The effects of postpartum depression can affect not only the mother, but it can affect the baby as well. For the mother, the effects may not allow her sleep and make her more irritable. Postpartum depression can affect a mother’s early interaction with her baby as well. PPD can cause mothers to feel distant from their baby. In a “meta-analysis of studies” (Field, 2009), it was found that mothers that suffer from the depression are less likely to interact and play with their newborn. They show to be less engaged, and more irritable and hostile towards their newborn (Lovejoy, Graczyk, O’Hare, & Neuman, 2000). The mothers also have different styles of interacting with their newborn. They show a “controlling and over-stimulating style or a withdrawn, passive and under-stimulating style.” (Field 2009, para. 6). The mothers also touch their baby in a more negative manner rather than an affectionate manner. (Field, 2009, para. 7). A large sample study also found that mothers suffering from the depression were also less likely to talk to their baby. This included not singing to the baby, not reading stories to the baby, as well as playing fewer games with the baby (Paulson, Dauber & Leiferman, 2006). Another way that PPD affects the baby is the nourishment it receives. It was found that women who suffer from PPD are more likely to stop breast-feeding their child 1 to 4 months after giving birth. Instead, they replace the milk by giving the child water, juice, or cereal (McLearn et al, 2006; Paulson, Dauber, & Leiferman, 2006). This is important because breastfeeding protects against infections, protects against diseases, and gives the child the necessary nutrients in proper portions (“Why is Breastfeeding Important for your Baby,” 2015).
Not only can postpartum depression affect mothers and their baby, but it can also affect the father. According article by the Mayo Clinic Staff (2015), postpartum depression can cause a “ripple effect.” This means that the depression can start to spread. As stated earlier, we know this affects the baby. When the mother is depressed, the father’s risk of depression increases (Mayo Clinic Staff, 2015). According to an article by Tammy Worth (2011), 10% of new fathers become depressed when expecting a child. The depression can, too, affect the father-child bonding as it does the mother-child bonding. As opposed to women, who can experience postpartum depression just weeks after giving birth, men tend to develop postpartum depression much later. Anywhere from 3 to 6 months postpartum and the signs can be more difficult to recognize (Worth, 2011). So, not only does postpartum depression affect only women, as often perceived, it can affect the entire family.
There is no single test to determine whether or not an individual has postpartum depression or not, but there are risk factors that doctors may look at to help diagnose the patient. According to the Mayo Clinic Staff (2015), risks for postpartum depression increase if the person has a history of depression, whether it be from a previous pregnancy or a different occasion. Risk also increases if you have stress factors present in your life for instance, financial problems, if you and your partner are having problems (i.e. arguments), or if you recently lost a job. Risks also increase if your family has a history of depression (Mayo Clinic Staff, 2015). Some questions that a doctor may ask are, “What are your symptoms, and when did they start?”, “How would you describe your energy level?”, and “Have you been diagnosed with any other medical conditions?” to name a few. A doctor may look at all of these things to help make a diagnosis. A doctor may also perform a physical exam that would evaluate the person’s health and screen for other conditions that might contribute to the symptoms (Edwards, 2015). Once diagnosed, the doctor can help the individual affected get treatment.
Treatments
Once diagnosed with postpartum depression, there are a couple of ways to get treatment. These include therapies, medications, self-care, and specialists. Postpartum depression can go away on its own within the first three months after giving birth, but 90% of women who suffer from the depression can be treated successfully with medication or therapy (Understanding Postpartum Depression—Diagnosis and Treatment, n.d., par. 3). It is also very important to seek treatment as soon as possible. As with many other disorders or diseases, if detected too late or not detected at all, the condition may worsen (Understanding Postpartum Depression—Diagnosis and Treatment, n.d., par. 3). The most common treatment is psychotherapy, medication or both (Mayo Clinic Staff, 2015). Psychotherapy allows the patient to talk through their emotions and feelings. The patient may talk with a psychiatrist, psychologist, or an other mental health provider. They can help the patient solve problems as well as set realistic goals and positively reacting to situations as opposed to looking at everything in an irritated, negative, way (Mayo Clinic Staff, 2015). And antidepressants can help, but when breast-feeding, any medication that is taken by the mother will enter the breast milk. This can obviously be a concern that has to be talked about with the patient and doctor (Mayo Clinic Staff, 2015).
There are several different types of therapy available to help treat postpartum depression. One is Interpersonal Psychotherapy (IPT). According to an article by Kate Kripke (2013), IPT is “currently thought to be one of the most effective therapy models for treating [postpartum depression]” (Kripke, 2013). IPT lasts anywhere from 12 to 16 weeks and is mainly focused on helping relieve the symptoms the patient is going through. The IPT therapist is active in trying to figure out the sources of the mother’s distress (Kripke, 2013). IPT is based on “the premise that postpartum distress is rooted in four ‘problem areas’.” (Kripke, 2013). These four are, grief, role transitions, interpersonal disputes, and interpersonal deficits. One of the main parts of IPT is to teach the mothers communication skills to help build and strengthen relationships as well as increase confidence in the patient. This form of therapy follows a specific course of treatment and can be very helpful to the patient (Kripke, 2013).
Other therapies include Dialectal Behavioral Therapy (DBT) in which the patient practices and uses homework as a part of the therapy process (Kripke, 2013). DBT teaches skills in mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness (Kripke, 2013). DBT can be supported through group or individual therapy and follows a specific guideline (Kripke, 2013). Psychodynamic Therapy is also an option to help treat postpartum depression, but not as common. In psychodynamic therapy the patient talks about their early childhood experiences as well as their relationships with their parents, siblings, etc. (Kripke, 2013). Another form of therapy is Cognitive Behavioral Therapy (CBT). CBT, helps a mother feel better equipped to manage stress by helping her develop coping strategies (Kripke, 2013). Some strategies include, homework, thought stopping, mental imagery, exposure therapy, and tools to change catastrophic thoughts and irrational thinking (Kripke, 2013.)
A couple of other therapies include Eye Movement Desensitization and Reprocessing (EMDR). EMDR is considered to be one of the most effective therapies in working through a traumatic experience (Kripke, 2013). EMDR uses a combination of CBT and Psychodynamic therapy that help reduce the “sensory impact of traumatic memories.” (Kripke, 2013). EMDR uses a bilateral stimulation of the brain along with beliefs, attention to body awareness, and visualizations to reprocess memories in a more effective manner (Kripke, 2013). EMDR helps mothers access their thoughts and feelings that are “positive, grounding, and healing” (Kripke, 2013).
Two of the more common therapies are group and couples therapy. Group therapy is usually conducted by a trained psychotherapist and it uses the role of a community for support (Kripke, 2013). In a postpartum depression support group, the psychotherapist combines psycho-education with validation from other members in the support group. Group therapy allows mothers to share with other mothers and be heard about how they’re feeling and assures them that they are not alone (Kripke, 2013). In couples therapy, couples work through challenges which may include communication and/or listening problems. Couples therapy allows space for each partner to talk and be heard by the other and helps keep the relationship healthy (Kripke, 2013).
Along with therapy, medications may be prescribed as well to help relieve postpartum depression. The first step in treating postpartum depression is to try and resolve the immediate problem(s) that the patient has, such as sleep and/or appetite changes and antidepressants are usually the most effective for this (Understanding Postpartum Depression—Diagnosis and Treatment, n.d.,par. 5). As stated earlier, this is something that the patient and the doctor must discuss carefully. Any medication taken will be secreted, in small amounts, in the breast-milk. If taking antidepressants, the patient will be advised to take the medication for 6 months to 1 year to avoid relapse. Depending on the patient’s symptoms and medical history, the medication may be advised to taken a little longer or just cut it off (Understanding Postpartum Depression—Diagnosis and Treatment, n.d, par. 5). If the patient has suffered form postpartum depression before, the doctor can suggest medication for the patient to take shortly after giving birth or medication to take while still pregnant to prevent the depression (Understanding Postpartum Depression—Diagnosis and Treatment, n.d., par. 5). As stated in an article called “Understanding Postpartum Depression” (n.d., para. 6), although all medications do have potential risks, “most antidepressants do not pose any risks to a developing fetus.” Although, also stated in the same article, some antidepressants such as Paxil, Zoloft, and Prozac have “rarely been associated with persistent pulmonary hypertension of the newborn” (n.d., para. 6).
The major types of antidepressant medication are selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine/dopamine reuptake inhibitors (NSRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs) (Dryden-Edwards, 2015). SSRIs are the most effective and generally the safest. SSRIs affects the levels of serotonin in the brain (Dryden-Edwards, 2015). Serotonin affects mood balance, and the lack of serotonin leads to depression (McIntosh, 2016). Some antidepressants include Luvox, Celexa, and Lexapro. (Dryden-Edwards, 2015). TCAs are prescribed when SSRIs or SNRIs are ineffective. Examples include, Elavil, Anafranil, and Tofranil (Dryden-Edwards, 2015). MOAIs cannot be taken with other medication or some foods that are high in thymine due to the possibility of interaction (Dryden-Edwards, 2015). Example include Geodon, Abilify, and Zyprexa (Dryden-Edwards, 2015).
Conclusion
In conclusion, postpartum depression is a common disorder and one that is a serious one. It is not a new disorder and is one that affects millions of women across the globe. If feeling symptoms, it is important to go visit your doctor as soon as possible and get treatment. As with other diseases or disorders, one must not feel embarrassed or ashamed about suffering from the disorder. Instead, take the initiative to better yourself and relive yourself of the disorder. Remember, postpartum depression affects not only the patient, but it can affect the entire family and affect the relationship that the patient has with their child. Postpartum depression is not a disorder to be taken lightly, but, then again, no disorder should be taken lightly.