Warning signs and treatments for Postpartum Depression

Having a baby brings happiness, love, and excitement. But it can also bring exhaustion, worry, and emotional changes to new mothers which rarely people talk about or understand the situation. Even new mothers don't feel like talking about it. New mothers go through episodes of crying more than usual, feel overwhelmed, and struggle to adjust to their new routines. However, these feelings last only for at most 2 weeks. But if they continue to feel these for longer periods, then they are probably experiencing postpartum depression.

It used to be one of those least-talked-about topics, but in January 2023, the case of Lindsay Clancy brought the topic of postpartum mental health to light when she killed her three young children. Her case involved a legal dispute over postpartum psychosis, a condition different from postpartum depression.

Understanding the differences and recognising the warning signs and mental well-being of the new mother. This blog explains those differences and covers the warning signs, why it happens, how it is treated, and when to get help.

What Is Postpartum Depression?

Postpartum depression (PPD) is a form of depression and a medical condition that can develop anytime in the first year after delivery. It usually happens in the first three months, when women find it difficult to sleep, concentrate, care for themselves, or feel emotionally connected to their baby. It's more than just feeling tired or teary. Women feel sadness and emptiness that stay with them and get in the way of their daily life.

PPD is not a weakness, and it is more common in India than you think. WHO studies found that about 22 in every 100 Indian mothers had postpartum depression. But this condition is treatable with the right support and approach.

Signs and Symptoms of Postpartum Depression

The symptoms of PPD are different in different women. Some mothers may be seen actively managing their daily responsibilities as if nothing happened but privately struggling with intense emotional distress. Or some may be seen crying all the time. However, the following are the common signs that need attention:

• Feeling persistent sadness, emptiness, or hopelessness.

• Feeling guilty or like a failure as a mother

• Irritability or sudden anger

• Constant worry or panic

• Feeling numb, or not feeling the love you expected to feel for your baby

• Difficulty in sleeping even when the baby is asleep, or sleeping too much

• Changes in appetite

• Feeling exhausted all the time, far beyond normal new-parent tiredness

• Trouble focusing or making simple decisions

• Pulling away from family and friends

• Finding it hard to care for yourself or your baby

• Not wanting to bond or struggling to bond with your baby

• Thoughts of hurting yourself, or feeling that your family would be better off without you

Some of these feelings may happen due to sleep deprivation, physical recovery after delivery, or the demands of caring for a newborn. But it needs to be taken seriously when these patterns last longer. A closer look must also be given to the intensity of the symptoms. Try to get immediate medical help and don't wait for the symptoms to get worse.

Warning Signs That Need Emergency Help

Postpartum psychosis is rare and must be treated as an emergency. It can begin suddenly, often within the first couple of weeks after delivery. It is an advanced stage of postpartum depression. The following are the warning signs that need immediate medical help:

• Hearing voices or seeing things that others do not

• Strong beliefs that are not true, such as thinking the baby is in danger or is not really theirs

• Being very confused or not making sense when speaking

• Not sleeping for days without feeling tired

• Sudden, extreme mood swings or unusual levels of energy

• Acting very differently from her usual self

• Any thought of harming herself or the baby

If these signs are visible in a mother, then do not leave her alone and do not wait any longer before you seek medical help. This is a medical emergency; take her to the nearest hospital or consult an experienced psychiatrist to understand her so that treatment can be started as early as possible.

Why Does Postpartum Depression Happen?

There is hardly a single reason behind postpartum depression. It happens due to the result of various factors, and the timeline for every mother is not the same. The following are the factors that contribute to postpartum depression:

1. Hormonal changes

After delivery, there’s a sharp decline in oestrogen and progesterone, which can affect mood and emotional well-being in some women.

2. Sleep deprivation

Newborns often need feeding and care throughout the day and night. It leads to broken sleep for weeks, leaving the mother feeling physically exhausted and emotionally overwhelmed.

3. History of depression

Women who have experienced depression or anxiety before or during pregnancy are at higher risk of developing PPD. Even a family history of mood disorder can also play a relevant role.

4. Difficult pregnancy or birth

Complications, an emergency C-section, or a baby who needs NICU care can affect a mother’s emotional well-being. Some women may experience trauma related to childbirth. Such experiences may contribute to depression, anxiety, or other mental health concerns

If you had a high-risk pregnancy, then our blog on high-risk pregnancy care may help you prepare.

5. Health problems

Thyroid changes after delivery can look a lot like depression, so doctors often check for them. Also, if the new mother was already dealing with some other health conditions, then after childbirth managing them could become difficult for her.

6. Lack of support

Caring for a newborn is a demanding job. It becomes a challenge when the new mother needs to manage everything herself. Limited support from her partner or family, financial crisis, and difficulties in the relationship can become stressful and will add to her stress.

7. Pressure to be a perfect mother

Motherhood is different for every woman. Some feel happy, while some experience sadness, frustration, fear, or emotional exhaustion. Society expects new mothers to be happy, patient, and grateful all the time, which can sometimes make new mothers feel guilty for not matching the expectation.

How is Postpartum depression diagnosed and treated?

PPD is highly treatable, but unlike other treatments, it does not involve blood tests to confirm the condition. You will initially have to undergo assessments, which are carried out by a qualified psychiatrist or other healthcare professional. Your diagnosis and treatment may include:

1. Understanding of symptoms:

Your doctor will begin by asking you about the symptoms and how they've been affecting your daily life. You will also be asked about your feelings, guilt, anxiety, hopelessness, bonding difficulties, and frightening thoughts that are difficult to control.

2. Screening tests:

Your healthcare professional may use standard screening questionnaires like the Edinburgh Postnatal Depression Scale (EPDS) to understand and identify the symptoms more clearly to determine if further assessments are required.

3. Talk therapy:

Cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) are evidence-based approaches that give mothers the space to discuss their feelings and changes in their life. It helps address the negative thought patterns, relationship difficulties, and emotional challenges associated with motherhood.

4. Medications:

Antidepressants may be prescribed when the symptoms are moderate to severe or when psychotherapy alone is not enough. However, these medicines must be taken under medical supervision after discussing the benefits and potential risks.

5. Treating other causes:

If a thyroid problem or anaemia is part of the picture, treating it can help your mood.

6. Treatment for severe postpartum conditions:

When symptoms are severe, or there are signs of postpartum psychosis, then a closed treatment is required immediately. This treatment is different from routine care that is used for normal postpartum depression.

7. Routine follow-ups:

It may take time to fully recover, and symptoms may change during the treatment, and that's the reason follow-up appointments are essential, as it allows doctors to monitor your progress, review medication, and address any new conditions. The treatment plan can also be changed depending on the improvement.

Seeing a psychiatrist does not mean you are weak or you will be on medicines for life. For many mothers, it is a short-term plan to get through a hard period, and this is one of the safest ways to deal with the condition.

Know the warning signs

Knowing what to watch for can help you get the right care at the right time. If something feels unusual or concerning, don’t wait and immediately contact your gynaecologist or seek immediate medical care if you notice:

• Heavy vaginal bleeding or leaking of fluid

• Severe or persistent abdominal pain

• Severe headache, blurred vision or flashing lights

• Sudden swelling with other concerning symptoms

• Difficulty breathing or chest pain

• Leakage of fluid from the vagina

• Reduced or changed fetal movements after the stage when you normally feel them

• Seizures or loss of consciousness

• Fever with chills

• Regular tightening or contractions before 37 weeks

Do not wait for your next appointment if something feels off because the warning signs nd urgencies vary depending on the stage of the pregnancy and medical conditions.

How Family and Partners Can Help new mothers?

Family members are the first to notice that something is off, and they play an important role in helping mother to seek treatment and recover early. If you are a husband, parent, or in-law, here are the practical ways you can help a new mother:

• Give the mother space to talk about how she feels without telling her to simply be positive.

• Help her by sharing the daily responsibilities, like helping with meals, household work, or baby care. This can make a great difference.

• Make sure she gets a long stretch of sleep at night because uninterrupted sleep can change how she feels.

• Never compare her with other mothers; it will only make her feel more guilty.

• Encourage her to seek professional help; offer her company to a psychiatrist or other healthcare professional.

• Pay attention to warning signs like hallucinations, confusion, delusions, as they require urgent medical help.

Postpartum Depression Treatment at Yuti Clinics, Kondapur

At Yuti Clinics, our qualified professional psychiatrists have years of experience in treating new mothers with care and without judgement. Deciding to have a consultation might already be the hardest thing you did, so at Yuti Clinics, our professionals just start by listening to you.

Our approach includes:

• A full assessment of your mood, sleep, stress, and health history

• Postpartum depression and anxiety screening

• Guidance on therapy and counselling

• Medicine plans that take breastfeeding into account

• Support and guidance for your partner and family

• Regular follow-ups to track your recovery - Coordination with your gynecologist when needed

If you are looking for the best psychiatrist in Kondapur, Hyderabad for your postpartum depression, then Yuti Clinics can help with all of your concerns.

If you or someone close to you is struggling after childbirth, please talk to a doctor. You do not have to handle this alone or wait for things to get worse.

Book your consultation with our psychiatry team at Yuti Clinics, Kondapur.

Medical disclaimer: This article provides general education and does not replace an individual medical consultation.