Postnatal depression is estimated to affect 1 in 5 women and is found in all cultural, social and age groups. There are different types of this condition experienced by mothers after birth. There is the 'Baby Blues' which usually occurs between the 3rd and 5th day and usually resolve by the 10th day. It is thought to be the response to hormone changes and the stress of giving birth and occurs in up to 70% of women.
- Postnatal depression has a gradual onset between the 3rd and 9th month.
- Postpartum Psychosis occurs in approximately 1 in 500 births and is quite rare. It seems to be genetically linked and typically occurs after the first baby. It presents as a manic depressive illness and requires urgent psychiatric treatment.
This condition results in a disturbance of mood, disturbance of thoughts and physiological disturbances. These disturbances and symptoms of postnatal depression will be discussed:
Disturbance of Mood
This includes the experience of a depressed mood, feelings of sadness, hopelessness, worthlessness, failure, shame, guilt, fear, anger and panic. Feelings of fatigue and exhaustion and the loss of sexual desire.
Disturbance of Thoughts
Poor concentration, loss of ability to plan and carry through tasks, poor memory, confused thinking, intrusive thoughts (eg thoughts of serious illness or death of self, baby or partner).
Physiological disturbance
The mother may experience sleep disorder such as difficulty falling asleep, early morning waking, always fatigued and exhausted. She may also experience stress symptoms such as panic attacks, tightness in the chest and stomach. Appetite changes, either a loss of appetite or overeating may be experienced.
Risk Factors
A number of factors are thought to contribute to postnatal mood disorders. Current research indicates that psychological, biochemical and environmental or social factors affect the onset of postnatal depression.
There are a number of factors that predispose a woman to this condition. One of the most significant risk factors is having a previous psychiatric illness or emotional problems. Women who have previously had depression, anxiety and bipolar disorder are at a greater risk.
Obstetric and gynecological problems impact a mother's physical health and can impact her emotional well being. This can include caesarean birth, permittivity, previous miscarriage, previous termination of pregnancy, neonatal death, and previous history of infertility.
If the baby or mother has problems post birth this can also increase the possibility of postnatal depression. Problems such as the baby experiencing gastric reflux, excessive crying, breastfeeding problems, sleep deprivation, low iron levels.
In addition environmental and relationship factors can impact a mother and predispose her to postnatal depression. Lack of support from ones partner or own mother can be significant. This may be through death, separation or conflict in the relationship. Furthermore a mother's isolation from extended family or friendship network can impact postnatal depression. This can be significant particularly for first time mothers who may shift from a busy life in full time work to being isolated at home. Women who would describe themselves as high achievers or perfectionists are at greater risk of postnatal depression as are women with anxious personalities. Finally if the woman experiences multiple stressors in her past or present life these may contribute to the onset of postnatal depression.
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