Am I Experiencing Mental Health Symptoms Of Peripartum Depression?
Finding out that you will be a parent or recently becoming one may bring up complex emotions. As exciting as it can be to bring a new life into the world, the initial joy you might feel at the news of a pregnancy could rapidly turn into fear, hopelessness, loss of interest, sadness, or anxiety. After a baby is born, it's not unusual to hear that a parent has developed the “baby blues.” However, in some cases, these challenges can signal the presence of peripartum depression, also known as postpartum depression. Peripartum depression is a severe and potentially debilitating mental health condition, but one that can typically be treated with the help of a doctor and/or a mental health care provider.
What is peripartum depression?
Peripartum depression is a type of depression that can be experienced by birthing parents of any gender as well as their non-birthing partners, other caregivers, and adoptive parents. According to one study, anywhere from 6.5 to 20% of pregnant individuals experience postpartum depression—which is a clinical mental illness, not just a case of what is sometimes referred to as the “baby blues.”
While many people are familiar with hormonal changes after childbirth, rapid hormonal changes actually begin at the start of pregnancy. When hormonal changes cause depressive symptoms from the beginning of the pregnancy and last after the child is born, this is called peripartum depression (or perinatal depression), a term that’s now more commonly used than postpartum depression. Mental health experts generally prefer the term peripartum depression because it more accurately reflects the hormonal changes over the life of the pregnancy than postpartum depression does.
As with many mental disorders, the exact causes of peripartum depression are unknown. However, several risk factors are thought to contribute to the disorder. These include a history of depression; genetic influences; hormonal changes; stress during pregnancy, birth, and early caregiving; and other environmental factors.
Toddlers and preschool-age children with parents who have depression of some type may be at increased risk of having poor self-control, cognitive difficulties, and difficulties with social interactions. School-age children and adolescents may be at increased risk for weakened adaptive functioning, conduct disorders, affective disorders, and anxiety disorders. Such potential risks to the child’s health are an additional reason that it’s typically recommended that you seek mental health care right away if you’re experiencing symptoms of peripartum depression.
What are the symptoms of peripartum depression?
- Crying without an apparent cause
- Feeling sluggish
- Experiencing fatigue
- Having feelings of hopelessness or worthlessness
- Showing little interest in the new baby
- Feeling a lack of bond with the new baby
- Losing interest in activities previously enjoyed
- Difficulty concentrating
- Feeling like a bad parent
- Feeling irritable, anxious, or restless
- Feeling isolated, guilty, or ashamed
When symptoms of major depression occur during pregnancy or from one month to six months after delivery, it can indicate a diagnosis of peripartum depression. According to a 2019 study, peripartum depression is the leading cause of disease burden for birthing parents and their families. It also reports that a gestational parent has a greater risk of being admitted to a psychiatric hospital within the first month after giving birth than at any other time in their life.
What is postpartum psychosis?
Note that postpartum psychosis is another related condition that can affect a birthing parent in the two weeks following delivery. It’s characterized by delusions, hallucinations, hyperactivity, severe depression, decreased need for sleep, paranoia, and other related symptoms. It’s more likely to occur in those with a personal or family history of bipolar disorder or psychotic episodes. Seeking treatment right away is typically recommended for these symptoms or symptoms of postpartum/peripartum depression.
Non-gestational parents can also experience peripartum depression
It’s worth noting that newer evidence suggests it’s not only gestational parents who may be at risk for developing a mental health condition like peripartum depression. Partners of any gender, adoptive parents, and other caregivers, such as family, can also experience postpartum depression after a new baby or child has been brought home.
According to an article in the US News and World Report, the APA reports that 4% of partners experience depression in their first year after their child's birth. Younger partners, those with significant financial burdens, and those with a history of depression are reported to be at increased risk. Non-gestational parents can also seek support and treatment when experiencing peripartum or postpartum depression or other mental health challenges.
Treatment options for peripartum or perinatal depression
The typical treatment for any type of depression is psychotherapy, either on its own or combined with medication. Note that the sooner the affected person begins treatment, the more effective it may be.
Medication-based treatment for depression
There are risks for pregnant and nursing parents and their babies if they take certain medications during this time. Because of these known risks, many doctors may recommend psychotherapy without medication as the first course of treatment for peripartum depression, especially if symptoms are mild.
If a doctor decides that medication is the right course of action for an individual experiencing peripartum depression, they will likely monitor its effects carefully. Remember that withdrawing from antidepressant medications too quickly could result in serious health consequences, which is why it’s critical to ask your doctor before stopping, starting, or changing your dose of any medication—especially while pregnant or nursing.
Psychotherapy
The first-line treatment for most types of depression, including peripartum depression, is usually psychotherapy, or talk therapy. Cognitive-behavioral therapy (CBT) in particular may be able to help an individual find symptom relief and embark on the path toward healing. A therapist can give them a safe space to express their emotions without judgment, help them learn to recognize and adjust distorted thoughts, and recommend healthy coping mechanisms for difficult feelings associated with depression or parenthood.
Lifestyle changes
A 2019 review of studies on the topic indicates that getting physical activity during and after pregnancy may help reduce the symptoms of peripartum depression. Even low-impact movement like going for a walk or a swim can be enough to produce mental health benefits. Another study suggests that eating a nutritious diet during pregnancy may be linked to decreased risk of mental health challenges after pregnancy. It notes that calcium, iron, and folate are nutrients that may be especially important for supporting positive mental health in gestational parents.
Crisis support
In some cases of peripartum depression, symptoms can be severe. Some may experience suicidal thoughts, thoughts of harming themselves, or thoughts of harming their newborns. These thoughts or actions can require immediate medical intervention, so don’t hesitate to reach out for help.
If you or someone you know is struggling or in crisis, help is available. Text or call 988 or chat 988lifeline.org. Support is available 24/7. If you are experiencing trauma, support is available.
Counseling treatment alternatives
Online therapy can represent a convenient alternative for receiving mental health care for those who are pregnant, have just given birth, and/or are a caregiver for a newborn. Instead of embarking on a regular commute to a therapist’s office, you can attend appointments to receive this type of health care from the comfort of your home, office, or another preferred space—all you need is an internet connection.
Studies suggest that online therapy can be an efficacious treatment for those experiencing symptoms of peripartum depression, postpartum depression, or another depressive disorder. In a 2021 study, for example, researchers evaluated the effectiveness of online interventions in reducing symptoms of depression and anxiety in individuals with peripartum depression, and their findings suggest that it effectively reduced symptoms.
If you want to talk to an online therapist, you can sign up with a platform like BetterHelp for individuals or ReGain for couples to learn more about online therapy and receive support. You're not alone, and treatment is available.
Takeaway
Is peripartum the same as postpartum depression?
Peripartum and postpartum depression are the same type of perinatal depression and are often used interchangeably; however, they are not entirely the same. Peripartum depression refers to depression that may begin either during pregnancy or within the first four weeks of childbirth. Postpartum depression is a term that refers to depression within the first year after childbirth.
Research indicates that developing peripartum depression can be influenced by stress hormones during late pregnancy. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) helps clinicians differentiate between peripartum and other conditions. Perinatal depression affects both pregnant and postpartum women and requires careful monitoring. Early and proper treatment can prevent untreated depression from worsening.
What causes baby blues and other mental health conditions after giving birth?
Baby blues and postpartum depression have many causes, including hormonal fluctuations, physical changes, emotional stress, family history, and post-traumatic stress disorder. Traumatic events around childbirth can trigger a depressed mood beyond the typical baby blues. Other mood disorders, such as anxiety disorders, may overlap with postpartum experiences. Stressful life events, like a lack of social support, can exacerbate early symptoms. Research suggests that participation in support groups may offer relief to many new mothers.
What is peripartum depression?
In the DSM-IV, there was a “postpartum onset” specifier for depression; however, in the DSM-5, the term was changed to “peripartum,” which refers to depression that may start during pregnancy or within the first four weeks after giving birth.
Perinatal mental health encompasses conditions like peripartum depression that begin in pregnancy. The postpartum period is a high-risk time for symptom onset. Treatment may include psychiatric medications such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants. The American Psychiatric Association provides guidelines for managing this medical condition.
What is postpartum psychosis?
Postpartum psychosis is a severe mental illness that may develop after childbirth. The two common symptoms of postpartum psychosis are hallucinations and delusions. This condition requires immediate help.
A psychiatric evaluation is crucial for diagnosing postpartum psychosis. Although rare, symptoms may mimic psychiatric disorders like obsessive-compulsive disorder, schizophrenia, or other conditions. Immediate medical attention is necessary to protect both mother and child.
Why do people experience postpartum depression?
Many factors may contribute to the development of postpartum depression. These may include family and personal history of depression, sleep deprivation, hormonal changes, and lack of support. Some individuals are also at higher risk of developing postpartum depression, such as those with bipolar disorder, those whose baby has health problems, or those with an unplanned pregnancy.
Hormonal fluctuations can lead to extreme sadness and trouble sleeping in postpartum women. Early follow-up in family medicine can ensure that at-risk mothers receive timely support and intervention. Certain birth defects or medical conditions affecting the infant can increase maternal stress and risk. Without proper screening tools, perinatal depression might go undetected until severe.
What's the difference between the mental health conditions PND and PPD?
Postnatal depression and postpartum depression are often used interchangeably. They both refer to the type of depression that may occur after childbirth. PND is often used interchangeably with PPD, but some experts argue they should be distinguished in primary care settings. The USPSTF, also known as the United States Preventive Services Task Force, recommends universal screening in early postpartum. Both conditions may share depression symptoms like persistent low mood. Identifying protective factors, such as strong partner support, can aid recovery.
How long does perinatal depression last?
Each person is different and may have a different experience during pregnancy and after giving birth. Some parents may feel better within a few weeks, while some parents may feel depressed for months or years.
According to a 2020 issue of JAMA Psychiatry, the US Preventive Services Task Force advises follow-up for anyone still struggling. Some people may have symptoms for over a year, but seeing a mental health professional early can speed recovery.
Is PPD the same as depression?
Depression is a broader term that refers to a variety of mood disorders, while PPD or postpartum depression is a type of depression that may occur after giving birth.
PPD is a depression subtype that occurs in postpartum individuals after childbirth. It does not cause persistent pulmonary hypertension, because PPHN risks aren’t linked to maternal mood, though late-pregnancy SSRI antidepressants may raise concerns. Its timing sets PPD apart from other affect disorders. SSRI antidepressants are effective and sometimes prescribed for postpartum women, benefiting both mother and child.
How can you avoid postpartum depression?
While many factors may contribute to postpartum depression, such as hormonal changes, focusing on your mental health, seeking early support from a professional, and prioritizing self-care may reduce the risk of developing this condition. Joining a local program focused on maternal mental health can foster resilience among new parents. Healthcare providers often consult the Diagnostic and Statistical Manual of Mental Disorders for updated criteria when advising on preventive strategies.
What is perinatal anxiety?
Perinatal anxiety is the excessive worry that may occur before and after childbirth. It can cause physical symptoms like restlessness, rapid heartbeat, and trouble sleeping. Left unaddressed, it may interfere with daily life and bonding with your baby. Talking with a mental health professional early can help manage symptoms and provide support.
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