Psychologists and psychiatrists at Shier Private Practice in Scottsdale, AZ specialize in the treatment of depression. Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.
It is estimated that as many as 80% of postpartum women experience at least some symptoms of the postpartum blues, otherwise known as baby blues, in the days following childbirth. Postpartum blues may include feelings of stress, sleep deprivation, and/or isolation and mothers with the postpartum blues may notice themselves feeling more overwhelmed, emotional, or tearful than usual. In most cases, postpartum blues begin in the first couple of days following delivery, peaking in severity around one week postpartum and tapering off by the end of the second week postpartum.
The postpartum blues share many symptoms with a more serious diagnosis of postpartum depression such as mood swings, sadness and irritability. Postpartum depression, however, is characterized by a more severe, and longer lasting depression that may include suicidal thoughts or an inability to care for one’s child. Mothers with postpartum depression may feel withdrawn from their partner or newborn and may experience out of control anxiety, guilt or feelings of worthlessness. In rare cases, hallucinations or delusions may be present. Postpartum depression should be considered an emergency medical condition for which treatment is sought quickly.
It is estimated that between 10% of women will experience some level of postpartum depression following childbirth.
The symptoms of postpartum depression usually develop in the first few weeks following childbirth, but may begin up to six months following birth. Symptoms may include, but are not limited to:
- Depressed mood or mood swings
- Difficulty bonding with baby
- Withdrawing socially
- Loss of appetite
- Insomnia or hypersomnia
- Reduced interests and pleasure
- Feelings of worthlessness, inadequacy or guilt
- Anxiety or panic attacks
- Excessive crying
- Intense anger or irritability
Postpartum depression is believed to result from hormonal shifts that occur during pregnancy and childbirth. During pregnancy, estrogen and progesterone levels are higher than usual. After delivery, these hormones drop rapidly; this may affect mood. In normal cases, these hormones return to pre-pregnancy levels after a week or so and postpartum blues resolve on their own. For individuals with postpartum depression, these levels may not normalize on their own, leading to a more severe and longer lasting bout of depression.
Factors that may increase the risk of a woman developing postpartum depression include prior episodes of postpartum depression, a history of general depression, and a family history of mood disorders. Women who have experienced postpartum depression with previous childbirths are 30-50% more likely to develop postpartum depression with childbirth than women who have not. Social stressors such as abusive relationships, financial trouble, or a lack of emotional support may also increase the likelihood of postpartum depression. An abrupt discontinuation of medications due to pregnancy may also be a risk factor.
The diagnosis of postpartum depression requires a thorough biopsychosocial psychiatric and medical assessment or psychological assessment to confirm the diagnosis and rule out other psychological or medical conditions.
Psychotherapy, medication, hormone therapy, or a combination of these, may be used in the treatment of postpartum depression. Interpersonal therapy, cognitive behavioral therapy or marriage counseling may be helpful in adjusting to parenthood, working on social and interpersonal relationships and overcoming maladaptive thoughts or behaviors.
The first-line medications used in the treatment of postpartum depression are selective serotonin reuptake inhibitors (SSRIs) such as Sertraline/Zoloft, Escitalopram/Lexapro, and Fluoxetine/Prozac.
Last update: February 25,2019
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