Bringing home a baby is a great joy. But for some mothers, along with this joy, they start to feel a lot of sadness, loneliness , and fear. They wonder, 'Why is this happening to me? Am I not a good mother?' If you feel this way, you are not alone. This is a very common condition. This condition is what we call Postpartum Depression (PPD) . Let's talk about this in detail.
How do I know if I have Postpartum Depression?
Although we've known about postpartum depression for a long time, experts say it's often underdiagnosed. But now that awareness is greater, doctors are looking for risk factors as early as the first clinic visit during pregnancy.
If you are at risk, your doctor will monitor your mental health throughout your pregnancy. After you have your baby, it is important for you and your loved ones (husband, mother, family) to be aware of any changes in your mood or signs of depression. Your doctor will also check for this at your 6-week postpartum clinic.
The important thing is that this is not a disease that can be diagnosed with a blood test or a scan. Instead, the doctor will make this determination by asking you a few questions about your mental state.
There are several commonly used questionnaires for this purpose.
| Screening Tool | Simply put, what happens? |
|---|---|
| Edinburgh Postnatal Depression Scale (EPDS) | This is what many doctors consider the best way to diagnose PPD. There are 10 short statements here. Things like "I felt anxious or scared for no reason" or "I had thoughts of harming myself." All you have to do is tell me how many times you've felt those things in the past week. |
| 2-Question Patient Health Questionnaire (PHQ-2) | This is a basic test consisting of two very short questions. It asks how much you have felt "lack of interest in doing things" or "sad, hopeless" over the past two weeks. |
| 9-Question Patient Health Questionnaire (PHQ-9) | If the PHQ-2 test above suggests that you have symptoms of depression, your doctor will use this questionnaire. They will ask about other symptoms, such as changes in sleep and appetite, difficulty concentrating, and fatigue. |
In addition to these questionnaires, your doctor will ask you other questions to assess the severity of your symptoms. In particular, they will ask if you have thoughts of harming yourself or your baby . They will also try to determine whether this is PPD or another condition, such as ``Bipolar Disorder'' or ``Postpartum Psychosis''. They may also check your thyroid hormone levels. This is because ``Hypothyroidism'' can cause symptoms similar to PPD.
What are the treatments for postpartum depression?
Sometimes this condition can improve on its own after about 3 months of having a baby. However, if it interferes with your daily activities , or if the general sadness called "baby blues" lasts for more than two weeks, you should definitely seek treatment.
The good news is that about 90% of women with PPD can recover successfully with medication or psychotherapy combined with medication . Also, participating in support groups is a big help.
In very severe cases of PPD or a condition called ``Postpartum Psychosis'', hospitalization may be necessary. In some extremely severe cases, where hallucinations, delusions, or suicidal thoughts are prevalent, a treatment called ``Electroconvulsive Therapy (ECT)'' is even used.
It is best to start treatment as soon as possible. If left untreated or delayed, the condition can worsen. Experts have also found that untreated PPD can affect children. Such children may experience sleep problems, impaired cognitive development, insecurity, and frequent tantrums.
Medications for treatment
Often the first step in treatment is to address immediate problems like sleep and appetite. Antidepressants are very effective for this.
However, if you are breastfeeding , whether or not to use medication, and which medication to choose, is a decision that you and your doctor should make very carefully. Some antidepressants can pass into breast milk in very small amounts. There is some controversy about some medications, such as lithium.
Therefore, it is important to talk to your doctor and make a decision after fully understanding the benefits and risks. If you are taking medication, it is recommended that you take it continuously for at least 6 months or a year to prevent the disease from recurring.
Also, if you have had PPD before, your doctor may advise you to start taking birth control pills soon after your next delivery or during your pregnancy.
How does psychotherapy help?
Psychotherapy, or simply "talk therapy," is used for PPD, either alone or in combination with medication. Your doctor can refer you to a qualified counselor who specializes in PPD.
All you have to do is meet and talk to the counselor on a set schedule. They will ask you about your life and how you are feeling. It is very important to tell everything honestly, without any judgment. Everything you say is confidential between you and the counselor.
In this type of therapy, the counselor teaches you to change your negative thoughts and behaviors and to look at things differently. Two of the most common types of therapy used for PPD are:
- Cognitive Behavioral Therapy (CBT): Simply put, it helps you identify and change the harmful, negative thoughts and behaviors that arise from them.
- Interpersonal Therapy (IPT): This helps you to resolve your social relationships (relationships with your spouse, family, friends) and the problems they cause, and to manage those relationships better.
Things you can do when living with PPD
While you're receiving treatment, you can also take care of yourself. These things will be a great help in your recovery process.
- Make time for yourself: Take a little time for yourself every day. Being with a baby all day is very tiring.
- Go outside: Get outside for a little while every day. At least walk around the house. Even that small change can be a big relief for your mind.
- Ask for help: Don't be afraid to ask a trusted family member or friend for help with household chores, babysitting, or talking things out. Don't try to do everything alone.
- Exercise: Once your body has recovered after having a baby, talk to your doctor and start an exercise routine that suits you. Exercise helps a lot to relax your mind.
- Support Groups: It's a great way to talk to other moms who have had similar experiences as you. Consider joining a new moms' group in your area.
Let's also learn about complementary and alternative therapies.
You may not want to take medication, especially if you are breastfeeding. If so, you can talk to your doctor about these alternative methods. But remember, if you are using these in addition to or instead of medical treatment, you should definitely seek the advice of your doctor.
- Yoga: According to one study, more than 75% of mothers suffering from depression who practiced yoga twice a week experienced improvement.
- Massage: Some studies have shown that massage can reduce PPD symptoms.
- Relaxation Training: You can learn to calm yourself through things like deep breathing exercises and guided imagery.
- Meditation: Meditation helps you focus your mind on the present moment and let go of unwanted thoughts. This can also help relieve depression.
Results for herbal supplements like St. John's wort are mixed. Acupuncture and light therapy have not yet been proven effective for PPD.
Take-Home Message
- Postpartum depression is not a weakness on your part, it is a medical condition that requires treatment.
- If you feel sad, anxious, or hopeless more than two weeks after having your baby, talk to your doctor immediately.
- This condition can be treated very successfully with medication and psychotherapy.
- Never be afraid to ask for help from your husband, family, and friends.
- Rest, good sleep, exercise, and taking some time for yourself are essential for your recovery.
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