POST PARTUM POST PARTUM DEPRESSIONDEPRESSION

INFORMATION AND INFORMATION AND PREVENTIONPREVENTION

Training ObjectivesTraining Objectives Define Baby BluesDefine Baby Blues Identify causes and symptoms of Baby Identify causes and symptoms of Baby

BluesBlues Recognize ways mothers can cope with Recognize ways mothers can cope with

Baby BluesBaby Blues Define Postpartum DepressionDefine Postpartum Depression Identify causes and symptoms of Identify causes and symptoms of

Postpartum DepressionPostpartum Depression Identify the differences between Baby Identify the differences between Baby

Blues and Postpartum DepressionBlues and Postpartum Depression

Identify the risk factors of Postpartum Identify the risk factors of Postpartum DepressionDepression

Identify the symptoms of Postpartum Identify the symptoms of Postpartum PsychosisPsychosis

Identify the forms of treatment for women Identify the forms of treatment for women with Postpartum Depression and Postpartum with Postpartum Depression and Postpartum PsychosisPsychosis

Identify ways women with Postpartum Identify ways women with Postpartum Depression can help themselves Depression can help themselves

Identify ways loved ones can help women Identify ways loved ones can help women who have Postpartum Depression who have Postpartum Depression

Identify Preventative Steps women can takeIdentify Preventative Steps women can take

Depression and New MothersDepression and New Mothers

Having a baby can be both an exciting Having a baby can be both an exciting and thrilling time for any mother. and thrilling time for any mother. However, it can also be a time when However, it can also be a time when many new mothers feel overwhelmed. many new mothers feel overwhelmed.

Nearly 10 percent of new mothers Nearly 10 percent of new mothers experience a distress known as experience a distress known as postpartum depression. postpartum depression.

Baby BluesBaby Blues

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

Signs and Symptoms of Signs and Symptoms of Baby BluesBaby Blues

••CryingCrying

••Mood swingsMood swings

••AnxietyAnxiety

••SadnessSadness

••Trouble sleepingTrouble sleeping

••Difficulty concentratingDifficulty concentrating

••IrritabilityIrritability(Mayo Clinic)(Mayo Clinic)

Causes of Baby BluesCauses of Baby Blues Baby Blues are believed to be caused by Baby Blues are believed to be caused by

hormonal changes. hormonal changes. Levels of estrogen and progesterone that Levels of estrogen and progesterone that

have increased during pregnancy drop have increased during pregnancy drop suddenly after delivery, and this can affect suddenly after delivery, and this can affect mood. mood.

These female hormones return to their pre-These female hormones return to their pre-pregnancy levels within a week or so. Baby pregnancy levels within a week or so. Baby Blues usually resolve on their own without Blues usually resolve on their own without medical treatment. medical treatment.

(Kids Health)(Kids Health)

Coping with Baby BluesCoping with Baby Blues According to Kids Health, new moms should According to Kids Health, new moms should

try to accept help from family and friends in try to accept help from family and friends in the first few weeks after labor and delivery. the first few weeks after labor and delivery. Family members can run errands, prepare Family members can run errands, prepare meals, or watch the baby. meals, or watch the baby.

Good nutrition and plenty of rest is Good nutrition and plenty of rest is important. important.

Talking to other new moms or family and Talking to other new moms or family and friends can help a new mom feel supported. friends can help a new mom feel supported.

If baby blues last longer than a week or two, If baby blues last longer than a week or two, a new mom should call her doctor to rule out a new mom should call her doctor to rule out postpartum depression. postpartum depression.

Postpartum DepressionPostpartum Depression According the Mayo Clinic, Postpartum According the Mayo Clinic, Postpartum

Depression may seem like Baby Blues at Depression may seem like Baby Blues at first; however, the symptoms are more first; however, the symptoms are more intense and longer lasting, eventually intense and longer lasting, eventually impacting a mother’s ability to care for her impacting a mother’s ability to care for her baby. baby.

Women experiencing Postpartum Depression Women experiencing Postpartum Depression often feel much pain during a time that often feel much pain during a time that should be joyful. Many are reluctant to tell should be joyful. Many are reluctant to tell someone when they feel this way. someone when they feel this way. Postpartum depression is a medical Postpartum depression is a medical condition that requires attention and condition that requires attention and treatment. treatment.

Signs and Symptoms of Signs and Symptoms of Postpartum DepressionPostpartum Depression

▪▪InsomniaInsomnia

▪ ▪Overwhelming fatigueOverwhelming fatigue

▪ ▪Intense anger and irritabilityIntense anger and irritability

▪ ▪Severe mood swingsSevere mood swings

▪ ▪Difficulty bonding with babyDifficulty bonding with baby

▪ ▪Lack of joy in lifeLack of joy in life

▪▪Loss of appetiteLoss of appetite

▪ ▪Feelings of shame, guilt, or Feelings of shame, guilt, or

inadequacyinadequacy

▪ ▪Withdrawal from family and Withdrawal from family and

friendsfriends

▪ ▪Loss of interest in sexLoss of interest in sex

▪ ▪Thoughts of harming self or babyThoughts of harming self or baby(Mayo Clinic)(Mayo Clinic)

Causes of Postpartum Causes of Postpartum DepressionDepression

According to the Mayo Clinic, there may be a According to the Mayo Clinic, there may be a number of causes of Postpartum Depression. number of causes of Postpartum Depression.

One such cause are physical changes. After One such cause are physical changes. After childbirth, a dramatic drop in estrogen and childbirth, a dramatic drop in estrogen and progesterone may contribute to postpartum progesterone may contribute to postpartum depression. The hormones produced by the depression. The hormones produced by the thyroid gland may also drop sharply thyroid gland may also drop sharply resulting in tired and depressed feelings. resulting in tired and depressed feelings. Changes in blood volume, blood pressure, Changes in blood volume, blood pressure, immune systems and metabolism can lead to immune systems and metabolism can lead to fatigue and mood swings.fatigue and mood swings.

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

Lifestyle influences can also be a cause Lifestyle influences can also be a cause of Postpartum Depression. These of Postpartum Depression. These include: include:

••A demanding baby A demanding baby

••Older siblingsOlder siblings

• •Difficulty breast-feedingDifficulty breast-feeding

• •ExhaustionExhaustion

• •Financial problemsFinancial problems

• •A lack of support from loved ones A lack of support from loved ones

Risk Factors of Postpartum Risk Factors of Postpartum DepressionDepression

Postpartum Depression can occur after Postpartum Depression can occur after the second or third child, not just the the second or third child, not just the first. A woman may experience first. A woman may experience Postpartum Depression after the birth Postpartum Depression after the birth of each child. of each child.

According to the Mayo Clinic, the According to the Mayo Clinic, the following may be risk factors: following may be risk factors:

••A history of depression, either during A history of depression, either during pregnancy or at other timespregnancy or at other times

••Postpartum Depression has been Postpartum Depression has been experienced after a previous pregnancyexperienced after a previous pregnancy

• •Marital problemsMarital problems

• •Lack of a support systemLack of a support system

• •Stressful events have occurred in the Stressful events have occurred in the past year, including illnesses, a difficult past year, including illnesses, a difficult pregnancy, or loss of a jobpregnancy, or loss of a job

• •The pregnancy was unplanned or The pregnancy was unplanned or unwantedunwanted

Postpartum PsychosisPostpartum Psychosis

According to the Mayo Clinic, some According to the Mayo Clinic, some women can develop a rare condition women can develop a rare condition that develops within two weeks of that develops within two weeks of delivery called Postpartum Psychosis. delivery called Postpartum Psychosis.

According to Kids Health, Postpartum According to Kids Health, Postpartum Psychosis affects 1 in 1,000 women Psychosis affects 1 in 1,000 women who give birth. It occurs within the first who give birth. It occurs within the first month after labor and delivery. month after labor and delivery.

Signs and Symptoms of Signs and Symptoms of Postpartum PsychosisPostpartum Psychosis

Hallucinations and delusionsHallucinations and delusions Confusion and disorientationConfusion and disorientation ParanoiaParanoia Attempts to harm self and the babyAttempts to harm self and the baby The risk for Postpartum Psychosis is The risk for Postpartum Psychosis is

higher for those women with Bipolar higher for those women with Bipolar Disorder. Disorder.

(Mayo Clinic)(Mayo Clinic)

When to Seek Medical AdviceWhen to Seek Medical Advice If signs and symptoms of depression If signs and symptoms of depression

do not fade after a couple weeks, it is do not fade after a couple weeks, it is important for women to tell their important for women to tell their doctors. If the depression is impeding doctors. If the depression is impeding them from doing every day tasks, it is them from doing every day tasks, it is very important to alert a physician. very important to alert a physician.

If a woman thinks she is developing If a woman thinks she is developing Postpartum Psychosis, she must call a Postpartum Psychosis, she must call a doctor immediately. This can lead to doctor immediately. This can lead to life-threatening behaviors or thoughts.life-threatening behaviors or thoughts.

(Mayo Clinic)(Mayo Clinic)

The Importance of Seeking The Importance of Seeking TreatmentTreatment

Without medical treatment, Postpartum Without medical treatment, Postpartum Depression can interfere with mother and Depression can interfere with mother and child bonding, as well as lead to family child bonding, as well as lead to family stress. stress.

According to the Mayo Clinic, children of According to the Mayo Clinic, children of mothers who have untreated Postpartum mothers who have untreated Postpartum Depression are more likely to have Depression are more likely to have behavioral problems, such as sleeping and behavioral problems, such as sleeping and eating difficulties, temper tantrums and eating difficulties, temper tantrums and hyperactivity. Another common problem are hyperactivity. Another common problem are delays in language development. delays in language development.

Untreated Postpartum Depression can Untreated Postpartum Depression can last for a year or longer. If left last for a year or longer. If left untreated, it can some times become a untreated, it can some times become a chronic depressive disorder. chronic depressive disorder.

Even when Postpartum Depression is Even when Postpartum Depression is treated, it increases a woman’s treated, it increases a woman’s chances of having future episodes of chances of having future episodes of major depression. major depression.

Treatment for Postpartum Treatment for Postpartum DepressionDepression

According to the Mayo Clinic, Postpartum According to the Mayo Clinic, Postpartum Depression is often treated with Depression is often treated with medication and counseling. medication and counseling.

Counseling can provide better ways to Counseling can provide better ways to cope with feelings, solve problems, and cope with feelings, solve problems, and set realistic goals. Talking to a set realistic goals. Talking to a psychiatrist, psychologist or other mental psychiatrist, psychologist or other mental health professional can be helpful. Family health professional can be helpful. Family or marital therapy may also be helpful.or marital therapy may also be helpful.

Anti-depressants are a proven treatment for Anti-depressants are a proven treatment for Postpartum Depression. Some anti-Postpartum Depression. Some anti-depressants can be taken with little risk of depressants can be taken with little risk of side effects to the baby if a mother is side effects to the baby if a mother is breastfeeding. A doctor can give the mother breastfeeding. A doctor can give the mother potential risks and benefits of specific anti-potential risks and benefits of specific anti-depressants. depressants.

Hormone therapy may be used to treat Hormone therapy may be used to treat Postpartum Depression as well. Estrogen Postpartum Depression as well. Estrogen replacement may help counteract the rapid replacement may help counteract the rapid drop in estrogen that accompanies drop in estrogen that accompanies childbirth. This may ease the signs and childbirth. This may ease the signs and symptoms of postpartum depression in some symptoms of postpartum depression in some women. women.

Treatment for Postpartum Treatment for Postpartum PsychosisPsychosis

Treatment for Postpartum Psychosis Treatment for Postpartum Psychosis must be immediate and often done in a must be immediate and often done in a hospital.hospital.

According to the Mayo Clinic, when According to the Mayo Clinic, when safety is assured, a combination of safety is assured, a combination of medications, including medications, including antidepressants, antipsychotic antidepressants, antipsychotic medications and mood stabilizers may medications and mood stabilizers may be used to control signs and be used to control signs and symptoms.symptoms.

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

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

Helping YourselfHelping Yourself

According to Kids Health, there are According to Kids Health, there are small things women can do along with small things women can do along with getting medical treatment for getting medical treatment for Postpartum Depression. These Postpartum Depression. These activities can include: activities can include:

▪▪Read something uplifting and positive Read something uplifting and positive that can be read a bit at a time. that can be read a bit at a time.

▪ ▪Focus on things to look forward to Focus on things to look forward to during the day such as a hot shower, during the day such as a hot shower, relaxing bath, or a visit with a friend. relaxing bath, or a visit with a friend.

▪▪Schedule a babysitter so that moms Schedule a babysitter so that moms can have some planned time for can have some planned time for themselves. themselves.

▪▪Indulge in simple pleasures such as Indulge in simple pleasures such as reading a magazine, sipping a cup of reading a magazine, sipping a cup of tea, etc. tea, etc.

▪▪Spend time with family and friends for Spend time with family and friends for comfort and company.comfort and company.

▪▪Ask for help whether it is for emotional Ask for help whether it is for emotional support or help in caring for the baby.support or help in caring for the baby.

▪▪Accept help when it is offered. Accept help when it is offered. ▪ ▪Rest when the baby sleeps. Rest when the baby sleeps.

▪▪Be optimistic and think of things to be Be optimistic and think of things to be grateful for. grateful for.

▪ ▪Be patient as it will take time to feel Be patient as it will take time to feel better. better.

▪ ▪Join a support group. Doctors and Join a support group. Doctors and women’s centers should be able to put women’s centers should be able to put moms in touch with groups in their moms in touch with groups in their area. area.

▪ ▪A daily walk can help to lift moods, but A daily walk can help to lift moods, but any new exercise program should be any new exercise program should be approved by a doctor. approved by a doctor.

Helping Someone with Helping Someone with Postpartum DepressionPostpartum Depression

Kids Health lists ways people can help Kids Health lists ways people can help their loved ones affected by their loved ones affected by Postpartum Depression. These Postpartum Depression. These activities can include: activities can include:

••Offer to go with her to the doctor, if Offer to go with her to the doctor, if she wants you to. she wants you to.

• •Listen to her when she wants to talk. Listen to her when she wants to talk.

• •Check in with her regularly to see how Check in with her regularly to see how she’s doing. she’s doing.

••Give her some breaks from child care Give her some breaks from child care and household responsibilities. and household responsibilities.

••Let her nap or take a relaxing bath, Let her nap or take a relaxing bath, while you care for the baby. while you care for the baby.

••Make her a nutritious meal. Make her a nutritious meal.

••Go on a walk with her. Go on a walk with her.

••Be patient and believe in her. She will Be patient and believe in her. She will need to be reminded of her strengths need to be reminded of her strengths and good qualities. and good qualities.

Preventative StepsPreventative Steps According to the Mayo Clinic, women with According to the Mayo Clinic, women with

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

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

For More Information, Visit these For More Information, Visit these WebsitesWebsites

Kids Health,Kids Health, http://kidshealth.org/parent/emotions/feelings/pphttp://kidshealth.org/parent/emotions/feelings/ppd.htmld.html

The Mayo Clinic,The Mayo Clinic, http://www.mayoclinic.com/health/postpartum-dehttp://www.mayoclinic.com/health/postpartum-depression/DS00546pression/DS00546

Medicine Net,Medicine Net, http://www.medicinenet.com/postpartum_depreshttp://www.medicinenet.com/postpartum_depression/article.htmsion/article.htm

Family Doctor,Family Doctor, http://familydoctor.org/online/famdocen/home/wohttp://familydoctor.org/online/famdocen/home/women/pregnancy/ppd/general/379.htmlmen/pregnancy/ppd/general/379.html

Missouri Department of Social Services Missouri Department of Social Services State Technical Assistance TeamState Technical Assistance Team

Address:Address:

PO Box 208PO Box 208Jefferson City, MO Jefferson City, MO 65102-020865102-0208

Telephone: Telephone: (573) 751-5980(573) 751-5980(800) 487-1626(800) 487-1626(8 a.m. to 5 p.m. CST, (8 a.m. to 5 p.m. CST, Monday – Friday) Monday – Friday)

Email:Email:

   dls.stat@dss.mo.govdls.stat@dss.mo.gov