Postpartum Depression

Having a baby is an emotional period, with so much to deal with. Depression is not one of the things that a new mother would expect.

Postpartum DepressionPostpartum depression is defined as a mood disorder that begins after childbirth and lasts up to eight weeks (with some extending to a year).

  • Baby blues is a mild attack of depression that happens in the first week after birth. The new mother feels anxious, irritable, and tearful, with frequent mood changes. This does not interfere with her ability to take care of her baby and usually resolves spontaneously within days.
  • In postpartum depression, the mother feels that she is unable to care for her baby with more severe symptoms of depression.
  • Postpartum psychosis is the most severe form of PPD; it is relatively rare with symptoms of agitation, confusion, delusion and hallucination.

Symptoms of Postpartum Depression

  • Anxiety
  • Changes in appetite
  • Difficulty in concentration
  • Fatigue
  • Frequent crying
  • Intense worrying about baby
  • Loss of interest
  • Mood swings
  • Withdrawal from family friends and activity
  • In severe cases, thoughts of suicide or infanticide can be present.

Causes of Postpartum Depression

The exact cause of postpartum depression is unknown, but the rapid hormonal changes which accompany pregnancy and delivery may trigger it.

At the beginning of pregnancy, progesterone is produced from the corpus luteum in the ovary, then starting from the seventh week of pregnancy the placenta produces high amounts of the progesterone hormone (about ten fold more than pre-pregnancy state), which helps to relax the uterus and prepare the mammary gland for lactation.

After the delivery of the baby and expulsion of the placenta, the level of progesterone drops markedly returning to the pre-pregnancy level [1, 2]. This dramatic change in hormone levels may trigger the mood changes experienced in postpartum depression [3-5]. In some studies, metabolites of progesterone have been found to be lower in women with postnatal depression [2]. Therefore progesterone supplementation may help control the depression that is sometimes experienced after giving birth.

Please contact us to speak to a pharmacist for more information on this condition (0800 HORMONE or info@pharmaceutical.co.nz)

References

1. Gilbert Evans, S.E., et al., 3alpha-reduced neuroactive steroids and their precursors during pregnancy and the postpartum period. Gynecol Endocrinol, 2005. 21(5): p. 268-79.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16373246

2. Nappi, R.E., et al., Serum allopregnanolone in women with postpartum "blues". Obstet Gynecol, 2001. 97(1): p. 77-80.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11152912

3. Harris, B., et al., Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II. Bmj, 1994. 308(6934): p. 949-53.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=8173402

4. Chang, J., Y. Zhang, and L. Cui, [Impact of placental hormone withdrawal on postpartum depression]. Zhonghua Fu Chan Ke Za Zhi, 1995. 30(6): p. 342-4.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7555367

5. Bloch, M., et al., Effects of gonadal steroids in women with a history of postpartum depression. Am J Psychiatry, 2000. 157(6): p. 924-30.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10831472