Symptoms can be different for different patients and usually show up within one year of childbirth. Maternity blues include emotional liability, irritability, mood swings, sleeplessness, sudden urge to cry and anxiety. These resolve spontaneously requiring no medication. These symptoms occur in varying degrees in most of the new mothers.

Along with above symptoms, there is a general loss of interest in daily activities along with a feeling of hopelessness so that it can be classified as Postpartum depression. Here the severity is more and along with these symptoms new mothers get thoughts of harming their babies, total lack of interest in baby and other negative thoughts. There may be loss of appetite and weight. Feelings of low self-esteem and self-worth will be prominent. In some cases onset maybe rapid and progressive.

Psychosis may occur in women with previous history of manic disorders. There is complete loss of contact with reality [5]. Delusions, hallucinations along with thoughts of killing might be there. Disorientation and confusion is marked. False ideas of new born baby being evil or deformed may be there as a result a want to kill may arise. This is a medical emergency which requires prompt treatment.

• Pain

  But depression that begins before or during pregnancy is ... read more Postpartum Depression Linked to Mother's Pain After Childbirth Oct. 14, 2018 — While childbirth pain has been linked to postpartum depression, the culprit may be the pain experienced [sciencedaily.com]

  The patient achieved pain relief through treatment with calcium, vitamin D, calcitonin, weekly alendronate, and venlafaxine for depression. PLO and depression may have a common etiopathogenesis that needs further investigation. [ncbi.nlm.nih.gov]

• Family History of Depression

  Significant risk factors found solely by univariate analysis were family history of depression in both parents of the expectant mother (prenatal and 6 weeks postpartum), family history of depression from subject's maternal side (6 months postpartum), [ncbi.nlm.nih.gov]

  Women with a personal or family history of depression are at increased risk. Untreated postpartum depression can lead to poor attachment with the baby, difficulties with work and or relationships, and, in severe cases, maternal suicide. [columbiadoctors.org]

  Although every woman is at risk, women with the following are at higher risk: Baby blues (eg, rapid mood swings, irritability, anxiety, decreased concentration, insomnia, crying spells) Prior episode of postpartum depression Family history of depression [msdmanuals.com]

  The following factors may contribute: exhaustion from childcare, altered relationship within the family, loss of independence, family history of depressive disorders, hormonal disturbances following pregnancy, low income and financial stress or stress [depressedtest.com]

  A personal or family history of depression, anxiety, or postpartum depression Premenstrual dysphoric disorder (PMDD or PMS) Inadequate support in caring for the baby Financial stress Marital stress Complications in pregnancy, birth or breastfeeding A [postpartum.net]

• Falling

  “What happens immediately postpartum is all of those really high hormone levels fall. They don’t fall gradually. They rise gradually, but postpartum, they just fall off a cliff. [tmc.edu]

  During pregnancy, hormonal levels increase considerably, particularly progesterone and estrogen, and fall rapidly within hours to days after childbirth. [aamft.org]

  "Some people are terrible at napping, but if your baby is sleeping at night and you're lying there too anxious or worried to fall asleep it can be a sign of PPD," Meltzer-Brody says. 2. You feel like you can't enjoy your baby. [shape.com]

  Difficulty falling asleep or sleeping too much. Overeating or loss of appetite. Thoughts of suicide or suicide attempts. Aches or pains that do not get better with treatment. [web.archive.org]

  Foli notes that things can fall similarly flat sometimes for adoptive parents. “There are casseroles sent, and there’s a little bit more celebration sometimes for the birth of a child,” she says. [theatlantic.com]

• Disability

  From Wikidata Jump to navigation Jump to search endogenous depression that involves intense, sustained and sometimes disabling depression experienced by women after giving birth Maternity blues (disorder) postnatal depression Postpartum depression,PPD [wikidata.org]

  Likewise, he recommends telling your employer you have a disability in writing, even if you aren’t asking for any changes to your work plan. [fastcompany.com]

  Postpartum depression occurs in 10 to 15% of women, lasts > 2 weeks, and is disabling (in contrast to baby blues). Symptoms may be similar to those of major depression and can also include worries and fears about being a mother. [msdmanuals.com]

  BACKGROUND: Postpartum depression is one of the major causes of disability among women who are on their childbearing years. Identifying people at risk of postpartum depression may improve its management. [ncbi.nlm.nih.gov]

• Hypersomnia

  […] all, activities most of the day, nearly every day Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day Insomnia (inability to sleep) or hypersomnia [psychcentral.com]

  Depressed mood, loss of interest or pleasure Change in weight or appetite Insomnia or hypersomnia Psychomotor retardation or agitation Loss of energy or fatigue Feelings of worthlessness or guilt Crying Problems with concentration Difficulty making decisions [verywellfamily.com]

  Insomnia or hypersomnia nearly every day. 5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). 6. Fatigue or loss of energy nearly every day. 7. [aafp.org]

• Diarrhea

  […] restlessness, out of control, or have no energy I’m having difficulty concentrating I find myself withdrawing from family, friends and social situations Some women may have more physical symptoms such as: Feeling weak or feeling flushed Gas, constipation or diarrhea [heretohelp.bc.ca]

  Antidepressant side effects and considerations All antidepressants can cause side effects, such as: dry mouth nausea dizziness headaches insomnia restlessness fatigue weight gain perspiration diarrhea constipation decreased sex drive anxiety tremors Antidepressants [healthline.com]

• Palpitations

  Frequent crying Irritability Low self-esteem Feeling exhausted Inability to concentrate Withdrawing from family and friends Feeling hopeless Losing interest in activities Anxiety attacks Panic attacks Headaches and chest pains Hyperventilation Heart palpitations [suicide.org]

  […] no energy or motivation Sleeping too little or too much Trouble focusing, remembering, or making decisions Feeling worthless and guilty Loss of interest or pleasure in activities Withdrawal from friends and family Having headaches, chest pains, heart palpitations [www1.nyc.gov]

  Heart racing or palpitations 'Have you ever felt like your heart skipped a beat,' Jamie asked. 'Anxiety can cause both a racing heart and palpitations. When you’re really amped up, it can affect your heart, making it race, skip, or irregular.' 3. [dailymail.co.uk]

  […] impaired concentration or memory; despondency or despair; thoughts of suicide; no feelings for the baby, or over-concern for the baby's health; guilt; panic attacks; feeling "out of control" or like you are "going crazy"; headaches; chest pains; heart palpitations [web.archive.org]

  […] too little or too much Sleeping too little or too much Trouble focusing, remembering, or making decisions Feeling worthless and guilty Loss of interest or pleasure in activities Withdrawal from friends and family Having headaches, chest pains, heart palpitations [medicinenet.com]

• Delusion

  Severe cases may be diagnosed as postpartum psychosis, a rare disorder characterized by violent thoughts, delusions, and bizarre thinking. This illness became more well-known as the media followed the Andrea Yates case. [depressedtest.com]

  However, psychotic symptoms can occur absent of such specific delusions or hallucinations. [↩] John M. Grohol, Psy.D. Dr. John Grohol is the founder and Editor-in-Chief of Psych Central. [psychcentral.com]

  It can be characterized by psychotic depression, mania, hallucinations (hearing or seeing things that other people cannot),delusions (fixed, false beliefs), extreme confusion and suicidal thoughts. [mooddisorders.ca]

  The symptoms include hallucinations, delusions, and quick mood swings. Essentially, women with postpartum psychosis lose touch with reality. And they are at an extremely high risk for suicide and for infanticide. [suicide.org]

• Feeling of Worthlessness

  […] of worthlessness, shame, guilt, or inadequacy Difficulty in thinking clearly, concentrating, or making decisions Severe anxiety or panic attacks Thoughts of harming yourself or your baby Thoughts of death or suicide It is thought that between 3 and 6 [psychcentral.com]

  worthlessness or guilt, or suicidal ideation. [fda.gov]

  […] of worthlessness, and suicidal ideation. [britannica.com]

  […] are slowed down Feelings of worthlessness or excessive guilt Difficulty concentrating or indecisiveness Thoughts of death or suicide or a suicide plan Anxiety and ruminating thoughts, which may occur with other mood symptoms Effects Postpartum depression [adaa.org]

• Compulsive Disorder

  What is Postpartum Obsessive-Compulsive Disorder (PPOCD)? Postpartum obsessive-compulsive disorder is one of the newer disorders that is part of the postpartum mood disorders group. [americanpregnancy.org]

  Maternal mental illness can include what is commonly known as postpartum depression, but can also take the form of anxiety, bipolar disorder, obsessive-compulsive disorder, or, in rarer cases, psychosis. [nytimes.com]

  Continued Do Anxiety or Obsessive-Compulsive Disorder Symptoms Increase With Postpartum Depression? Symptoms of obsessive-compulsive disorder that are new rarely occur in the postpartum period (about 1%-3% of women). [webmd.com]

• Suicidal Ideation

  Prediction of suicidal behaviour in clinical research by lifetime suicidal ideation and behavior ascertained by the electronic Columbia-Suicide Severity Rating Scale. [doi.org]

  ideation Anxiety or panic attacks Typically, symptoms develop insidiously over 3 months, but onset can be more sudden. [msdmanuals.com]

  Symptoms Depressed mood, anger, and irritability Sleep and appetite changes Lack of interest in the baby Feelings of guilt, hopelessness Frequent crying Anxiety or excessive worry Intrusive thoughts about the baby’s safety Suicidal ideation Risk Factors [columbiadoctors.org]

• Low Self-Esteem

  Feelings of low self-esteem and self-worth will be prominent. In some cases onset maybe rapid and progressive. Psychosis may occur in women with previous history of manic disorders. There is complete loss of contact with reality. [symptoma.com]

  Symptoms of postpartum depression Edwards says that common symptoms of postpartum depression include: Gloomy mood Irritability Low self-esteem Guilt Sleep problems Suicidal thoughts Fatigue Low interest in plans or activities that the mother used to find [insider.com]

  self-esteem Trouble managing stress Unrealistic ideas about motherhood Lack of sleep If the pregnancy was unwanted A complicated pregnancy Having a newborn with physical or behavioral problems New fathers can have postpartum depression, too. [web.archive.org]

  Symptoms of postpartum depression include: Intense sadness Strong mood swings Frequent crying Irritability Low self-esteem Feeling exhausted Inability to concentrate Withdrawing from family and friends Feeling hopeless Losing interest in activities Anxiety [suicide.org]

  In addition, they should be aware of other factors that increase a woman's depression risk, such as a family or personal history of depression, stressful or traumatic life events, poor social or partner support and low self-esteem. [uclahealth.org]

• Agitation

  Other symptoms of postnatal depression include: loss of appetite poor concentration tiredness all the time problems sleeping being agitated crying easily Feelings and thoughts you might experience include: feeling inadequate feeling panicked feeling rejected [www2.hse.ie]

  If you’re experiencing hallucinations, agitation, anger, insomnia, or a desire to harm yourself or the baby, get help right away. The cause of PPD and related disorders is likely a mix of biochemical, genetic and psychological factors. [swedish.org]

  New mothers with postpartum depression may experience a great deal of anxiety, become agitated, worry excessively and have trouble bonding with the baby. [uclahealth.org]

  Postpartum psychosis may be preceded by agitation, confusion, memory problems, irritability, worsening insomnia, and anxiety. [verywellfamily.com]

  The symptoms include extreme confusion, fatigue, agitation, alterations in mood, feelings of hopelessness and shame, hallucinations and rapid speech or mania. Studies indicate that it affects only one in 1000 births. [web.archive.org]

• Behavior Problem

  problems New fathers can have postpartum depression, too. [web.archive.org]

  Furthermore, maternal depression is associated with long-term cognitive, emotional, and behavioral problems in the child. [emedicine.com]

  The impact of untreated postpartum depression on the child could include low birth weight, disruption of the bonding process, insecure attachments, and social/behavioral problems in the older child. [breastfeedingusa.org]

  Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, excessive crying, and delays in language development. [mayoclinic.org]

• Forgetful

  Don’t forget to add to this list other things personal to you, maybe some pears, fresh coconut pieces, brown rice, oatcakes, coconut milk, oily fish or lentils. [postnataldepression.com]

  Forget enjoying my family and life in general—I felt like an empty shell of a person. I knew I wasn’t myself, but no matter how much I prayed, read Scripture, or tried to get better, I couldn’t snap out of it. [christianitytoday.com]

• Lethargy

  Nearly 6 percent to 9 percent of women develop PPT and manifest symptoms that can readily be construed as depression: fatigue, hair loss, depression, impairment of concentration, inability to lose weight, lethargy, and dry skin. [massagetoday.com]

  […] present in human milk, exercise caution when administering to nursing womenPlasma levels in breastfed infants are undetectable, one case of seizure in 6-month old infant5-HT 2A Receptor AntagonistsNefazodone * CPremature birth, infants drowsiness and lethargy [ncbi.nlm.nih.gov]

  […] present in human milk, exercise caution when administering to nursing women Plasma levels in breastfed infants are undetectable, one case of seizure in 6-month old infant5-HT 2A Receptor Antagonists Nefazodone * CPremature birth, infants drowsiness and lethargy [web.archive.org]

  Drops in the following hormone levels may also contribute to depressive episodes: estrogen (decreases serotonin and may mimic signs of depression) progesterone (may cause anxiety and poor sleep) thyroid (may cause lethargy and fatigue). [journals.lww.com]

  Table 4 lists the ACOG and AAP risk categories of commonly prescribed antidepressants. 62 Regardless of risk level, parents and clinicians should be attentive to symptoms of antidepressant toxicity in the infant, such as lethargy, irritability unresponsive [aafp.org]

• Apathy

  Different types of disorders should warn about a possible psychic suffering of the baby: behavioral disorders (agitation or apathy), psychomotor development disorders, relationship disorders or somatic disorders. [peertechz.com]

  […] baby at night, even when the baby is asleep and you’re feeling exhausted difficulty concentrating and making decisions low self-confidence poor appetite (not eating enough) feeling very agitated or, alternatively, you can’t be bothered with anything (apathy [tommys.org]

  A. if you feel you are not enjoying things you usually do, if you sit in a gloomy state at home, apathy to your child and maybe even wanting to harm him and you ,overwhelming fatigue, insomnia,loss of appetite. all this can lead to Postpartum depression [medical-dictionary.thefreedictionary.com]

• Sexual Dysfunction

  METHODS: Symptoms of female sexual dysfunction using the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Function Short Form Questionnaire (PISQ-12), symptoms of PPD using the Edinburgh Postnatal Depression Scale (EPDS) score, symptoms of male sexual [ncbi.nlm.nih.gov]

  Adverse effects of this drug category include insomnia, jitteriness, nausea, appetite suppression, headache, and sexual dysfunction. [reference.medscape.com]

  Adverse effects of the TCAs include sedation, weight gain, dry mouth, constipation, and sexual dysfunction. [emedicine.com]

Diagnosis cannot be reached by a single test. Diagnosis is done by a thorough medical, family and mental history. Complete assessment of patient’s background is done. Laboratory tests may be done to detect any hormonal imbalance [6].

Postpartum psychosis should be differentiated from maternity blues as the former affects daily functioning and can prove to be dangerous for both the mother and the baby.

Treatment is an integration of physical, psychological, social and medical therapies. Hospitalisation should be done for potentially sucidal, severely depressed patients and in mania [7].

Medications along with psychotherapy prove useful and are the only treatment in most cases. Antidepressants such as selective serotonin reuptake inhibitors are given which are known to have lesser side effects. Hormone replacement therapy is given along with the above medications.

Counselling for both mother and partner go a long way in the treatment. Opportunities to express should be given to patients thus enabling to resolve minor episodes of depression. Reassurance along with family and social support helps the new mother to adjust to the changes in her life [8].

Patients with Postpartum depression have higher chances of getting some form of depression again at some point in their life. Relapse of this condition is very common. Children born to women with postpartum depression have a tendency to behavioural problems and difficult relationships.

Numerous factors play a role in the etiology, but it varies from individual to individual. Social and psychological factors are known to play an important role, but there is no specific cause.
The most common theories postulated are:

• Hormonal changes: Sudden drop in hormones post-delivery along with fluctuations in thyroid hormones that occur to every woman. These fluctuations result in changes in the body metabolism, which are thought to stimulate this condition [3].
• Physical changes: Various physical changes along with significant physical trauma occur during pregnancy and childbirth. Women go through emotional insecurity and anxiety which can lead to depression and low self-esteem.

Coping with a newborn baby is physically, emotionally and mentally taxing for a new mother. Thus, interplay of above factors is supposed to be responsible for postpartum depression. There are a number of risk factors, women with previous history of depression, perinatal depression, premenstrual syndrome, birth related physiological or psychological trauma and poor family or marital relations.

Although perinatal depression occurs, postpartum depression is more common. All over the globe, approximately 9-15% of women will experience postpartum depression. [4]

One in eight women will experience some form of depression post childbirth. Maternity blues occurs in 65 -90% of childbearing women. Severe types occur once in every 500-1000 births.

Postpartum depression is higher among poorer sections, teen pregnancies and women with poor family support. Depression occurs in fathers in about 1-25% cases. [2]

Extreme physiological changes occur in a woman during pregnancy and childbirth. The exact pathogenesis is not known but hormonal irregularities along with abnormalities in hypothalamic-pituitary-adrenal (HPA) axis have been implicated.

Oestrogen and progesterone are steroid hormones derived from common fatty acids. Along with their reproductive function, they also display potent neuroregulatory effects, especially on mood and cognition. Irregularities in HPA axis also contribute to this condition.

Hormones have a striking effect on the HPA axis causing mood changes. The HPA under normal circumstances responds to stress and trauma by releasing cortisol along with negative feedback mechanisms, but in cases with severe depression the HPA axis reacts abnormally. Thus, the resulting inability to respond to periods of stress and trauma forms one of the most important biological finding in postpartum depression.

Early diagnosis along with intervention helps prevent PPD. Patients with high risk factors should be educated about this medical condition. Counselling and support groups can also help.Homevisits along with family support [9] help reduce anxiety in new mothers.

Proper exercise along with diet should be given to women. Screening of high risk patient should be done. Family support and social support help in overcoming the depression [10].

Postpartum depression is a subtype of clinical depression which occurs to women after childbirth. The main trigger factor for this condition is childbirth. The onset of postpartum depression is within 4 weeks after delivery [1]. The severity of symptoms and duration determines the type of depression.

More than 80% cases are slow and gradual, starting within two weeks of delivery. This condition can happen even after a miscarriage or stillbirth.

Postpartum depression can affect normal functioning and have serious adverse effects on both the mother and the family. The symptoms range from mild to severe psychosis. Usually, every new mother will experience a certain level of anxiety, irritability, and sensitivity and mood changes post-delivery. These all resolve within 2-3 weeks, without any specific treatment. A more severe type of depression occurs late, often many weeks after childbirth, which is usually characterized by sadness, fatigue and depression. Recovery is within few months [2].

Postpartum depression is a common type of depression which occurs after childbirth. Depression can happen anytime during pregnancy but post childbirth is more common. About 15% women are affected, with this condition being more common in poorer people and broken families.

For a new mother, maternity blues are perfectly normal and usually settle down within a few days. This does not affect daily functioning of the mother. Hormonal changes are the supposed cause but the exact cause still remains unknown.

Normally, after having a baby, a woman will go through severe emotional turmoil along with mood swings, anxiety, sleeping disorders and concentration problems. There is no need to worry as they settle on their own without any treatment.

In case the severity as well as the duration of symptoms is greater, immediate attention needs to be given. Here symptoms can occur anytime from childbirth till one year of postpartum. Along with severe baby blue symptoms, patient may have negative thoughts towards the baby. Suicidal thoughts may prevail. The ability and desire to care for infant may be hampered.

Knowledge of risk factors is important for timely prevention. High risk factors include women with history of depression, depression during pregnancy, difficult pregnancies, poor family relations and various other factors.

The medical health provider will take a complete history of the patient, and after complete evaluation the treatment plan suiting the patient will be adopted. Anti-depressants are the medications of choice.

Counselling in the form of psychotherapy is very useful. Alternative modes of treatment like homeopathy or naturopathy might help. Family and social groups help the patients to come out of this condition. New mothers should take time out to relax, other than only tending to the baby. Good nutritious food along with exercise keeps the mother alert and fit.

There is no need for the patient to feel ashamed of the symptoms or guilty and it is best to consult a physician as soon as possible. Postpartum depression in does not indicate that the lady is a bad mother but it is a common condition.

If left untreated, it can interfere with normal functioning of mother. Thus, timely intervention will help the mother enjoy the bliss of motherhood.

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