed and restless
• Mood swings
• Difficulty sleeping and in some cases experiencing sleeping disorders
• Reduced concentration
• Appetite problems (Loss of appetite or overfeeding)

Postpartum Psychosis

It also develops in the first week after delivery or during pregnancy. It could last for 2-12 weeks or 6-12 months. It is mainly triggered by the abrupt shift of hormones after delivery and requires immediate treatment. It mainly occurs in about 1 out of every 1000 births. Women with a history of bipolar affective disorder or schizoaffective disorder and psychotic episodes are at the highest risk. Postpartum psychosis symptoms include;

• Feeling lost and confused and having disorganized thinking
• Rapid mood swings similar to bipolar disorder
• Obsessive thoughts about your baby
• Having delusions and hallucinating
• Sleep difficulties
• Feeling upset/ having too much energy
• Being paranoid
• Attempting self-harm or harming the baby
• Having life-threatening thoughts or behaviors
• If not treated immediately, it leads to increased depression and anxiety

Postpartum Depression

It could be easily mistaken for baby blues. However, its symptoms are more severe and are prolonged. It mainly occurs six weeks- 6 months after childbirth and can last up to a year or longer. Studies have shown that approximately 6.5% to 20% of women experience it. Of 75% of women that have experienced baby blues, up to 15% develop postpartum depression. Important to note is that the symptoms can be experienced during pregnancy, after the termination of a pregnancy, or following a miscarriage. Some studies show that new fathers can experience postpartum depression too. The symptoms can begin during pregnancy, the first few weeks after childbirth, or even a year later. They include;

• A depressed mood or intense mood swings
• Excessively crying
• Having a hard time connecting with your child
• Feeling of numbness or being disconnected from the baby
• Isolating oneself from relatives and friends
• Appetite loss or overeating
• Insomnia, often known as sleeplessness or sleeping excessively
• Excessive fatigue or lack of energy
• Loss of interest in and enjoyment from past activities
• Severe irritation and fury
• The apprehension that you are a terrible mother
• Hopelessness
• Feelings of inadequacy, shame, remorse, or worthlessness
• Reduced capacity for clarity of thought, concentration, and decision-making
• Self-injury or harm to your child in your thoughts
• Uneasy
• Severe anxiety or anxiety attacks
• Recurring suicidal or dead thoughts

The effects are; interference with the ability to care for the baby, e.g., breastfeeding for a shorter time or not breastfeeding at all, reduced breast milk, and inability to carry out daily tasks.

Paternal Postpartum Depression

For new fathers, they may;

• Undergo changes in their usual sleeping and eating patterns
• Feel tired, sad, anxious, and overwhelmed

Young fathers that have financial struggles, relationship problems, and a history of depression are most likely to experience it. It is also caused by inadequate social support for parenting, feeling excluded in mother-infant bonding, and extreme stress from being a parent.

When does one seek medication for postpartum depression?

It is advisable to visit medical personnel immediately after the symptoms occur. One may be reluctant to admit it as it sounds embarrassing but schedule an appointment with your primary health care provider, gynecologist, or obstetrician. Also;

• If the baby blues do not go away after two weeks
• Are worsening
• If you have ideas of injuring yourself or your baby
• If you find it difficult to connect or care for your baby

In case of thoughts on suicide;

• Seek help from a medical practitioner
• Call a mental health provider
• Contact a suicide helpline in your country
• Reach out to someone close

Consequences Of Untreated Postpartum Depression

Untreated postpartum depression can affect parent-child bonding and cause family problems.

Mothers; may stop breastfeeding, stop caring for the infant, and increases the risk of suicide or infanticide. Even after treatment, it increases the mother’s risk of having major depression. There is also trouble bonding with your baby.

It can ripple effect on fathers, resulting in emotional stress for all those close to a newborn baby.

For children, if the mother has untreated postpartum depression, there is a probability they experience behavioral and emotional problems such as eating and sleeping difficulties, obesity, delays in language development, hyperactivity disorder, attention deficit disorder, and crying too much. It also affects a child’s development and safety.

How do I help a loved one experiencing postpartum depression?

Be aware of the signs of depression and anxiety. Sometimes the victims may fail to realize they are depressed or have a disorder. If you notice it, help them reach out to medical personnel immediately. Do not stay and hope for improvement. A mother cannot figure it out like in the case of other illnesses.

• Offer to organize an appointment or accompany them as a support person.
• Be a good listener
• Offer to take care of their child while they rest
• Offer to aid with daily tasks like running errands and house chores

Diagnosis, Prevention, and Treatment of Postpartum Despression

For those with a history of depression, inform your healthcare provider as soon as you realize you are pregnant or when you are planning to get pregnant.

• During pregnancy, the health care provider can closely monitor you for any depression signs. This is achievable by attending childbirth education classes. They may ask you to fill out a depression-screening questionnaire during your pregnancy and after delivery, discuss your health history, and carry out lab tests, e.g. blood tests and a pelvic exam. Mild depression is manageable through therapy (talk and cognitive behavior), counseling, or with support groups. In some cases, antidepressants can be recommended even during pregnancy.
• After delivery, the healthcare provider can recommend an early postpartum checkup to screen for depression signs. The earlier, the better. In case of a history of postpartum depression, your healthcare provider can recommend talk therapy or antidepressants immediately after delivery. Most antidepressants are safe to take as you breastfeed. Exclusive breastfeeding has an optimistic effect on relaxing depressive symptoms from childbirth to three months.
• Societal support from family and health care providers and enough maternal sleep can help prevent postpartum depression.
• If you fail to respond to the above treatment, electroconvulsive therapy is recommended.

How To Cope with Postpartum Depression

• Eat healthily and create time for exercise
• Find someone to talk to. Someone who will listen and help you, e.g. a friend, therapist, family member
• Make your expectations and those of your baby realistic
• Go out and have time with friends
• Get help with house chores and errands
• Create time for self-care and engaging in things you enjoy, such as swimming and other hobbies.
• Prioritize rest for yourself
• Limit visitors when you first go home
• Join a support group for new parents

Postpartum depression does not define you as a bad parent. Talk to your healthcare provider to help determine how best to manage your symptoms.