Postpartum Psychiatric Disorders
Over 80% of all postpartum mothers will undergo some degree of mood disruption, and while for the majority of those the symptoms are relatively slight and fleeting, over fifteen percent of those women will develop more severe symptoms of sadness or worry. Postpartum psychiatric illness is divided into three main categories: postpartum "blues," postpartum depression, and full-blown postpartum psychosis. Postpartum blues is on the mild end of the continuum, and is generally considered a normal occurrence following childbirth. Most postpartum women who experience these blues report that their symptoms max out several days after delivery, last approximately two weeks and consist of tearfulness, irritability, or anxiety. Keep in mind that this level of postpartum depression does not affect a woman's ability to perform normal tasks or care for her baby, and generally can be attributed to hormonal fluctuations, the emotions that come from caring for a new baby, and lack of sleep.
More Serious Postpartum Depression
A step above postpartum blues, full-blown postpartum depression emerges over the first several months following delivery. Some women who suffer from PPD note that their depression symptoms actually began to occur during the last few months of their pregnancy. Symptoms of postpartum depression can include inability to concentrate, appetite changes, disturbance in sleep patterns (possibly due in part to a new baby who is not sleeping), chronic fatigue, incompetent or worthless or guilt feelings, crying for no apparent reason, depression or sadness, and feeling no interest in usual activities. In more severe cases, women may experience full-blown panic attacks, or even obsessive-compulsive disorder. Women who have thoughts of harming their infant, or suicidal thoughts should get immediate help, and those with the less severe symptoms should also consult their physician.
The most severe form of postpartum psychiatric disorders is classified as postpartum psychosis and is relatively infrequent, occurring in approximately one in 1000 women following childbirth. The presentation of postpartum psychosis can be rapid and dramatic, occurring as soon as two to four days following delivery, and almost always develop within two weeks postpartum. Doctors believe postpartum psychosis most closely represents an episode of bipolar disease, and the earliest signs typically include severe insomnia, irritability and a high level of restlessness. Delusional beliefs regarding the new baby are common as are auditory hallucinations which tell the new mother to hurt her baby or herself. Both suicide and infanticide are significant risks in women who suffer from postpartum psychosis. Andrea Yates, the mother who drowned her five children some six months after the birth of her youngest, Mary. Mrs. Yates had experienced several episodes of psychotic hallucinations, survived two suicide attempts, taken a number of different medications, and had been diagnosed in several institutions with major postpartum depression.
What Factors are Responsible for Postpartum Depression or Psychosis?
Following the birth of a baby, a woman's body undergoes rapid shifts in hormones; within the first two days following delivery, both progesterone and estrogen levels decline rapidly, and it is theorized that some women are especially sensitive to these hormonal changes. Often, the women who are most at risk for postpartum depression which is caused by fluctuating hormones have also experienced PPD and other hormonally driven mood disturbances which typically occur during the premenstrual phase or during peri-menopause. Women who have little support or help following delivery are also at a higher risk for postpartum depression. While any women may suffer from postpartum depression, certain risk factors include non-existent or inadequate social support, stressful life events prior to giving birth, bipolar disorder or a depression history, a high level of depression during the pregnancy, or a prior episode of postpartum depression.
It's very important that post-delivery mothers be aware of the symptoms of postpartum depression and contact their physician immediately should those symptoms move beyond "normal" baby blues.