May is considered the National Maternal Depression Awareness Month recognizing the seriousness of depression during and after pregnancy. Mothers are usually the cornerstones of every family. They help provide the family with emotional support, love, financial obligations, and household chores and do a large amount of the child rearing. When a mother is sick or under stress the whole family, including her children can suffer tremendously. For many pregnancy can be the happiest time in one’s life however in other pregnancy can be extremely stressful resulting in mental and physical illness. Studies have shown that mental health disorders such as anxiety and depression impact 15-20 percent of women during pregnancy and the postpartum period. These mental health disorders can have long-term consequences on a mother and her family including her infant’s cognitive and behavioral development, the well being of other children and her relationship stability. Postpartum blues, postpartum depression and postpartum psychosis are well-known mental health disorders affecting mothers and unfortunately not enough recognition and awareness is given to these disorders.
Postpartum blues is similar to a mild depression meaning that symptoms usually peak on the 4th or 5th day after delivery and only last for approximately 2 weeks in duration. The symptoms include rapidly fluctuating mood, tearfulness, irritability, and anxiety and do not interfere with the mother’s ability to function and care for her newborn child. These symptoms are mild in severity and usually resolve spontaneously without any treatment.
Postpartum depression is more persistent and severe than postpartum blues and often interferes with the mother’s ability to care for herself and her newborn child. Postpartum depression occurs in approximately 10-15% of the female general population and develops most commonly in the first four months following delivery however it can occur anytime in the first year after delivery and therefore this disorder often goes unrecognized by many individuals including mental healthcare professionals. The risk of recurrence for postpartum depression is 25% and the signs and symptoms are indistinguishable from major depressive disorder. These symptoms include depressed mood, tearfulness, recurrent thoughts of death, insomnia, fatigue, feelings of guilt, poor concentration, appetite disturbance, suicidal thoughts, and lack of interest.
Postpartum psychosis is the most severe illness on the postpartum mood disorder spectrum and occurs very rarely affecting approximately one to two per 1000 women after childbirth. Symptoms include mania, disorganized behaviors, delusional beliefs, depressed mood, irritability and thoughts about harming the infant or committing suicide. These symptoms usually present within the first two weeks after delivery and can present as early as two or three days after giving birth. Inpatient hospitalization is required in order to prevent harm to the mother and the baby. Medications include antipsychotics and mood stabilizers and studies have shown that electroconvulsive therapy (ECT) is well tolerated and rapidly effective.
Seeking help for mental health disorders in pregnancy
Mental health disorders in pregnancy and the postnatal period can have severe consequences for both the mother and the children and therefore it is imperative to seek help immediately after symptoms arise. Consulting with your OB/GYN or primary care specialist can allow you to become connected with the proper psychiatrist and mental health treatment team. Treatment for each one of these disorders can vary depending on the severity and duration of symptoms. Psychotherapy with or without medication is generally the mainstay treatment for both postpartum depression and postpartum psychosis.