Understanding Postpartum Depression

Motherhood can be challenging, especially when dealing with postpartum depression. While quite common, it is not often talked about. We highlight signs, when to seek help, and how to support a new mother.

By URLife Team
11 Apr 2023

Motherhood can bring with it a mix of good feelings and challenging experiences. About 22 per cent of Indian mothers suffer from postpartum depression (PPD), and the country requires more resources for capacity building in maternal health care, finds a 2018 study in the paper Medical Dialogues. While mild depression called 'baby blues' is common in new mothers, postpartum depression can feel exhausting and isolating. If left untreated, it may affect a woman's capacity to care for the baby and herself.


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Postpartum depression can start soon after childbirth or as a continuation of antenatal depression and needs to be treated. The global prevalence of postpartum depression has been estimated at 100‒150 per 1000 births. A study published in the 2019 Journal of South Asian Federation of Obstetrics and Gynaecology reveals that 1 in 25 Indian women suffers from postpartum depression. To address the issue, every year on the 11th of April, National Safe Motherhood Day is observed to honour motherhood and raise awareness about care and treatment during pregnancy, childbirth, and post-natal assistance. They aim to provide necessary care and treatment during and after the delivery.

The physical, emotional, and hormonal changes that come with childbirth can lead to a range of symptoms that can make it difficult to cope and can trigger postpartum depression. Keep reading to understand what postpartum depression is, how it can manifest, and possible treatment options.


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What Is Postpartum Depression

Postpartum depression is triggered by hormonal changes, psychological adjustments to motherhood, and fatigue. It is a condition that is often unrecognised and undertreated.

As per a 2022 study issued in the paper Cureus, the duration of 6 weeks after the delivery of a baby is called the postpartum course; when a woman's body starts to resume its pre-pregnancy state. This is also the time when women, usually new mothers, experience postpartum “baby blues” which comprises mood swings, anxiety, and sleeping problems. Baby blues start within the first two to three days post-delivery and usually prevail for up to two weeks.

A few new mommies encounter a severe, long-lasting form of depression known as postpartum depression. It also goes by the name peripartum depression because it starts during pregnancy and may persist after childbirth. Rarely, an extreme mood disorder called postpartum psychosis also may occur after childbirth in some cases.


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Risk Factors of Postpartum Depression

Stress: Women living under stress or stressful events such as poor living conditions, family disputes, crises, financial issues, sick children, c-sections, or unsatisfying delivery experiences are more likely to suffer from postpartum depression.

Hormone fluctuations: After childbirth, a rapid fluctuation in hormones can be seen. Hormone deficiencies in estradiol, an oestrogen steroid hormone and the major female sex hormone that regulates the estrous and menstrual female reproductive cycles and progesterone, a sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans in vulnerable women can lead to postpartum blues and depression.

Vitamin-D deficiency: Due to the transfer of nutrients to the foetus during pregnancy, the mother's body may lack certain minerals. Vitamin D receptors are widely dispersed in the human brain and a vitamin D deficiency affects neurotransmitters known to be exposed to depressive symptoms.

Genetic psychiatric history: The depression history of a patient determines the prevalence of postpartum depression. Genetical psychiatric conditions in women, like bipolar disorder, obsessive-compulsive disorder, eating disorder, and schizophrenia increases the probability of postpartum depression. Various other conditions, such as preterm birth (less than 34 weeks of pregnancy) and giving birth to a child with a genetic disability, can also cause depression.

Young age: As per research issued in the 2017 Journal of Education And Health Promotion, women who get pregnant at younger ages are more at risk for postpartum depression. It can be due to increased pregnancy complications. The highest number of cases of depression post-pregnancy are seen in women less than 19 years of age.

Anaemia: Anaemia is a common issue during pregnancy that occurs due to iron deficiency. Low haemoglobin levels in the first week of delivery were increased risk attributed to the consequence of postpartum depression in mothers, says Journal of Nutrition.


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Symptoms Postpartum Depression

Becoming proud parents of a newborn is an unexplained feeling in the world. However, soon enough, fatigue, tiredness, and depression can get too much for new mothers.. They may not even realise they are depressed but may feel lost, sad, and hopeless. Postpartum depression symptoms may look similar to baby blues, but the symptoms are more intense and may last longer. These may ultimately hinder your ability to tend to your newborn and manage other day-to-day chores. Symptoms usually emerge within the first few weeks after delivery. While untreated postpartum depression may prevail for weeks or months.


List of symptoms

1. Mood swings (baby blues) worsen

2. Sadness or guilt engulfs thoughts

3. Begin to lose interest in things you enjoy

4. Have trouble concentration and decision-making

5. You question yourself if you will be a good mom or not

6. Sleeping patterns have changed, and insomnia

7. You’ve had big, stressful changes in your life

8. Think of harming your baby or yourself

9. Feel like crying your heart out

10. Difficulty bonding with your baby

11. Withdrawing from family and friends

12. Loss of appetite or eating too much

13. Overwhelming tiredness or loss of energy

14. Intense irritability and anger

15. Severe anxiety and panic attacks


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Treatment For Postpartum Depression

Once postpartum depression symptoms have been observed, one should immediately contact a healthcare professional. Treatment for postpartum depression encloses medication, certain forms of therapy, and support groups. Typically, a combination of medication and therapy is the most effective and practical.

1. Medication: Ideally, anti-depression medication like selective serotonin reuptake inhibitors (SSRIs), atypical, tricyclic and monoamine oxidase inhibitors is given to people with postpartum depression, which can help reduce many of the symptoms of depression, but they take time — typically 6 to 8 weeks — to start working fully. Also, all these medications mentioned should only be taken when prescribed by a medical expert.

2. Therapy: After childbirth, levels of sex hormones oestrogen and progesterone in females drop exponentially. A sudden dip in sex hormones causes postpartum depression in mothers. The good news is that hormone therapy may play a role in managing postpartum depression effectively.

Cognitive behavioural therapy (CBT) can significantly improve postpartum depression symptoms. Cognitive behavioural therapy (CBT) is a form of psychological treatment that uses techniques and strategies to change thinking patterns and teaches to recognise and solve problems to deal with difficult situations. This method effectively treats medical problems such as depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness.

3. Home remedies: For treating symptoms of postpartum depression, it is wise to practise healthy habits like eating a proper diet, walking, practising meditation or yoga, and spending time in nature and with loved ones.


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Ways To Support New Mothers

Postpartum depression is not a defect or illness but rather a complication of giving birth. If your wife/partner has postpartum depression, it is advisable to be her support system emotionally and mentally to help manage those symptoms.

  • As a partner, family member, or loved one, you must try to lift her mood and keep her away from negativity in all forms.
  • Make sure to provide her with healthy and nutritious food, and appreciate her when she is feeling low or sad.
  • Sleep can be hard to come by in the first few weeks of motherhood. Ask her if she wants to take a nap to relieve all the stress, a shower or fresh air.
  • Loneliness can cause suicidal thoughts. Encourage friends and family to visit and spend time with the new mom. Give your partner your full attention and support.


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