Post-Partum Depressive Illnesses – Clinical Depression and Risk Factors

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‘Post partum’ refers to the first year after childbirth. The levels of the sex hormones fall abruptly at delivery. If you are sensitive to the effects of estrogen and progesterone changes, you may develop mood disorders at this point.

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Post-Partum ‘Blues’
After your baby is born, you may experience ‘blues’, feeling weepy and sad for the first two to three days. Support and reassurance are usually enough to get you past this time. Caring and love from your partner and family help as well. Don’t expect to be a super-mum! Get plenty of sleep when you can, and don’t pretend to feel great if you don’t.

Post-Partum Depression
Sarah had been looking forward to the birth of her first son. She had married late and become pregnant soon after her honeymoon. When she gave birth to a premature daughter, she was disturbed to realize that motherhood was not what she had fantasized. She couldn’t decide on a name for her daughter, and didn’t feel any great love for the infant. In fact, :he felt flat and uninterested in the people around her, including her husband. She fed the baby with a bottle, as she couldn’t tolerate the infant sucking her breast. She was ashamed of herself, and hated the baby, and felt unnatural as a mother.

Sarah didn’t want anyone, even her husband, to know what an awful person she was, so she hid her tears and moodiness and tried to pretend she could manage, although she was having terrifying dreams about harming the baby. She finally confided to her best friend, who was a doctor, how miserable she was feeling. Her friend told her that she was probably suffering from post-partum depression, and arranged for Sarah and her husband to see a psychiatrist. Sarah’s husband spent more time at home until Sarah started to feel better, and he and her mother agreed to give the baby her bottle during the night so Sarah could get some uninter¬rupted sleep. She began taking an antidepressant, and had psychotherapy sessions to talk about the pressures she was feeling. Sarah was reassured that she and her husband could get a babysitter and go out for the evening; she had been worried that she had to be on call twenty-four hours a day, because the baby was premature and never slept more than two hours at a time. At last report, Sarah had begun to enjoy playing with her new little girl, and they looked like a happy pair.

If you are among the 10 per cent of new mothers who develop a clinical depression after a week or two or, less often, over the first three or four months, you may require treatment. The depression can interfere with your attachment to your new baby. Sometimes you and your doctor can predict this sensitivity if you have had problems with premenstrual tension or birth control pills, or if you or a close relative previously had a bout of post-partum depression. A loving relationship with a partner helps buffer the effects. Let up on your expectations of yourself, ask for help if you need it, and get adequate sleep.

Antidepressants from the SSRI group can be safely prescribed for you while you are breastfeeding, as there is very little risk to the baby. If you are on lithium it’s important to stop breastfeeding, because babies are very sensitive to its effects. If your depression is caused by changes in hormone levels, you will probably respond well to antidepressants. But other changes in your life at this time, such as leaving work, tension in the family, financial worries, sleepless nights, and exhaustion, may aggravate the depression.

Risk factors for post-partum depression

– fertility problems
– psychiatric illness
– family history of post-partum depression
– being a single parent
– financial difficulties
– being an adolescent mother
– being a mother over thirty-five
– worries about the health of your newborn
– difficult labour
– premature baby
– social isolation
– marital problems

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