Postpartum Depression and how it affects your Emotional Health

Author: Ivelisse Ginorio Master's Student at UAGM Online English

The topic of depression is very common to hear, but few of us hear about what postpartum depression is, its cause, effects, and treatments. The birth of a baby can generate a variety of intense emotions, from excitement and joy to fear and anxiety. However, it can also lead to something you may not expect from depression. Last week the disappearance of Celiverys Rivera Santiago, 29, leaves her home, in Canóvanas Puerto Rico, in the midst of a crisis due to an alleged suffering of postpartum depression. The diagnosis had not been confirmed by a mental health professional. This case has generated a wide public discussion on the issue of mental health in Puerto Rico. Uncovering Pandora's box which remains silent is about one of the many mental health problems which Puerto Rican families face every day. According to clinical psychologist María Isabel Picó Palou, the main symptoms occur two weeks after childbirth and are detected because the mother begins to show signs of sadness, anhedonia – what she previously enjoyed doing no longer likes – crying, does not feed or sleep, in addition to the treatment of the child changes drastically.

What is postpartum depression? According to Ko, J.Y., (Ko, 2017) postpartum depression is a serious mental illness that involves the brain and affects your physical and behavioral health. If you have depression, feelings of sadness, discouragement, or emptiness don't go away and can interfere with your daily life. You may not feel connected to your baby like you're not the mother, or you may not love or care about your baby. These feelings can be mild to severe. It often happens that mothers may experience an anxiety disorder during or after pregnancy. Anxiety is a normal response to stress. But when it is difficult to control, it can affect and interfere with your daily life. Anxiety disorders affect about 1 in 5 adults in the United States.

What are the causes that can cause postpartum depression?

Hormonal changes may arise that create a trigger for symptoms of postpartum depression. When you're pregnant, levels of the female hormones estrogen and progesterone are at an all-time high. In the first 24 hours after delivery, hormone levels drop rapidly to normal pre-pregnancy levels. Researchers believe that this sudden change in hormone levels can lead to depression. This is similar to hormonal changes prior to a woman's menstrual period but involves much more extreme changes in hormone levels. In turn, thyroid hormone levels may drop after childbirth. Low thyroid levels can cause symptoms of depression.

Other feelings that may contribute to postpartum depression. Many mothers who have just given birth report feeling:

• Tired after labor and delivery.

• Tired from sleeping too little or having slept poorly.

• Overwhelmed with a newborn.

• Doubtful about her ability to be a good mother.

• Stressed by changes in work and home routines.

• With an unrealistic need to be a perfect mom

• Distraught over the loss of who they were before they had the baby.

• Less attractive

• With a lack of free time

In other cases, postpartum psychosis may arise. What is postpartum psychosis?

Postpartum psychosis is very rare. It occurs in up to 4 out of every 1,000 mothers who have just given birth. It usually starts in the first 2 weeks after you have the baby. It's a medical emergency. Women who have bipolar disorder or another mental health condition called schizoaffective disorder are at higher risk of developing postpartum psychosis. Symptoms may include:

• See or hear things that aren't there

• Feeling confused most of the time

• Having sudden mood swings within a few minutes (e.g., crying hysterically, then laughing out loud, followed by extreme sadness)

• Trying to hurt yourself or your baby.

• Paranoia (thinking other people want to hurt you)

• Restlessness or agitation

• Behaving recklessly or that is not normal for you.

Treatments for postpartum depression

To determine the appropriate treatment, it is very important to know the mental health history of that mother. In this type of case, the mother is recommended to visit the gynecologist, attend psychotherapy and join maternal support groups. In case the depression is severe and the mother lactates, the possibility of providing medication should be evaluated.

According to the National Institute of Mental Health, the most used treatment

• Psychotherapy/Therapy. During therapy, you talk to a therapist, psychologist, or social worker to learn strategies for changing the way depression makes you think, feel, and act.

• Medication. There are different types of medications for postpartum depression. All of them must be prescribed by a doctor or nurse. The most common type is antidepressants. Antidepressants help relieve symptoms of depression and some can be taken while you're breastfeeding. Antidepressants may take several weeks to take effect.

• Electroconvulsive therapy (ECT). It can be used in extreme cases to treat postpartum depression.

References

Ko, J. R. (2017). Trends in symptoms of postpartum depression - 27 states, 2004, 2008, and 2012. USA: OASH: Retrieved from: https://espanol.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

(English version). MMWR Morb Mortal Wkly Rep; 66: 153–158.

Korhonen, M., Luoma, I., Salmelin, R., Tamminen, T. (2014). Symptoms of maternal depression: associations with social competence and adolescents' internal and external problems. Nordic Journal of Psychiatry; 68(5): 323–332. https://espanol.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression

Martinez-Toboas Alfonso Ph.D. (2021). The 5 most common mental health conditions in Puerto Rico. Guaynabo Puerto Rico, endi. Recovered: 5 Most Common Mental Health Conditions in Puerto Rico - El Nvodia.com)

Postpartum depression: what it is and how we can identify it | Health | elvocero.com

Postpartum depression | Office on Women's Health (womenshealth.gov)