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Perinatal Depression: Treatments & Symptoms

Perinatal Depression

Postpartum depression—the depression that occurs in new
mothers after the birth of a child—may be better known, but mood disorders
during the pregnancy itself are more prevalent in expectant mothers than
previously thought.

The combination of the two types of depression (both
prenatal and postpartum) is known as perinatal depression.

Prevalence

Pregnancy can be one of the happiest times in a woman’s
life, but it can also play havoc with hormones and create plenty of unforeseen
stress.

The combination of biological and emotional factors may
lead to anxiety and depression. It was once believed that pregnancy protected a
woman from emotional disorders, but that has turned out to be a myth. This is
largely due to the difficulty in diagnosing perinatal depression.

Also, there has been an inordinate focus on postpartum
depression in recent years. It is estimated that between 10 and 20 percent of
women develop some type of pregnancy-related mood disorder and approximately
one in 20 women in the U.S. will suffer from a major depressive disorder (MDD)
during the perinatal phase.

Symptoms of Perinatal Depression

Because they share symptoms, signs of depression such as
tiredness, insomnia, emotional changes, and weight gain are often masked by the
pregnancy itself.

Symptoms to watch for include:

  • frequent crying or
    weepiness
  • trouble sleeping not
    related to frequent urination
  • fatigue or low energy
  • changes in appetite
  • loss of enjoyment in
    once pleasurable activities
  • increased anxiety
  • poor fetal attachment

Symptoms of the ‘Baby Blues’

As many as 80 percent of women are affected by what is
known as the “baby blues.”

During a woman’s pregnancy her levels of estrogen and
progesterone rise dramatically (to assist in the expansion of the uterus and
to help sustain the placenta). However, within 48 hours of delivery, the levels
of both hormones plummet drastically.

Since these hormones are associated with mood, many
researchers believe this “postpartum hormonal crash” causes the baby
blues and may make some women more susceptible to postpartum depression.

Symptoms of the baby blues usually resolve within one or
two weeks of delivery and may include:

  • irritability
  • anxiety
  • frustration
  • feelings of being
    overwhelmed
  • rapid mood changes
    (elation one moment, weeping the next)
  • exhaustion
  • insomnia or
    hypersomnia (excessive sleeping)

Symptoms of Postpartum Depression

Like perinatal depression, postpartum depression affects
between 10 and 20 percent of new mothers. It includes symptoms such as the
following that occur for more than 14 days after delivery:

  • feelings of being
    overwhelmed
  • intense anxiety
  • frequent crying or
    weeping
  • irritability or anger
  • pervasive sadness
  • fatigue or low energy
  • feelings of
    worthlessness, hopelessness, or guilt
  • changes in sleeping or
    eating habits
  • lack of concentration
    or forgetfulness           
  • intense worries about
    the baby
  • a lack of interest in
    the newborn or once pleasurable activities
  • physical symptoms such
    as headaches, chest pains, or hyperventilation

A more severe form of postpartum depression is called
postpartum psychosis. It is an extremely rare condition that affects between
one and two women per 1,000.

Postpartum psychosis is usually accompanied by symptoms
such as hallucinations (either auditory or visual) and delusions. Other
symptoms may include suicidal ideation or thoughts of harming the baby.

Postpartum psychosis is an extremely serious condition that
requires immediate emergency hospitalization for the safety of both the new
mother and her baby.

Treatment

Treatments for perinatal depression are the same as with
other forms of depression and the success rates are typically much
higher—between 80 and 90 percent of women are helped by either medications,
interpersonal cognitive behavioral or psychotherapy, or a combination of drugs
and talk therapy.

Antidepressant drugs—especially selective serotonin reuptake
inhibitors (SSRIs)—are the most common treatment for perinatal depression both
during pregnancy and after the delivery of a child.

Several studies, both in the U.S. and the U.K., have
determined that SSRIs are generally safe for pregnant women and nursing
mothers. There is currently no evidence that antidepressant drugs have
long-term harmful effects on a child when taken during pregnancy. However,
there is a chance of drug withdrawal reactions in newborns that may include
jitteriness or irritability. The risk of seizures is rare.

It is understandable, however, that new mothers are
concerned about any side effects that may affect their infants and, so, many
women opt for other treatments besides antidepressants.

Interpersonal therapy has proven very effective for
perinatal depression, as have (to a lesser extent) cognitive behavioral therapy
and psychotherapy.

Additionally, alternative treatments such as massage and
especially acupuncture have shown great promise in the treatment of perinatal
forms of depression. A recent Stanford University study found that women who
received a depression-specific form of acupuncture (the placement of small
needles in the body at specific locations) had a 63 percent response rate to
the treatment.

It is important to note that prolonged depression may be
more harmful to a mother and her child than the side effects of any treatments
or medications. A woman should talk to her doctor about all of the options
available in order to make an informed decision before choosing a treatment—one
that will be best for both her and her baby.

Posted by: Dr.Health

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