Postpartum DepressionPostpartum DepressionA Mothers’ Mental Health Toolkit Project Learning Video

with Dr. Joanne MacDonald Reproductive Mental Health Service IWK Health Centre Halifax NS

Postpartum DepressionPostpartum Depression

Postpartum DepressionPostpartum DepressionDepression that begins for the mother within the first

12 months after a baby is born is called Postpartum Depression.

This comes from the word partuition which is a medical term for the process of delivering the baby.

1 in 10 women will experience Postpartum Depression.

This mental health problem is then one of the most common complications of childbirth.

60 + % will have no previous history of diagnosed illness.

Postpartum DepressionPostpartum Depression

Family and friends may not expect PPD

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Signs?

Inability to rest when baby restsMind working very slowly or very quicklyLow motivation Poor concentration, planningLack of ability to enjoy usual activities or peopleLow self-concept, unusual hopelessnessOverwhelmed easily compared to past copingUnexplainable changes in sleep or appetite

Postpartum DepressionPostpartum Depression

True or False?1.PPD is more common with teen

mothers2.Family history of PPD increases risk3.The depression will lift in time4.It is better to cope without treatment

for the sake of the baby/child5.There is little family or friends can do

Postpartum DepressionPostpartum Depression1. Teen mothers have the same rate of Major Depression

as older mothers in formal studies. But they may have more difficulties with adjustment if supports are few, and increased social disadvantage because of deficits in education or income.

2. Family history of PPD with mother, aunts, sisters or cousins, does increase a woman’s risk.

3. Up to 20 % of untreated postpartum depression becomes chronic depression that affects function and quality of life.

4. Untreated depression in a mother is strongly associated with delays in development and attachment for the baby.

5. High levels of social support seems to protect from PPD and improve recovery.

Postpartum DepressionPostpartum Depression

Social Determinants of Health influence availability and accessibility of health care

Postpartum DepressionPostpartum Depression

Fast Fact:

Postpartum depression can be a mixture of mood disturbance – with sad, blue or low mood, unusual irritability and tension and/or increased anxiety in the body and in thinking. It can be dismissed as adjustment and not recognized as a treatable illness.

Postpartum DepressionPostpartum Depression

Why does depression risk increase after a baby is born?

Sleep deprivation is a general trigger for mood regulation problems

Major changes in role, relationships and expectations contribute to depression risk in any person

Usual coping strategies may not be as easy to do, such as daily exercise routine

Some women have brain chemistry that is triggered by the hormones that change in pregnancy and after birth. This is the factor that is shared by family members at risk.

Postpartum DepressionPostpartum Depression

Strategies to Prevent PPD include:

Reducing stresses where possibleHelp with tasks other than baby careRest periods from baby careBuilding in extra sleep whenever possibleActive treatment of depression in

pregnancyCognitive-behavioral & emotional

regulation strategies and therapies

Postpartum DepressionPostpartum DepressionTreatment Options:Mindfulness & Relaxation TechniquesPhysical Exercise including Practices that increase

relaxation and focusInterpersonal and Cognitive-Behavioral PsychotherapyAntidepressant Medications ( safety for each woman

and her baby if breastfeeding needs to be evaluated; many medications are safely and effectively used)

Antianxiety MedicationsSleep MedicationsNutritional Enhancement, including Supplements such

as Omega-3-Fatty Acids

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Who can help?Friends & Family

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Who can help?Partner

Postpartum DepressionPostpartum Depression

Who can help?Primary care doctor or nurse

Postpartum DepressionPostpartum Depression

Who can help?Mothers supporting other mothers

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Who can help?Community Support Workers

Postpartum DepressionPostpartum Depression

Who can help?Mental Health Professionals

Postpartum DepressionPostpartum DepressionWhat can help?Self-care Self-directed recovery strategiesPeer support and connection

Key Resources: www.postpartum.netwww.heretohelp.bc.cawww.bcwomens.ca/services/healthservices/reproductive mentalhealth.htm

Postpartum DepressionPostpartum Depression

What’s the outcome?

Full pre-baby recovery is typical with treatment

Full physical and emotional recovery can come slowly though over weeks to months

Self-care strategies and stress reduction may need to become lifelong habits

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What is a woman’s risk for depression after her next pregnancy if she has had one episode of Postpartum Depression?

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Risk first time is 10%One episode risk increases to 20 %But chance of remaining well is still

80%Self-care, stress reduction, quick

assessment and treatment of new depression reduces risk and effects of illness

Postpartum DepressionPostpartum Depression

Take Home Point:Community service providers can be

critical as sources of support, recognition of a woman’s struggle, knowledge of local resources and leadership in reducing stigma in mental health care for mothers.

Postpartum Depression can be a serious but treatable illness with a good outcome with care.