Understanding Postpartum Depression

“I am a first-time mother of a baby and some days I feel overwhelmed with this new role.  How do I know if I have postpartum depression?”

Becoming a new parent is a new and exciting experience that can bring a great amount of joy into a person’s life!   At the same time, adjusting to this new role can be physically and emotionally challenging as a result of a lack of sleep, hormonal changes, and learning how to care for a new little being. 

Cindy Pritchard is a Nurse Practitioner at Ontario Shores Centre for Mental Health Sciences.  She works in the Integrative Community Access Program in the following three outpatient clinics: Anxiety and Mood, Psychosis, and Women’s Consultation Services.

In the first few weeks after the baby is born, you may go from feeling happy and grateful one minute to tearful, anxious or irritable the next.  These mood swings may cause you to feel guilty or inadequate as a parent, as these feelings seem to come out of nowhere!  These are normal feelings that many new parents experience in the first few days to weeks after a baby is born, better known as the “baby blues”.  As you eventually settle into your new role and get more comfortable with the day to day routines of parenthood, these “ups and downs” eventually go away within a few weeks.  

So how is this different from postpartum depression?

Postpartum (or peripartum) depression can occur during pregnancy or in the first 4 weeks and up to one year following delivery.  Symptoms include a persistent sad or depressed mood, anxiousness, irritability, guilt, poor concentration, and little interest in the baby or doing things that you would normally enjoy.  Even more serious, if you start to have thoughts of hurting yourself or the baby, these are not “normal” thoughts and you should call 911 or go to your nearest Emergency Department for assessment.  You may feel embarrassed or scared to tell others about how you feel, but there are lots of treatment options and support to help new parents cope with postpartum depression.

Postpartum depression can affect any person and can develop after the birth of any child, although certain risk factors can increase your chances.   These include a personal history of depression either during the pregnancy or at other times, a history of postpartum depression with a previous pregnancy, a positive family history, and situational and environmental factors (e.g. poor social support, financial worries, etc.).  According to Motherisk, recent studies suggest that at least 1 out of 10 pregnant women meet the criteria for major depression and there is growing awareness that many women go undiagnosed, putting them at further risk into the postpartum period.  Screening for depression during pregnancy and in the postpartum period is imperative and something your health care provider may do either by asking some basic screening questions or get you to complete a written screening tool called the Edinburgh Postnatal Depression Scale.  It is important to be open with your health care provider about how you are feeling both during and after your pregnancy.

Treatments for postpartum depression include cognitive behavioural therapy (CBT), interpersonal therapy (IPT), group psychoeducation, and psychotropic medications.  There are different classes of psychotropic medications and some are safer to use during pregnancy and while breastfeeding, so it is important to discuss your options with your health care provider.  Motherisk is a valuable resource for both mothers and health care providers, as they have the most recent data on medication risk profiles for the mother and fetus or infant.

Community Supports
Local Public Health Departments (depending on your regional municipality)
Motherisk   www.motherisk.org or 1-877-439-2744 (Hotline)
Ontario Early Years Centres   www.ontarioearlyyears.ca 

This article was originally publised for the Nurse Practitioner Association of Ontario. Access the original article by visiting: http://npao.org/2014/04/10969/#.U5mpmLH75GM