Post Partum Depression is an Epidemic
Post partum depression affects roughly 13-15% of all mothers following the birth of their child. Post partum is considered a moderate to severe form of depression and generally can start up anytime from directly after birth until your child reaches 1 year of age.Most of the time this occurs 2-3 months after your baby is born. These numbers should be alarming and it is the job of health care providers and the national institute of mental health to make post partum depression a priority in both funding for research and creating treatments that are not medication based as these can have an affect on children who are breast feeding
Risk Factors and Symptoms
Generally speaking the first indicators happened under a category we call baby blue. Typically baby blues only last a few days where post partum depression stays with the women for a while.
· Mood swings
· Feeling anxious
· Feeling sad
· Crying spells
· Feeling overwhelmed
The symptoms of postpartum depression are the same as the symptoms of depression that occurs at other times in life. Along with a sad or depressed mood, you may have some of the following symptoms:
· Agitation or irritability
· Changes in appetite
· Feelings of worthlessness or guilt
· Feeling withdrawn or unconnected
· Lack of pleasure or interest in most or all activities
· Loss of concentration
· Loss of energy
· Problems doing tasks at home or work
· Negative feelings toward the baby
· Significant anxiety
· Thoughts of death or suicide
· Trouble sleeping
· Decreased sex drive
On top of these symptoms a mother with Post Partum depression may also
· Be unable to care for herself or her baby
· Be afraid to be alone with her baby
· Have negative feelings toward the baby or even think about harming the baby (Although these feelings are scary, they are almost never acted on. Still you should tell your doctor about them right away.)
· Worry intensely about the baby, or have little interest in the baby
What if you Have Post Partum Depression
Generally there is no test designed specifically for post partum depression so it is up to you to tell your primary care provider or obgyn how you are feeling. It is also the doctors job to recognize signs and symptoms as well. The treatment options for post partum depression are very minimal if you are a breast feeding mother. A few medications are declared as safe to take while breast feeding yet no real research is available to prove this since you can’t do research on babies or on the fetus generally speaking. So safety is determined through animal studies. What is known is that most of these medications do get into the breast milk its just whether or not the amount entering your baby is safe.
Therapy is another option. If the therapy path is chosen cognitive behavior therapy is generally the best option for post partum depression. Therapy is a very helpful tool when dealing with depression or really any other type of issues. The risk still being that a severely depressed mother should probably not be left alone with her children.
Where is the Research
Minimal research seems to truly be aiming at the treatment of post partum depression. Many researches seems to step away from this area directly because it requires strictly regulations, more challenging protocol and finding some to watch the newborn babies while a treatment is being provider. What is interesting is that a small study was done using Transcranial Magnetic Stimulation (TMS), I have written on TMS directly if you are wondering what it is look at some of my previous depression blogs.
The small studies provided great outcomes for depression during pregnancy and post partum depression.
Review of Post Partum Research
The post partum study using TMS was conducted by Washington University. The study followed 9 women with PPD who received TMS daily for 30 treatments. The outcomes of the study were robust. Showing that 8 out of the 9 women achieved full remission, free of depressive symptom burden. 1 women did not but did respond with a 50% improvement. At a 3 and 6 month follow-up appointment all 8 women were still in full remission. This showed the TMS provided a durable treatment. Although the study was small it was the first of its kind. The outcomes made a strong case for further research. The benefit of TMS was the women did not need to take anti depressants which meant that they could still breast feed their children.
Another small study was done using TMS on pregnant women. 10 women participated in the study and long term data was collected to see if there were on issues to the unborn baby through year 10. The TMS was given daily for 20 treatments using low frequency TMS. Of the 10 women 70% achieved responder statues which is a 50% drop in symptoms. Three achieved for remission and the other 3 saw a 25% drop in symptoms. All the babies were followed and non of them had delays or any other type of concerns through the first 10 years of life. This also provided evidence base for TMS treatment.
Post Partum depression treatment needs to be a priority in the field. Data is out their suggesting that other options are available which benefit both the mother and child. The industry should push for such a treatment.