Did you know that the majority of new mothers may experience a period of so-called “baby blues,” sometimes lasting up to ten days? Often peaking during the fourth day, this syndrome may include irritability, weeping, sadness, anxiety and confusion. This mood disturbance is transient, does not affect functioning, and resolves spontaneously. It is attributed in great measure to hormonal changes.
When the mood disturbance is more pervasive and lasts longer, it may be classified as “postpartum depression.” Postpartum depression is diagnosed in about 13 percent (one of every eight) of women after delivery. In the United States alone, this means about a half-million women every year. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), an episode of depression is considered to have postpartum onset if it manifests within four weeks after delivery. For research purposes, an onset within three months is usually adhered to. Some practitioners may diagnose this condition even prior to giving birth. Often, it qualifies as a “major” depression.
While in some cases they may co-exist, it is important to differentiate between postpartum depression and postnatal posttraumatic stress disorder (PTSD), as treatment may differ.
Major depression is diagnosed when several symptoms are present, including a decrease in interest or pleasure in activities that were previously enjoyed or a depressed mood. In addition, various symptoms of dysregulation must be present for most of the day over a minimum period of two weeks or longer. These include sleep disturbance, changes in appetite, and cognitive changes, such as a predominance of negative cognitions and attendant feelings (“I am worthless,” accompanied by despair or guilt) and difficulty concentrating. Consequently, it may be difficult to make decisions. There may also be suicidal ideation or recurrent thoughts of death. Clearly, it is important to seek timely professional help.
The rapid decline of reproductive hormone levels after delivery.
Birth trauma – an event or series of events experienced as traumatic during labor or childbirth, including a medical trauma (e.g., unplanned emergency C-section.)
The following symptoms of postnatal post traumatic stress disorder (PTSD) may co-exist with post partum depression:
Various self-administered questionnaires may assist the clinician in determining the need for further professional attention. One such scale is the Edinburgh Postnatal Depression Scale. Another might be a PTSD Checklist. A high score should be followed up by a clinical interview designed to review the symptoms and establish a diagnosis.
Treatment may include psycho-education and participation in a support group comprising other women dealing with similar issues, individual psychotherapy, couples therapy and in some cases, anti-depressant medication (with special attention given to its potential impact on the fetus and/or breast-feeding infant).
Osmond, M. (2001). Behind the smile: My journey out of postpartum depression. Warner Books.
National Women’s Health Information Center (http://www.4woman.gov)
Postpartum Support International (http://www.chss. iup.edu/postpartum)
Depression after Delivery (http://www.depressionafterdelivery.com).
What is Birth Trauma? (https://www.birthtraumaassociation.org.uk/for-parents/what-is-birth-trauma)
פיכולוגית קלינית ומטפלת בטראומה (SEP). בעלת תואר ראשון ושני בפסיכולוגיה מטעם אונ' בר-אילן ותואר שלישי בפסיכולוגיה קלינית מטעם ביה"ס לפסיכולוגיה מקצועית בסן דייגו.