1. IMPACT of UNTREATED POSTPARTUM DEPRESSION
Dr Violet Okech- Helu
Department of Mental Health, KNH

2. Postpartum Depression: The Facts
Depression is one of the commonest, treatable yet undiagnosed mental health disorders with a HUGE impact on bio-psycho-social functioning.
Approximately 10% of mothers experience
postpartum depression.
Numbers could be higher due to under-diagnosis.
Left untreated can severely affect the mother,baby,father, siblings and wider society.

4. Baby blues or Postpartum depression?
Many women experience the "baby blues" after childbirth.
Symptoms
Mood swings
Crying easily,
Poor concentration
Irritability
Sadness
Resolve within 1-2 weeks
Due to hormonal changes
& physiological changes
Postpartum Depression
More severe symptoms
Last longer than 2 weeks
Interfere with Mom’s ability to care for:
Baby
Herself
Family
Daily tasks
In postpartum psychosis
hallucinations may pose harm to the baby or Mom
Insert picture of can I call u back after 5 years

5. Postpartum depression(PPD)
Loss of appetite
Insomnia
Intense irritability and anger
Overwhelming fatigue
Loss of interest in sex
Lack of joy in life
Feelings of shame, guilt or inadequacy
Severe mood swings
Difficulty bonding with your baby
Withdrawal from family and friends
Thoughts of harming yourself or your baby
NB:PPD is not a sign of weakness nor mom’s fault. It’s a disease.

6. Postpartum psychosis Symptoms Confusion and disorientation
Hallucinations and delusions
Paranoia
Attempts to harm yourself or your baby
An EMERGENCY!
Mom’s should seek help if..
Symptoms last more than two weeks
Are getting worse
Difficulty in baby care
Difficulty in completing everyday tasks
Have thoughts of harming self or your baby

7. Risks for postpartum depression
Previous depression, either during pregnancy or at other times
Previous postpartum depression
Recent stressful events.. complicated pregnancy
illness, job loss.
Bipolar mood disorder
Unplanned or unwanted pregnancy
Financial difficulties
Young, unwed mother
Problems with spouse or baby’s dad/family
Weak social support system
Please Screen for these risks actively…

8. Edinburgh Postnatal Depression Scale
The Edinburgh Postnatal Depression Scale (EDPS) was developed in 1987 to help doctors determine whether a mother may be suffering from postpartum depression.
The scale has since been validated and confirmed to be both reliable and sensitive in detecting depression.
During the postpartum period, 10 to 15% of women develop significant symptoms of depression or anxiety.
Unfortunately, many moms are never treated, and although they may be coping, their enjoyment of life and family dynamics may be seriously affected.

9. Edinburgh Postnatal Depression Scale
In the past 7 days:
1. I have been able to laugh and see the funny side of things -
a. As much as I always could b. Not quite so much now c. Definitely not so much now d. Not at all
2. I have looked forward with enjoyment to things -
a. As much as I ever did b. Rather less than I used to c. Definitely less than I used to d. Hardly at all
3. I have blamed myself unnecessarily when things went wrong -
a. Yes, most of the time b. Yes, some of the time c. Not very often d. No, never
4. I have been anxious or worried for no good reason -
a. No, not at all b. Hardly ever c. Yes, sometimes d. Yes, very often

10. Edinburgh Postnatal Depression Scale
5. I have felt scared or panicky for no good reason -
a. Yes, quite a lot b. Yes, sometimes
c. No, not much d. No, not at all
6. Things have been getting on top of me -
a. Yes, most of the time I haven’t been able to cope at all b. Yes, sometimes I haven’t been coping as well as usual c. No, most of the time I have coped quite well d. No, I have been coping as well as ever
7. I have been so unhappy that I have had difficulty sleeping -
a. Yes, most of the time b. Yes, some of the time c. Not very often d. No, not at all
8. I have felt sad or miserable -
9. I have been so unhappy that I have been crying -
a. Yes, most of the time b. Yes, quite often c. Only occasionally d. No, never
10. The thought of harming myself has occurred to me -
a. Yes, quite often b. Sometimes c. Hardly ever d. Never

11. Impact on baby Difficulty in attachment and breastfeeding
Difficulty in regulating emotion
Reduced cognitive ability
Poor social skills and the ability to from successful relationships
Increased fussiness and irritability
Increased risk of mental illness in later life-elevated cortisol, reduced dopamine and serotonin
Because mother not attention or is very withdrawn or is overly intrusive. Inconsistent parenting

12. Impact on baby Difficulty in matching facial expression to emotion
Reduced ability to show empathy-conduct disorder, later development of psychopathic behaviour?...
Increased impulsivity
Increased social withdrawal
Decreased access to healthcare options, immunization etc..

13. Impact on mother/father/family
Decreased use of postpartum care for Mum and child
Reduced chances or time for breastfeeding
Inconsistent parenting leading to reduced ability of children to listen to and obey instructions
Increased likelihood of marital conflict over sex and family roles
Maternal withdrawal or over-intrusiveness
Possible harm to baby in psychotic episodes

14. Managing Postpartum depression
Early detection
Medication
Psychotherapy-personal and couple
Destigmatization of PPD
Increasing social support
Mom “me” time/selfcare
Promoting adherence to treatment

15. Aint Mama happy, aint nobody happy…Happy mama, happy n healthy families coz mothers set the emotional tone of the family and home.