Postpartum depression must be recognized and addressed

Although most mothers experience something called ‘baby blues’, it is different from depression

New Delhi, February 22, 2018: According to statistics by the WHO, postpartum depression affects about 20% of mothers in developing countries. Given that India sees about 130 million births every year, if this situation persists, more women are likely to suffer the same. Recent research has indicated that this condition not only has an adverse effect on mothers’ relationships with their children, but also impacts the emotional, cognitive, and physical development of kids.

Postpartum depression is a mood disorder that can affect women after childbirth. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said, “The levels of hormones estrogen and progesterone drop drastically post childbirth leading to chemical changes in the brain. This is the trigger for mood swings in women after delivery. In India, particularly, this is not taken seriously. Apart from this, many women are unable to get the amount of rest needed to recover from childbirth. All this can cause a lot of physical discomfort and exhaustion, which further contribute to the symptoms of postpartum depression. Such extreme feelings can even interfere with a woman’s ability to care for herself or her family. If not recognized on time, postpartum depression can exacerbate and require treatment.”

Some women are more prone to postpartum depression. These include those with a history of depression, a stressful life event during pregnancy or shortly after giving birth, those with medical complications during childbirth, etc.

Adding further, Dr Aggarwal, who is also the Group Editor of IJCP, said, “It is a good idea to have birth companions during deliveries. A trained birth companion contributes to reduced tension and shortened labor, increased mother’s feelings of control, decreased interventions and cesareans. They also help in enhancing the partner’s participation, improve outcome for the newborn, facilitate parent/infant bonding, and decrease postpartum depression while increasing positive feelings about the birth experience.”

Tips to cope with depression after childbirth.

• Tiredness can make anxiety worse and give you a constant gloomy feeling. Try catching small naps when the baby is asleep.
• Low energy levels can impact mental health and thus, it is important to eat a balanced and healthy meal.
• Understand that this is a temporary phase and it is not wrong to ask for help.
• Indulge in activities that can help you in getting distracted from any negative thoughts, such as reading a book and listening to music. Take a short walk if it helps you feel better
• Lastly, understand that each pregnancy is different, and you do not have to feel guilty in case of misses.

Some facts

1. Primary care clinicians (including obstetricians, gynecologists, or pediatricians) screen all postpartum women for depression
2. Screening should be implemented with services in place to ensure follow-up for diagnosis and treatment.
3. The rationale for screening is that postnatal depression is serious, prevalent, under-recognized, and treatable, and that standardized, valid screening tools are available.
4. The simple screening tool is to ask questions such as, “During the last month, have you often been bothered by feeling down, depressed, or hopeless?” and “During the last month, have you often been bothered by having little interest or pleasure in doing things?”. Patients who screen positive require a clinical interview to make the diagnosis.
5. Depressive symptoms can appear in both postpartum major depression and postpartum blues. However, postpartum blues does not require a minimum number of symptoms and the symptoms of postpartum blues are mild and self-limited; symptoms typically develop within two to three days of delivery, peak over the next few days, and resolve within two weeks of onset. By contrast, the diagnosis of major depression requires a minimum of five symptoms that must be present for at least two weeks. Symptoms of postpartum blues that persist beyond two weeks are best viewed as postpartum depression rather than postpartum blues.