1. POST PARTUM DEPRESSION
INFORMATION AND PREVENTION

2. Training Objectives Define Baby Blues
Identify causes and symptoms of Baby Blues
Recognize ways mothers can cope with Baby Blues
Define Postpartum Depression
Identify causes and symptoms of Postpartum Depression
Identify the differences between Baby Blues and Postpartum Depression

3. Identify the risk factors of Postpartum Depression
Identify the symptoms of Postpartum Psychosis
Identify the forms of treatment for women with Postpartum Depression and Postpartum Psychosis
Identify ways women with Postpartum Depression can help themselves
Identify ways loved ones can help women who have Postpartum Depression
Identify Preventative Steps women can take

4. Depression and New Mothers
Having a baby can be both an exciting and thrilling time for any mother. However, it can also be a time when many new mothers feel overwhelmed.
Nearly 10 percent of new mothers experience a distress known as postpartum depression.

5. Baby Blues
According to Kids Health, “Baby Blues” are feelings of sadness and surges of emotions that may occur in the first few days after child birth. A woman may feel happy one minute and then tearful the next. Baby Blues normally only last a few days, but can last up to two weeks.

6. Signs and Symptoms of Baby Blues
•Crying
•Mood swings
•Anxiety
•Sadness
•Trouble sleeping
•Difficulty concentrating
•Irritability
(Mayo Clinic)

7. Causes of Baby Blues
Baby Blues are believed to be caused by hormonal changes.
Levels of estrogen and progesterone that have increased during pregnancy drop suddenly after delivery, and this can affect mood.
These female hormones return to their pre-pregnancy levels within a week or so. Baby Blues usually resolve on their own without medical treatment.
(Kids Health)

8. Coping with Baby Blues
According to Kids Health, new moms should try to accept help from family and friends in the first few weeks after labor and delivery. Family members can run errands, prepare meals, or watch the baby.
Good nutrition and plenty of rest is important.
Talking to other new moms or family and friends can help a new mom feel supported.
If baby blues last longer than a week or two, a new mom should call her doctor to rule out postpartum depression.

9. Postpartum Depression
According the Mayo Clinic, Postpartum Depression may seem like Baby Blues at first; however, the symptoms are more intense and longer lasting, eventually impacting a mother’s ability to care for her baby.
Women experiencing Postpartum Depression often feel much pain during a time that should be joyful. Many are reluctant to tell someone when they feel this way. Postpartum depression is a medical condition that requires attention and treatment.

10. Signs and Symptoms of Postpartum Depression
▪Insomnia
▪Overwhelming fatigue
▪Intense anger and irritability
▪Severe mood swings
▪Difficulty bonding with baby
▪Lack of joy in life

11. ▪Feelings of shame, guilt, or inadequacy ▪Withdrawal from family and
▪Loss of appetite
▪Feelings of shame, guilt, or
inadequacy
▪Withdrawal from family and
friends
▪Loss of interest in sex
▪Thoughts of harming self or baby
(Mayo Clinic)

12. Causes of Postpartum Depression
According to the Mayo Clinic, there may be a number of causes of Postpartum Depression.
One such cause are physical changes. After childbirth, a dramatic drop in estrogen and progesterone may contribute to postpartum depression. The hormones produced by the thyroid gland may also drop sharply resulting in tired and depressed feelings. Changes in blood volume, blood pressure, immune systems and metabolism can lead to fatigue and mood swings.

13. Emotional changes can also cause Postpartum Depression
Emotional changes can also cause Postpartum Depression. Many new moms are sleep deprived and overwhelmed, and may have trouble handling even minor problems. Moms may be anxious about their ability to care for a newborn. They may feel less attractive and feel they have lost control over their life. Any of these factors can contribute to postpartum depression.

14. Lifestyle influences can also be a cause of Postpartum Depression
Lifestyle influences can also be a cause of Postpartum Depression. These include:
•A demanding baby
•Older siblings
•Difficulty breast-feeding
•Exhaustion
•Financial problems
•A lack of support from loved ones

15. Risk Factors of Postpartum Depression
Postpartum Depression can occur after the second or third child, not just the first. A woman may experience Postpartum Depression after the birth of each child.
According to the Mayo Clinic, the following may be risk factors:
•A history of depression, either during pregnancy or at other times

16. •Postpartum Depression has been experienced after a previous pregnancy
•Marital problems
•Lack of a support system
•Stressful events have occurred in the past year, including illnesses, a difficult pregnancy, or loss of a job
•The pregnancy was unplanned or unwanted

17. Postpartum Psychosis
According to the Mayo Clinic, some women can develop a rare condition that develops within two weeks of delivery called Postpartum Psychosis.
According to Kids Health, Postpartum Psychosis affects 1 in 1,000 women who give birth. It occurs within the first month after labor and delivery.

18. Signs and Symptoms of Postpartum Psychosis
Hallucinations and delusions
Confusion and disorientation
Paranoia
Attempts to harm self and the baby
The risk for Postpartum Psychosis is higher for those women with Bipolar Disorder.
(Mayo Clinic)

19. When to Seek Medical Advice
If signs and symptoms of depression do not fade after a couple weeks, it is important for women to tell their doctors. If the depression is impeding them from doing every day tasks, it is very important to alert a physician.
If a woman thinks she is developing Postpartum Psychosis, she must call a doctor immediately. This can lead to life-threatening behaviors or thoughts.
(Mayo Clinic)

20. The Importance of Seeking Treatment
Without medical treatment, Postpartum Depression can interfere with mother and child bonding, as well as lead to family stress.
According to the Mayo Clinic, children of mothers who have untreated Postpartum Depression are more likely to have behavioral problems, such as sleeping and eating difficulties, temper tantrums and hyperactivity. Another common problem are delays in language development.

21. Untreated Postpartum Depression can last for a year or longer
Untreated Postpartum Depression can last for a year or longer. If left untreated, it can some times become a chronic depressive disorder.
Even when Postpartum Depression is treated, it increases a woman’s chances of having future episodes of major depression.

22. Treatment for Postpartum Depression
According to the Mayo Clinic, Postpartum Depression is often treated with medication and counseling.
Counseling can provide better ways to cope with feelings, solve problems, and set realistic goals. Talking to a psychiatrist, psychologist or other mental health professional can be helpful. Family or marital therapy may also be helpful.

23. Anti-depressants are a proven treatment for Postpartum Depression
Anti-depressants are a proven treatment for Postpartum Depression. Some anti-depressants can be taken with little risk of side effects to the baby if a mother is breastfeeding. A doctor can give the mother potential risks and benefits of specific anti-depressants.
Hormone therapy may be used to treat Postpartum Depression as well. Estrogen replacement may help counteract the rapid drop in estrogen that accompanies childbirth. This may ease the signs and symptoms of postpartum depression in some women.

24. Treatment for Postpartum Psychosis
Treatment for Postpartum Psychosis must be immediate and often done in a hospital.
According to the Mayo Clinic, when safety is assured, a combination of medications, including antidepressants, antipsychotic medications and mood stabilizers may be used to control signs and symptoms.

25. The Mayo Clinic lists electroconvulsive therapy (ECT) as being recommended as well. During ECT, a small amount of electrical current is applied to the brain to produce brain waves similar to those that occur during a seizure. The chemical changes triggered by the electrical currents can reduce the symptoms of depression, especially when other treatments have failed or when immediate results are needed.

26. A mother’s ability to breast-feed can be challenged while being treated for Postpartum Psychosis. Mothers are separated from their babies and some medications used to treat postpartum psychosis are not recommended for women who are breast-feeding. However, a team of health care providers will help a mother work through these challenges.

27. Helping Yourself
According to Kids Health, there are small things women can do along with getting medical treatment for Postpartum Depression. These activities can include:
▪Read something uplifting and positive that can be read a bit at a time.
▪Focus on things to look forward to during the day such as a hot shower, relaxing bath, or a visit with a friend.

28. ▪Schedule a babysitter so that moms can have some planned time for themselves.
▪Indulge in simple pleasures such as reading a magazine, sipping a cup of tea, etc.
▪Spend time with family and friends for comfort and company.
▪Ask for help whether it is for emotional support or help in caring for the baby.
▪Accept help when it is offered.
▪Rest when the baby sleeps.

29. ▪Be optimistic and think of things to be grateful for.
▪Be patient as it will take time to feel better.
▪Join a support group. Doctors and women’s centers should be able to put moms in touch with groups in their area.
▪A daily walk can help to lift moods, but any new exercise program should be approved by a doctor.

30. Helping Someone with Postpartum Depression
Kids Health lists ways people can help their loved ones affected by Postpartum Depression. These activities can include:
•Offer to go with her to the doctor, if she wants you to.
•Listen to her when she wants to talk.
•Check in with her regularly to see how she’s doing.

31. •Give her some breaks from child care and household responsibilities.
•Let her nap or take a relaxing bath, while you care for the baby.
•Make her a nutritious meal.
•Go on a walk with her.
•Be patient and believe in her. She will need to be reminded of her strengths and good qualities.

32. Preventative Steps
According to the Mayo Clinic, women with a history of depression, especially postpartum depression, should mention it to their doctor as soon as they find out they are pregnant. Doctors will monitor closely for signs and symptoms of depression. Sometimes mild depression can be managed with support groups, counseling or other therapies. In other cases, antidepressants are recommended (even during pregnancy).

33. After a baby is born, doctors may recommend an early postpartum checkup to screen for signs and symptoms of postpartum depression. The earlier postpartum depression is detected, the earlier treatment can begin. If there is a history of postpartum depression, a woman’s doctor may recommend antidepressant treatment immediately after delivery.

34. For More Information, Visit these Websites
Kids Health,
The Mayo Clinic,
Medicine Net,
Family Doctor,

35. Missouri Department of Social Services State Technical Assistance Team
Address:
PO Box 208 Jefferson City, MO
Telephone: (573) (800) (8 a.m. to 5 p.m. CST, Monday – Friday)